{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T03:02:33Z","timestamp":1779850953457,"version":"3.53.1"},"reference-count":10,"publisher":"American Dental Society of Anesthesiology (ADSA)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:p>Challenges may occur during nasal intubation in patients with a history of cleft lip and palate who undergo orthognathic surgery. A 22-year-old man with a history of cleft lip and palate along with a pharyngeal flap was scheduled to undergo bilateral sagittal split ramus osteotomy. Due to the planned surgery, nasal intubation was requested; however, adhesions between the right inferior nasal turbinate and the nasal septum made intubation through the right nasal cavity unfeasible. Since nasal intubation was time-consuming, the airway was first secured by oral intubation. Under fiberoptic bronchoscopy guidance, a nasotracheal tube was inserted into the left nasal cavity and directed through the left pharyngeal flap orifice. After surgery, the airway was again resecured orally, the nasal tube was removed, and the airway was assessed for complications prior to emergence and extubation. A comprehensive preoperative assessment, simulation using imaging and nasopharyngeal endoscopy, and creation of intubation strategies and validation techniques helped ensure pharyngeal flap integrity and appropriate airway management during this challenging anesthetic case.<\/jats:p>","DOI":"10.2344\/24-0024","type":"journal-article","created":{"date-parts":[[2025,6,9]],"date-time":"2025-06-09T05:08:16Z","timestamp":1749445696000},"page":"109-111","source":"Crossref","is-referenced-by-count":0,"title":["Limited Nasal Intubation Route After Pharyngeal Flap Surgery: A Case Report"],"prefix":"10.2344","volume":"72","author":[{"given":"Yuka","family":"Momota","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, Osaka Dental University, Osaka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takuya","family":"Uchida","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Osaka Dental University, Osaka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hazuki","family":"Hira","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Osaka Dental University, Osaka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mari","family":"Nishimura","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Osaka Dental University, Osaka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshiko","family":"Yanase","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Osaka Dental University, Osaka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshihiro","family":"Momota","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Osaka Dental University, Osaka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1191","reference":[{"issue":"6","key":"i1878-7177-72-2-109-b01","series-title":"Plast Reconstr Surg","first-page":"581","article-title":"Factors related to the success of pharyngeal flap procedures","volume":"32","author":"Moll KL","year":"1963","unstructured":"Moll KL,\nHuffman WC,\nLierle DM,\nSmith JK. Factors related to the success of pharyngeal flap procedures. Plast Reconstr Surg. 1963;32(6):581\u2013588."},{"issue":"2","key":"i1878-7177-72-2-109-b02","series-title":"J. Jpn. Dent. Soc. Anesthesiol","first-page":"217","article-title":"Safety nasal intubation 3D-CT simulation to avoid the pharyngeal flap injury under the fiberscopic monitoring[in Japanese]","volume":"40","author":"Taguchi A","year":"2012","unstructured":"Taguchi A,\nFujiwara K,\nKonno A, et al. Safety nasal intubation 3D-CT simulation to avoid the pharyngeal flap injury under the fiberscopic monitoring[in Japanese]. J. Jpn. Dent. Soc. Anesthesiol. 2012;40(2):217\u2013218."},{"key":"i1878-7177-72-2-109-b03","series-title":"Anaesthesia","first-page":"780","article-title":"Dental mirror for difficult nasotracheal intubation","volume":"52","author":"Matot I","year":"1997","unstructured":"Matot I,\nHevron I,\nKatzenelson R. Dental mirror for difficult nasotracheal intubation. Anaesthesia. 1997;52:780\u2013782."},{"issue":"1","key":"i1878-7177-72-2-109-b04","series-title":"J Maxillofac Surg","first-page":"64","article-title":"The submental route for endotracheal intubation. A new technique","volume":"14","author":"Altemir FH.","year":"1986","unstructured":"Altemir FH. The submental route for endotracheal intubation. A new technique. J Maxillofac Surg. 1986;14(1):64\u201365."},{"key":"i1878-7177-72-2-109-b05","series-title":"J. Jpn. Cleft Palate Assoc","first-page":"250","article-title":"A new approach of oral intubation after pharyngeal flap operation during orthognathic surgery for a patient with cleft palate [in Japanese]","volume":"35","author":"Iijima S","year":"2010","unstructured":"Iijima S,\nMatsuo S,\nTsunoda K, et al. A new approach of oral intubation after pharyngeal flap operation during orthognathic surgery for a patient with cleft palate [in Japanese]. J. Jpn. 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Cleft Palate Assoc. 2010;35:250\u2013253."}],"container-title":["Anesthesia Progress"],"original-title":[],"link":[{"URL":"https:\/\/anesthesiaprogress.kglmeridian.com\/view\/journals\/anpr\/72\/2\/article-p109.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/anesthesiaprogress.kglmeridian.com\/downloadpdf\/journals\/anpr\/72\/2\/article-p109.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/anesthesiaprogress.kglmeridian.com\/downloadpdf\/journals\/anpr\/72\/2\/article-p109.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T02:19:54Z","timestamp":1779848394000},"score":1,"resource":{"primary":{"URL":"https:\/\/anesthesiaprogress.kglmeridian.com\/view\/journals\/anpr\/72\/2\/article-p109.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6]]},"references-count":10,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.2344\/24-0024","relation":{},"ISSN":["1878-7177","0003-3006"],"issn-type":[{"value":"1878-7177","type":"electronic"},{"value":"0003-3006","type":"print"}],"subject":[],"published":{"date-parts":[[2025,6]]}}}