Bi-orifice approach to nasal intubation in children: A case series of anticipated difficult airways undergoing orthognathic surgeries

Airway management of pediatric patients with craniofacial disorders can be challenging, especially when compounded by the surgical requirement for nasal intubation. Life-threatening complications can occur during induction of general anesthesia in patients with abnormal anatomy (laryngospasm, inability to mask ventilate due to obstruction, total loss of airway, death) [1,2,3]. Although awake nasal fiberoptic intubation (FOI) is a common method of securing adult difficult airways, it may not be appropriate for children due to emotional, physiological, and anatomical differences.

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