The Use of Flexible Fiberoptic Cystoscope for Difficult Endotracheal Intubation in TMJ Ankylosis Patients: A Case Series.

Background: Fiberoptic bronchoscopes might be vital for the safe performance of difficult endotracheal intubations. However, many hospitals in low or middle-income countries are unable to afford the equipment. We describe the use of a flexible fiberoptic cystoscope, as an alternative to a bronchoscope, for difficult nasoendotracheal intubation in patients with temporomandibular joint ankyloses.

Methods: Eight Jordanian patients (five females and three males) with severe restriction of mouth opening, due to ankylosis of the temporomandibular joint, underwent awake nasoendotracheal intubation using a flexible fiberoptic cystoscope under local anesthesia.

Results: The procedure was successful and well tolerated in all eight patients.

Conclusion: A flexible cystoscope can be a successful alternative to a flexible bronchoscope, for difficult nasoendotracheal intubation in hospitals at rural areas in low-or middle-income countries with limited financial resources.