Nasopharyngeal Airway Causing Partial Tracheal Obstruction During an Awake Nasotracheal Fiberoptic Intubation: A Case Report.

Awake nasotracheal fiberoptic intubations are used to manage difficult airways. Nasopharyngeal airways can be placed into the nostril to facilitate fiberoptic intubation and has been shown to be a useful pathfinder. We describe a case where this nasopharyngeal airway was inadvertently advanced with the bronchoscope and led to partial tracheal obstruction. To our knowledge, this represents the first reported case of this mishap. Aspiration of the nasopharyngeal airway can lead to complete airway obstruction and devastating consequences. Simple techniques such as attaching a hemostat or using an assistant to hold on to the nasopharyngeal airway may prevent this occurrence.