Nasotracheal intubation in the presence of frontobasal skull fracturePurpose: To present a case of maxillofacial trauma and basal skull fracture (BSF) in whom nasotracheal intubation (NTI) was successfully used, without complication, to facilitate surgical fixation. To present alternative methods of airway management in this situation and to review the evidence supporting the notion that NTI is contraindicated in the presence of basal skull fracture.Clinical features: A 17-yr-old man was referred for surgical fixation of bilateral mandibular fractures. Cranial computed tomography revealed intracranial air and blood in all four sinuses and distortion of the nasal passage on the right. There was no cerebral injury and the left nasal passage appeared patent. In order to facilitate intraoperative intermaxillary fixation fibreoptic NTI was undertaken in preference to tracheostomy. The patient made an uneventful recovery without evidence of meningitis or direct cerebral injury. Conclusion:In selected patients NTI may be performed in the presence of BSE Available evidence suggests that BSF should not be regarded as an absolute contraindication to NTI.Objectif : Pr&enter un cas de traumatisme maxillo-facial avec fracture de la base du cr~ne (FBS) chez qui une intubation nasotrach~ale (INT) a 6t6 utilis& e~cacement et sans complications pour une ost~osynth~se chirurgicale. Pr&enter des alternatives pour le contr61e des voles a&iennes et revoir pourquoi on a toujours consid&~ I'INT comme contre-indiqu~e en pr&ence d'une fracture de la base du cr~ne.

No abstract

No abstract