N CONSIDERING the anatomic factors im-I portant for successful endotracheal intubation, the literature emphasizes the anatomy of the nasopharynx, larynx, trachea, and bronchi. Little importance is given to other related structures.In a previous paper1 we (V.L.B.) discussed the importance of the articulations of the cervical spine and the atlanto-occipital joint. In the present paper, we wish to discuss anatomic and pathologic factors relating to the temporomandibular joint, the mandible, and associated structures. That such information needs presentation is attested by the fact that one textbook dedicated to anatomy for anesthesiology does not even mention these structures.2 Anomalies that arise in these areas, however, may preclude successful intubation, whereas the knowledge of these anomalies may forewarn the anesthesiologist of necessary precautions or modifications for the proper placement of the endotracheal tube.
ANATOMIC CONSIDERATIONSThe Temporomandibular Joint-The temporomandibular, or mandibular, articulation is the articulation between the mandible and the cranium. It is in many ways a highly specialized joint, characterized by the facts that the articulating surfaces of the bone are covered by an avascular fibrous tissue rather than by hyaline cartilage and that the two articulating complexes of bone carry the
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