J Anesth Perioper Med. 2016;3(6):276-279. https://doi.org/10.24015/ebcmed.japm.2016.0037

Unanticipated Difficult Nasal Intubation Due to a Prominent Anterior Tubercle of the First Cervical Spine

David Watton, and Orlando R. Hung

From Department of Anesthesiology, Dalhousie University, Victoria General Hospital, Halifax, Canada.

Correspondence to Dr. David Watton at david.watton@dal.ca.

EBCMED ID: ebcmed.japm.2016.0037 DOI: 10.24015/ebcmed.japm.2016.0037


Nasal intubation is frequently used for airway management in patients undergoing many surgical procedures. This is a case report of an unanticipated difficult nasal intubation due to a prominent anterior tubercle of the first cervical spine vertebra (C1) resulting in aspiration of blood and hypoxemia following intubation. The subsequent airway management of the rescheduled elective case is also described. The specific difficulties in securing the airway for nasal intubation are described as well as the management strategies to circumvent this anatomical variant. This case report will be of interest to health care practitioners providing airway management via the nasal route for different populations.

Article Type
Case Report

Declaration of Interests
No potential conflict of interest relevant to this article was reported.

This is an open-access article, published by Evidence Based Communications (EBC). This work is licensed under the Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium or format for any lawful purpose. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.