Submucousal Fibrosis: The Anaesthesiologist's Guide to Taming the Difficult Airway

Oral submucous fibrosis (OSMF) is a progressive collagen disorder resulting in restricted mouth opening and airwaychallenges, particularly during anaesthesia.This case report discusses a 24 -year -old male with severe OSMF and a BMI of 32 kg/m who presented with limited and painful mouth opening.Preoperative evaluation revealed a mouth opening of 1.5 cm and adequate neck movements.Due to anticipated airway difficulty, an awake fibreoptic intubation (FOB) strategy was employed.Preoperative preparation included airway topicalization with lignocaine and nerve blocks.On the day of surgery, the patient underwent FOB -guided nasal intubation using a 7.5 mm cuffed tube under sedation and local anaesthesia.General anaesthesia was maintained with oxygen, nitrous oxide, and sevoflurane.Delayed extubation was performed postoperatively with close monitoring.This case highlights the importance of thorough preoperative assessment, proper airway preparation, and awake FOB intubation for safe management of anticipated difficult airways in patients undergoing maxillofacial surgeries (1).