Accidental inferior turbinectomy: a complication of nasotracheal intubation

Nasotracheal intubation is commonly performed for airway management during maxillofacial surgery. The semi-soft PVC tubes are known to cause upper airway injuries, including bleeding, avulsion of turbinates or nasal polyps. However, complete obstruction of the tube is a rare phenomenon. We report a case of an 18 years old male patient posted for fixation of fractured mandible in whom the inferior turbinate was avulsed while performing nasotracheal intubation. It occluded the endotracheal tube, resulting in ventilation failure which was successfully managed. We stress that if one encounters ventilation difficulty after nasal intubation, possibility of turbinate tissue occluding ETT lumen should be kept in mind and forceful ventilation must be avoided. "When in doubt, take it out."