Anaesthetic Management in A Case of Temporomandibular Joint Ankylosis Using A Newer Bronchoscope-Ambu Ascope

We are presenting a case report of anaesthetic management in a case of temporomandibular joint (TMJ) ankylosis with an intraprocedural finding of choanal atresia in a 17yr old male posted for elective lateral gap arthroplasty. Anticipated difficult airway in TMJ ankylosis patients has always made the surgeon to be cautious during airway management, adding on problem like choanal atresia made the intubation even more difficult. Hence, reporting the management of such difficulties with different approach, in which serial dilatation of nostrils using nasogastric tubes and nasal airway, then endotracheal tube was passed through one nostril and bronchoscope through other nostril.