ABSTRACT :Temporomandibular joint (TMJ) ankylosis results in inability to open mouth either partially or completely. It is observed from 2 to 60 years of age. Trauma and infection are the major causes of TMJ ankylosis. Facial asymmetry, malocclusion are the consequences. It also leads to increased airway obstruction, obstructive sleep apnea and corpulmonale. All these structural deformities lead to difficulty in ventilation, intubation &extubation.

METHODS : A 23yr old male patient, who was diagnosed as unilateral Temporo Mandibular Joint ankylosis , presented with restricted mouth opening since childhood. On examination there was facial asymmetry, malocclusion, anemia, 3mm wide mouth opening. Surgery planned was gap arthroplasty on left side and coronoidectomy&eminectomy on right side. We managed the case by Awake fibre optic intubation successfully with proper preoperative preparation, which will be discussed in detail further.

RESULTS : .

CONCLUSIONS : Fibre optic intubation technique is one of the techniques which can be mastered by practice & is useful in managing difficult intubation cases.