Introduction :
Ameloblastoma is a rare tumour of mandible characterised by unilateral swelling restricting opening of mouth leading to difficulty in laryngoscopy and intubation. Patients presenting with such infiltrating jaw tumours are labelled as anticipated difficult airway and managed with difficult airway algorithm.

Materials and Methodology :
Our patient is a 45 year old male diagnosed to have Ameloblastoma and planned for Hemimandibulectomy. An awake fiberoptic nasotracheal intubation was done with 7.0 mm flexometallic tube after anaesthetising the airway over a period of five minutes. General anaesthesia was instituted with N2O:O2 3:1.5 and Sevoflurane 0.5-1% . 2 hours intraoperative period went uneventful. On table extubation was deferred owing to difficult airway and post surgical jaw wiring status. Patient was mechanically ventilated and extubated the next day.

Discussion :
These patients are not only difficult to intubate but may be nearly impossible impossible to mask ventilate owing to indentation of mass into oropharynx. Hence induction follows endotracheal intubation. Direct laryngoscopy is generally difficult regardless of blade type. Timing of extubation is important on account of post airway instrumentation edema with difficult rescue mask ventilation and intubation. Measures to hasten the recovery of surgical site and removal of jaw wires are important predictors in extubation.

Conclusion :
It is a rare tumour with concerns relating to airway management, ventilator dependency and nutritional needs in the perioperative period.