Surgery 2026

Oral submucous fibrosis (OSMF) is an insidious chronic disease that affects any part of the oral cavity and sometimes the pharynx, leading to epithelial atrophy that results in stiffening of the oral mucosa and causes trismus and inability to eat. However, a more serious complication of this disease is the risk of developing oral carcinoma. Securing an airway with trismus in OSMF with minimum mouth opening is an anesthetic challenge. Among the available methods such as submandibular intubation, retrograde intubation, and tracheostomy, fiberoptic nasotracheal intubation technique remains the gold standard. When difficult airways are anticipated, anesthesiologist must consider securing the airway while the patient is awake without the use of anesthetics or muscle relaxants. Awake fiberoptic intubation is a noninvasive technique for securing the airway in such patients. During treatment of ODMF in which tracheostomy could be avoided by awake fiberoptic intubation. Awake fiberoptic intubation under local anesthesia may be the ideal method for securing the airway in advanced cases of OSMF. Because the procedure can be very uncomfortable, the patient must be psychologically and pharmacologically prepared for awake intubation. If fiberoptic bronchoscopy is not feasible, unavailable, or has failed, awake tracheostomy may be the preferred option. Conclusion- The multidisciplinary approach of Oral and Maxillofacial Surgeons [OMFS] and anaesthesiologists is important to achieve maximum disease-free mouth opening in OSMF patients. Self-confidence and composure are important qualities for an anaesthesiologist in such cases. Prior planning of the anaesthetic technique and a good relationship with the surgeon is critical to a successful outcome in such difficult airway cases.

Bhushan Bhagat has completed his M.D.S. and B.D.S. from Maharashtra University of health sciences, Nashik. He is Ph.D. scholar at Nair Dental College Mumbai in Oral and Maxillofacial Surgery. He is an associate professor, Oral and Maxillofacial Surgery, at Dr. D Y Patil Dental College and Hospital, Dr. D Y Patil Vidhyapeeth, Pimpri, Pune [India]. He has published more than 20 papers in reputed journals and has been serving as an editorial board member in international medical journals. He was awarded with CEGR Young Faculty 2021 Award in 15 th Rashtriya Shiksha Gaurav Puraskar Ceremony 2021 and also honored with National Faculty Award – Outstanding Graduate Students Teaching Award.  He was honored with the “Covid-19 Dentist Warrior Award” by MSDC, Mumbai [ Government of Maharashtra].