Awake Fiberoptic Nasotracheal Intubation of a Patient with Ankylosing Spondylitis Expected Difficult Intubation

Fusion of vertebral bones in ankylosing spondylitis causes flexibility loss in the neck and back. In advanced stages of the disease, airway management can be difficult due to the ankylosis of the cervical, thoracic, and lumbar vertebrae. In this paper, we report the awake fiber–optic nasotracheal intubation of a patient with expected difficult airway due to ankylosing spondylitis, whose extremely limited mouth opening and neck mobility required an urgent tracheostomy, causing respiratory distress