Nasotracheal intubation is a commonly performed procedure in the operating room for oromaxillofacial and oral cancer surgery to secure the airway. Compared to oro-tracheal intubation, the intubation time are longer for naso-tracheal route and despite the optimal laryngeal views directing the tube into the trachea can be challenging and there is often the need of magill forcep to aid the intubation procedure.

The success of this procedure depends on the ability of the anesthesia provider to effectively visualize the glottis and secure a clear airway. Use of Macintosh laryngoscope remains a gold standard for Direct laryngoscopy for more than 50 years as it is easy to perform and master. In recent years, video laryngoscopy has emerged as an alternative to traditional direct laryngoscopy in nasotracheal intubation.

Video laryngoscopy provides a clear and magnified view of the glottis, which can be particularly beneficial in patients with difficult airways. This improved visualization can lead to a higher success rate of oro-tracheal intubation and a lower incidence of adverse events, such as failed intubation or esophageal intubation. However, there is limited data on the comparison between direct laryngoscopy and video laryngoscopy in nasotracheal intubation, and further research is needed to determine the benefits and limitations of each technique.

The purpose of this study is to compare the effectiveness, safety, and ease of use of direct laryngoscopy and video laryngoscopy in nasotracheal intubation. The study will assess factors such as intubation success rates, intubation times, and adverse events, and will provide important information to guide clinical decision making in this area

Overall, the literature suggests that video laryngoscopy can provide several benefits compared to direct laryngoscopy in nasotracheal intubation, including improved visualization, shorter intubation times, and improved ease of use. However, further research is needed to fully understand the benefits and limitations of this technique, and to determine the best patient populations and settings for its use.