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Bu vaka raporunda; bilateral sagittal split ramus osteo- tomisi planlanan hastada, gecirmis oldugu rinoplasti ameliyatlari nedeniyle retromolar entubasyonla yapilan ortognatik cerrahinin sunumu amaclanmistir. Mandibular deformitesi olan 22 yasindaki bayan hasta Agiz Dis ve Cene Cerrahisi klinigine basvurdu. Hastada bilateral sagittal split ramus osteotomisi yapilarak alt cenenin 6 mm geri alinmasi planlandi. Genel anestezi oncesinde rutin hazirliklarinda hastanin 3 ay once rinoplasti yaptirdigi ogrenildi. Rinoplasti islemi sonrasi elde edilen estetik gorunumun bozulmamasi icin nazal entubasyondan vazgecildi. Ameliyat sirasinda okluzyon kontrollerini etkilemeyecek sekilde retromolar entubas- yon yapilarak hasta basarili bir sekilde opere edildi. Hava yolu guvenligini saglamada siklikla kullanilan oral ve nazal entubasyon her zaman uygulanamayabilir. Retromolar bolgede yeterli bosluk varsa retromolar entubasyon teknigi ortognatik cerrahi ameliyatlarinda alternatif bir yontem olarak dusunulebilir. Anahtar Kelimeler: entubasyon, ortognatik cerrahi, retromola RETROMOLAR INTUBATION IN A PATIENT WITH RHINOPLASTY UNDERGOING BILATERAL SAGITTAL SPLIT RAMUS OSTEOTOMY ABSTRACT In this case report, we aimed to present retromolar intubation in a patient undergoing bilateral sagittal split ramus osteotomy. Nasal entubation was impossible for this patient with rhinoplasty. A-22-year old female with mandibular deformity was referred to the Department of Oral and Maxillofacial Surgery. Orthognathic surgery was planned as a first surgery concept according to patient’s individual and orthodontist request. Bilateral sagittal split osteotomy was planned for mandibular setback. Patient has been operated for rhinoplasty by her plastic surgeon three months ago. Because of adverse effects and risks of damage to rhinoplasty, nasotracheal intubation was contraindicated. Retromolar intubation was preferred. This tecnique allowed intraoperative assessment ofthe occlusion and maxillomandibular fixation during the operation. Sometimes orotracheal and nasotracheal intubation are contraindicated. In the presence of enough space in the retromolar region, retromolar intubation techniques in orthognathic surgery can be considered as an alternative method of operation. Key Words: intubation, orthognathic surgery, retromolar

RİNOPLASTİ NEDENİYLE RETROMOLAR ENTÜBASYON YAPILAN HASTADA BİLATERAL SAGİTTAL SPLİT RAMUS OSTEOTOMİSİ