[Retrograde nasal intubation for a patient with difficult airway by using 28 Fr double lumen tube].

We experienced retrograde nasal intubation with a 28 Fr double lumen tube (DLT) in a patient with difficult airway. A 56-year-old man who had undergone an operation for carcinoma of the floor of the mouth was scheduled for right upper lobectomy with video-assisted thoracic surgery. Because of the postoperative anatomical anomaly, the usual laryngoscopy and retrograde oral intubation was not successful. So we reduced the tube size to 28 Fr and succeeded in retrograde nasal intubation. The positioning of the DLT was confirmed by auscultation and clinical signs. We could complete one lung ventilation. There was no trouble of inflation and deflation in anesthesia term. We conclude that 28 Fr DLT is one of the useful tools for difficult airway.