Background: Although there are reports targeting children with micrognathia, there is no report how orotracheal intubation difficulty of normal adult patients changes with aging. We surveyed orotracheal intubation episodes after more than 20 years from the initial surgery.

Methods: Seventy one patients underwent general anesthesia again after 23 years in average. Change of orotracheal intubation difficulty was checked retrospectively. The same anesthesiologist assessed 73.2% of cases.

Results: Intubation of 4 patients became more difficult, in one patient it became easier, and in the remainder did not change. There was no relation between the change in difficulty and presence or absence of maxillary incisor. Restricted neck mobility or opening of mouth caused by progressive musculoskeletal diseases made orotracheal intubation more difficult

Conclusions: We conclude that in adult patients, if there are no changes in the degree of opening mouth and neck mobility, almost all patients remained in the same situation regarding orotracheal intubation after 23 years in average.

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