Nasotracheal intubation is an invaluable tool for securing a definitive in patients where laryngoscopy (either direct or video) would be difficult or has failed. This technique is especially helpful when intubating the patient awake. Endoscope intubations can also be performed orally or even blindly, which we have covered before. Nasotracheal route is generally preferred over the oral route in awake patients because it is better tolerated and the path to supraglottic space is more direct from the nasopharynx. Situat