So you come to see your next patient in pre op. This individual is here for a cysto green light laser of an 80 gm prostate.

when you talk to the pt you see they have a left eye patch. Upon looking closer you see there is no eye and you can see right down into a huge cavity.

The patient had severe sinus cancer and it resulted in removal of the left eye leaving a sizable hole. This hole extends down to the lower half of the nose though the nose itself is intact. You can actually hear air moving as the pt breaths through the hole.

The patient has dentures and as they are removing the upper denture you discover it is a full on appliance about the size of 3/4 a hand. Without it there is total communication between the sinus cavity and the oral cavity. He cannot communicate and air moves even more freely between the cavities.

So, how do you do this case.

Oh, one more thing. He cant open his mouth more than 2 fingers wide.

Good luck and DONT over think this.