Tehran University of Medical Sciences Journal of Craniomaxillofacial Research 2345-5489 6 2 2019 10 13 80 84 Babak Babakhani Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran. Mohammad Moharrami Craniomaxillofacial Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Amir Abbasi Craniomaxillofacial Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran AND Department of Oral and Maxillofacial Surgery, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran. 2019 08 09 2019 08 09 This technical note aims to introduce a new approach for intubation of patients with restricted mouth opening in cases that conventional and fiberoptic-assisted endotracheal intubation are not possible. The proposed technique is a modification to the previously well-established retrograde intubation method. The main advantage of this new technique is the employment of fiberscope for direct visualization which eliminates the use of guide wire. The endotracheal tube enters through the nostril and is railroaded using the fiberscope as a guide. Using this new technique can prevent the complications of tracheostomy and the traditional retrograde intubation in patients that anterograde intubation is not feasible. The promising result of conducting the intubation with this approach can be considered the basis for future clinical investigation. Keywords: Fiberscope; Modified retrograde intubation; Direct visualization. https://jcr.tums.ac.ir/index.php/jcr/article/view/297 https://jcr.tums.ac.ir/index.php/jcr/article/download/297/266