## 3 Discussion  
The necessity of adequate NTI tube placement and its secure positioning was modified over time when the advancement of various craniofacial surgeries developed [3; 4; 5; 6]. Nowadays, the necessity of the NTI safe position is mostly related to not only long-lasting surgeries but also those relying on nasal tip symmetry, visualized maxillary and jaw bones, easy access to facial bones in trauma or tumor cases, and reducing possible complications from long surgeries, such as skin irritations, bedsores, nasal disfigurement, bleeding, or others [7; 8; 9]. The usage of bandages, plasters, or other devices is helpful but also has its limitations, which are related to a wet environment, blood, the presence of hair, and the scope of the surgical field. Plasters of various sizes and fabrics are non-invasive methods, while additional tube suturing is considered an invasive approach [10; 11]. It seems that classic orrotracheal intubation is less demanding than NTI, especially in cases of its positioning (Figure 6). Particularly in classical orrotracheal intubation, the proper occlusion and bite cannot be evaluated and established properly [10; 11; 12]. In cases that do not include orthognathic surgery, correction of skeletal malocclusion, or temporomandibular surgeries or those not requiring nasal intubation, classic orrotracheal intubation can be used [4; 5; 6; 7; 8; 9; 10; 11; 12]. Other methods of airway management might be troublesome and require some special devices and skills to perform them; however, they are also used either in surgical wards or in anesthesiology departments [7; 8]. In cases of severe facial trauma, either submental intubation, presented first by [PERSON] et al. in 1986, or, alternatively, perhaps a classical surgical tracheostomy or percutaneous ones, presented by [PERSON] or [PERSON], can be used [7; 8; 9]. When successful nasotropical intubation is achieved, in cases of long surgeries, with patients with difficult airways, or simply to maintain a good and stable position of the nasotropical tube (without its flexion), many possibilities are known to stabilize the tube passively [2; 3; 4; 5; 6; 7; 8; 9; 10; 11; 12]. Despite some plaster materials, bandages, special clamping devices, metal/plastic wires, splints, and others, there are many possibilities and alternatives  
Figure 6: A classic orrotracheal intubation visualized on an LDCT imaging. No proper bite and jaw position can be established in this intubation, and the technique of [PERSON] et al. is then sufficient modification to improve the oral cavity easy access. for how to achieve a good and safe tube position [8; 9; 10]. Furthermore, when a stable tube position is achieved, the better the view and the surgical field exposure that can be granted. This situation also influences the proper maxilla-mandibular complex bone cutting, titanium plate fixation, and overall orientation in a bigger field. There are some interesting alternatives for intubation tube stabilization, especially those including NTI in craniofacial surgery procedures. [PERSON] et al. developed a 3D-printed fabricated device for proper nasotracheal tube placement [6]. This method included a taping of the device onto the patient's forehead while the surgical cap would remain safe and would not fall down or slide. A patient's forehead remains a stable anatomical landmark. A study of 335 cases revealed good outcomes, with limited complications, which were related to small and local skin irritations, such as redness of the nasal ala caused by used plaster [6]. On the other hand, [PERSON] et al., in a 5-year observation study, investigated the usage of their own self-designed M-bent wire support form with additional U-shaped curved extremities [10]. An additional turban-like cap and surgical compress with plasters helped to maintain safe NTI tube placement in maxilla-facial surgeries. The authors suggest that out of 197 cases in just 10 cases the escribed turban was loose and in just 6 cases the patients suffered from nasal hyperemia [10].