Kim H, Lee JM, Lee J, et al. - In this randomized controlled trial, researchers investigated how the progress of tracheal tubes from the nasal cavity into the oropharynx during nasotracheal intubation is influenced by neck extension. Overall 32 patients were randomized to the ‘neck extension group (E group)’ and 33 in the ‘neutral position group (N group)’. Insertion of a nasal Ring-Adair-Elwyn tube via a nostril was performed following anesthesia induction. With the patient’s neck extended, the tube was advanced from the nasal cavity into the oropharynx, in the E group, by an anesthesiologist. The tube was advanced without neck extension for the N group. In the E group vs in the N group, a significantly higher success rate of tube passage during the first two attempts was reported (93.8% vs 60.6%). Overall, nasotracheal intubation could be aided by neck extension during tube advancement from the nasal cavity to the oropharynx before laryngoscopy.