If basal skull fracture is suspected, which airway adjunct is preferred to avoid cranial injury?

• A. Oropharyngeal airway
• B. Nasopharyngeal airway
• C. Endotracheal tube
• D. Laryngeal mask airway

Answer: (A)

When a basal skull fracture is suspected, the airway plan avoids anything that travels through the nose. A nasal airway could pass through fracture lines in the skull base, risking intracranial entry or further injury. The oropharyngeal airway is preferred because it sits in the mouth and oropharynx, not the nasal passages, helping to keep the airway open without crossing the skull base. This makes it safer for avoiding cranial injury, provided the patient is unconscious and lacks a gag reflex. If the patient has a gag reflex or is awake, other airway strategies should be considered, but for minimizing cranial risk, the oropharyngeal airway is the safer adjunct.