Sir,I have read with interest the article of Sharma et al. titled ‘Hard palate tumour – A nightmare for the Anaesthesiologists: Role of modified molar approach’ published in a recent issue of IJA.[1] First of all, let me congratulate the team for the successful management of the case. I would like to highlight some of my concerns about this study.The authors had planned for awake/blind nasal intubation in this case. For awake/blind nasal intubation,[234] the whole of airway from nasal cavity up to glottis has to be anaesthetised. Mere spraying the nasal and oral cavity with 10% lignocaine alone is not sufficient. This could be the reason for failed attempts. Apart from local spray of oral and nasal cavities with lignocaine, bilateral blocking of superior laryngeal nerves with 2-3 ml of local anaesthetic, translaryngeal spray with 2 ml of local anaesthetic through the cricothyroid membrane and gargling with lignocaine viscous gel prior to procedure would help.[5] If the airway had been properly and completely anaesthetised, awake/blind nasal intubation would have been easier and the success rate, high.Secondly, the authors have gone for molar/modified molar approach for intubation. If the tumour mass is large enough wherein the molar space is compromised, it may be difficult to pass the laryngoscopy blade, Magill's forceps and endotracheal tube, intubation would have been difficult and the outcome could be catastrophic.Thirdly, modified molar approach of pulling the tumour mass externally may not be always possible as it depends upon the tumour mass, vascularity and mobility etc.Therefore, in this particular difficult intubation case, success rate for awake intubation would be fair, if the airway is anaesthetised completely; to quote ‘blocks of supralaryngeal nerves bilaterally along with translaryngeal injection of local anaesthetic provides anaesthesia of airway from infraglottic area to the epiglottis.’[6]