Due to the trismus, they had to administer anthesesia, oyygen through the nasal passage. Once knock out it was ok, but they had to do several numbing sprays, some on cotton sticks, in the nose and mouth, before they started. Still better than a trach I was somewhat expecting, and I tried to open my mouth as far as I could to help prevent, which my ENT said was fine, but not for the anesthesiologist.