Nasotracheal intubation is generally used in maxillofacial and oral surgeries under general anesthesia. However, nasal intubation may cause various complications including epistaxis, retropharyngeal dissection, and intracranial penetration of the nasotracheal tube, which occurs in patients with basal skull defects or fractures. Therefore, nasotracheal intubation is usually contraindicated in such patients. Herein, we describe an alternative technique using a balloon catheter in nasotracheal intubation to avoid surgical airway management in a patient with a history of transsphenoidal surgery. The use of a balloon catheter may be a simple and safe method of nasotracheal intubation in patients with basal skull defects.