A modified nasal trumpet to facilitate fibreoptic intubation

Abstract

The MNT has a place in the operating room suites as a useful airway management device.

Practical aspects and training in fibreoptic intubation

“…These manoeuvres improve the success rates at first attempt and decrease intubation times [58]. Internal methods include using intubating oral or nasal aids to splint open the airways; positive pressure ventilation via a 'modified nasal trumpet' [59]; tongue traction with Magill's forceps or with applied suction; lower mandibular lift with the operator's thumb; concomitant use of direct or indirect laryngoscopy devices; or SAD which then acts as a conduit [60]. Direct laryngoscopy provides significantly better airway clearance than jaw thrust at the level of the soft palate but equal clearance at the larynx [61].…”

A newborn with pedunculated teratoma of oral cavity: Possible role of modified nasopharyngeal airway in yet another situation of impossible mask ventilation

“…[23] Such an airway could be used as a primary tool for induction of inhalational anesthesia and also as a “dedicated airway” in patients with impossible mask ventilation. [3] Further, the technique of delivering positive pressure ventilation via MNPA with mouth and opposite nostrils closed using one hand has been described;[2] it could be further modified according to the need of the case. [3] The DL scopy could be considered following inhalational induction through the MNPA.…”

Induction of anesthesia in a case of impossible mask ventilation

“…Further, as a tool to facilitate intubation, nasopharyngeal airway is potentially superior to both LMA and COPA as it may be inserted in a spontaneously breathing patient, either awake or anesthetized. [10]…”

“…To avoid nasal trauma, a smaller sized (6 mm ID), uncuffed nasopharyngeal airway was introduced in the patent nostril using 2% lignocaine gel as a lubricant for the tube. Though the technique of delivering positive pressure ventilation via nasopharyngeal airway with mouth and opposite nostril being closed using one hand has been described,[10] we modified it according to the need in our patient. As the left nasal cavity was completely blocked, there was no need to close the left nostril.…”