Accidental middle turbinectomy by nasotracheal intubation −A case report−

김, 동림; 정, 용훈; 오, 종인; 박, 용희

doi:10.17085/apm.2016.11.2.217

Cited by 2 publications

(1 citation statement)

References 12 publications

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“…However, nasotracheal intubation is associated with a higher risk of cuff damage because the passage of the nasal cavity is narrow and there are more structures compared to the oral cavity. Abnormal structures that can affect nasotracheal intubation include concha bullosa, septal curvature, septal spurs, nasal polyps, and other anatomical variations [7]. Therefore, intubation is performed by using a route that contains fewer abnormal structures that may affect nasotracheal intubation.…”

Section: Discussionmentioning

confidence: 99%

Repeated endotracheal tube cuff tears during nasotracheal intubation due to nasal cavity orthodontic micro-implant - A case report -

Seo

Lee

et al. 2021

Anesth Pain Med

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Background: Nasotracheal intubation is generally performed for intraoral surgery.Case: A 34-year-old female patient who underwent orthognathic surgery exhibited repeated endotracheal tube cuff tears during nasotracheal intubation. After intubation, leaks developed, and torn endotracheal cuff was observed in the removed endotracheal tube. Subsequently, re-intubation through the same nasal cavity was performed immediately, but leakage from the torn endotracheal tube cuff was re-observed. A leakage test of the extubated tube revealed air bubbles and leaks near the tube cuff due to the tear. Nasotracheal intubation was performed through the other nasal cavity, and there were no leakage findings or abnormalities. During the course of the surgery, the surgeon noticed that the orthodontic micro-implant deposited in the mid-tube cavity was exposed to the nasal cavity. Conclusions: We aimed to emphasize caution and discuss the possibility that orthodontic micro-implants that are not confirmed during preoperative evaluation may cause repeated endotracheal tube cuff tears.

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Section: Discussionmentioning

confidence: 99%

Repeated endotracheal tube cuff tears during nasotracheal intubation due to nasal cavity orthodontic micro-implant - A case report -

Seo

Lee

et al. 2021

Anesth Pain Med

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Effect of bevel direction on the tracheal tube pathway during nasotracheal intubation

Won

Kim

Chang

et al. 2020

European Journal of Anaesthesiology

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BACKGROUND For nasotracheal intubation, the nasal pathway between the inferior turbinate and hard palate (lower pathway) is preferred for patient safety. However, selecting the lower pathway can be challenging because passage of the tube through the nasal pathway is usually performed blindly. OBJECTIVES We investigated whether facing the bevel of the tracheal tube in the cephalad direction of the patient could help in advancing the tracheal tube through the lower pathway during nasotracheal intubation. DESIGN A randomised, blinded trial. SETTING SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea from January 2019 to March 2020. PATIENTS Sixty-eight adult patients undergoing oromaxillary surgeries were enrolled in this study. INTERVENTIONS Patients were randomly allocated to undergo nasotracheal intubation with the bevel of the tube facing the cephalad direction (intervention group) or to the left (conventional group). MAIN OUTCOME MEASURES The effects of bevel direction on the pathway of the tube in the nasal cavity, and the incidence of epistaxis were evaluated by fibreoptic bronchoscopy. RESULTS The success rate of the tracheal tube passing through the lower pathway was significantly higher in the intervention group than the conventional group (79.4 vs. 55.9%, relative risk 1.421, 95% CI 1.007 to 2.005, P = 0.038). The incidence of epistaxis was also lower in the intervention group than in the conventional group (41.2 vs. 73.5%, relative risk 0.560, 95% CI 0.357 to 0.878, P = 0.007). CONCLUSIONS Facing the bevel of the tracheal tube in the cephalad direction of the patient facilitated selection of the lower pathway and reduced the incidence of epistaxis during nasotracheal intubation in patients undergoing oromaxillary surgery. TRIAL REGISTRATION ClinicalTrial.gov, NCT03740620.

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Accidental middle turbinectomy by nasotracheal intubation −A case report−

Cited by 2 publications

References 12 publications

Repeated endotracheal tube cuff tears during nasotracheal intubation due to nasal cavity orthodontic micro-implant - A case report -

Repeated endotracheal tube cuff tears during nasotracheal intubation due to nasal cavity orthodontic micro-implant - A case report -

Effect of bevel direction on the tracheal tube pathway during nasotracheal intubation

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