Nasal turbinate dislocation caused by nasotracheal intubation

Dost, P.; Armbruster, W

doi:10.1111/j.1399-6576.1997.tb04787.x

Cited by 17 publications

(7 citation statements)

References 4 publications

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“…The middle turbinate is attached to the base of the cranium formed by cribriform plate by a thin lamella and it is highly vascular. Any trauma leading to avulsion of the middle turbinate can lead to massive epistaxis or cerebrospinal fluid rhinorrhea or injury to olfactory nerve secondary to damage to the cribriform plate;[14151617] this is very commonly seen with middle turbinate hypertrophy or concha bullosa. [18] Traditionally, it was also taught that lower pathway for nasal intubation is safer by advancing the ETT caudally along the floor of the nasal cavity away from the middle turbinate and cribriform plate to avoid trauma, thus supporting the thought.…”

Section: Anatomical Anomaliesmentioning

confidence: 99%

Nasal intubation: A comprehensive review

Chauhan

Acharya

2016

Indian Journal of Critical Care Medicine

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Nasal intubation technique was first described in 1902 by Kuhn. The others pioneering the nasal intubation techniques were Macewen, Rosenberg, Meltzer and Auer, and Elsberg. It is the most common method used for giving anesthesia in oral surgeries as it provides a good field for surgeons to operate. The anatomy behind nasal intubation is necessary to know as it gives an idea about the pathway of the endotracheal tube and complications encountered during nasotracheal intubation. Various techniques can be used to intubate the patient by nasal route and all of them have their own associated complications which are discussed in this article. Various complications may arise while doing nasotracheal intubation but a thorough knowledge of the anatomy and physics behind the procedure can help reduce such complications and manage appropriately. It is important for an anesthesiologist to be well versed with the basics of nasotracheal intubation and advances in the techniques. A thorough knowledge of the anatomy and the advent of newer devices have abolished the negative effect of blindness of the procedure.

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Section: Anatomical Anomaliesmentioning

confidence: 99%

Nasal intubation: A comprehensive review

Chauhan

Acharya

2016

Indian Journal of Critical Care Medicine

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“…32 The most common injury is bruising at the septum or inferior turbinate. 26,27 However, forceful nasotracheal intubations can also cause inadvertent injury to the lateral nasal wall, causing accidental avulsion of the turbinates [33][34][35] and posterior pharyngeal lacerations. 36,37 Although generally considered a temporary mode of intubation, some patients require prolonged intubation via the nasotracheal route.…”

Section: Injury By Anatomic Sitementioning

confidence: 99%

Complications of Airway ManagementDiscussion

Pacheco-Lopez¹,

Berkow

Hillel³

et al. 2014

Respir Care

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Although endotracheal intubation is commonly performed in the hospital setting, it is not without risk. In this article, we review the impact of endotracheal intubation on airway injury by describing the acute and long-term sequelae of each of the most commonly injured anatomic sites along the respiratory tract, including the nasal cavity, oral cavity, oropharynx, larynx, and trachea. Injuries covered include nasoseptal injury, tongue injury, dental injury, mucosal lacerations, vocal cord immobility, and laryngotracheal stenosis, as well as tracheomalacia, tracheoinnominate, and tracheoesophageal fistulas. We discuss the proposed mechanisms of tissue damage that relate to each and present their most common clinical manifestations, along with their respective diagnostic and management options. This article also includes a review of complications of airway management pertaining to video laryngoscopy and supraglottic airway devices. Finally, potential strategies to prevent intubation-associated injuries are outlined.

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“…Patients with anatomic abnormalities of the nasal pathway have been shown to have an increased risk of developing epistaxis. 9 This study was performed based on the hypothesis that the Portex NPT, which has a soft structure, will reduce the risk of complications such as epistaxis after examining previous studies. 10 , 11 In this study, the Portex NPT and spiral tube (ST) were compared for their ability to provide a nasal airway passage in patients during maxillofacial surgery.…”

Section: Introductionmentioning

confidence: 99%

North Polar Tube Reduces the Risk of Epistaxis during Nasotracheal Intubation: A prospective, Randomized Clinical Trial

Özkan

Akbaş

Toy

et al. 2019

Current Therapeutic Research

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ObjectiveIn this study, a north polar tube (Portex® North Polar tube [Ivory PVC Portex tube; Smiths Medical International, Hythe, United Kingdom]) (NPT) and spiral tube (ST) were compared for their ability to provide a nasal airway in patients during maxillofacial surgery.MethodsPatients who were aged 18 to 65 years with American Society of Anaesthesiologists score 1 to 2 and Mallampati score 1 to 2 were included in the study. The anesthesia technique was standardized in all patients. Patients were divided into 2 groups randomly: the NPT (n = 35) and ST groups (n = 35). Anesthesia was administered with 1% to 2% sevoflurane and a mixture of 50% oxygen + 50% air in both groups. The mean arterial pressure and heart rate values of preinduction; preintubation; and the first, second, third, and fifth minutes of intubation were recorded. Epistaxis, intraoral bleeding, cuff burst, use of Magill pens, duration of intubation, intubation difficulty, laryngeal compression, head position change, and glottic grade were evaluated.ResultsThere were no significant differences between groups in terms of demographic data (gender, age, height, weight, body mass index, American Society of Anaesthesiologists score, and Mallampati score). Macintosh laryngoscopes were used during intubation in all patients. There was no significant difference between groups in terms of intubation difficulty, duration of intubation, use of Magill pens, and determination of the glottic grade (P > 0.05). Epistaxis was significantly lower in the NPT group than in the ST group (P = 0.012). Intraoral bleeding was significantly higher in the ST group than in the NPT group (P = 0.001). During intubation, laryngeal compression (Sellick maneuver) and head position changes were significantly lower in the NPT group than in the ST group (P = 0.003 and P < 0.001, respectively). There were no significant differences in mean arterial pressure and heart rate between the 2 groups.ConclusionsWe conclude that the NPT was associated with less epistaxis and manipulations such as laryngeal compression and head position changes when compared with the ST during nasotracheal intubation. The velvet-soft polyvinyl chloride material of the NPT appears to be responsible for this advantage.

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Nasal turbinate dislocation caused by nasotracheal intubation

Cited by 17 publications

References 4 publications

Nasal intubation: A comprehensive review

Nasal intubation: A comprehensive review

Complications of Airway ManagementDiscussion

North Polar Tube Reduces the Risk of Epistaxis during Nasotracheal Intubation: A prospective, Randomized Clinical Trial

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