Nasotracheal intubation for head and neck surgery

Abstract

SummaryNasotracheal intubation offers the head and neck surgeon more scope for surgical manoeuvre in operations of the mouth, pharynx, larynx and also the neck. Concern over the complications of using this route of intubation and lack of training may be limiting its use. A thorough knowledge of the anatomy, benefits of using nasal vasoconstrictors and attention to technique are prerequisites to maintaining the skill. This article reviews each of these topics and aims to encourage the appropriate use of nasotracheal intubation in current practice.

Use of the Airtraq® optical laryngoscope for nasotracheal intubation in predicted difficult airway management in oral surgery

“…The standard method is generally performed using the Macintosh laryngoscope supported by Magill forceps. 1 However, it is recommended to perform awake tracheal intubation in situations where a difficult airway is predicted, a scenario where this technique may be poorly tolerated by the patient. Although fibreoptic intubation is considered the ''gold standard'', sometimes it is difficult to perform and, therefore, alternatives are necessary.…”

The submental endotracheal intubation as an alternative to tracheostomy in selected cases of the facial fracture: literature review and technique report.

“…Nasotracheal intubation, on the other hand, allows most intraoral and extraoral approaches and leaves the oral cavity free of interferences for intermaxillary fixation (IMF). [1] Some conditions, nonetheless, contraindicate the use of a nasotracheal tube, [2][3][4] and for those cases, a tracheostomy is the most commonly used method for establishing an airway. [5] In 1984, Spanish author Hernández-Altemir first described the use of a submental approach for orotracheal intubation.…”

Efficacy and complications of submental tracheal intubation compared with tracheostomy in maxillofacial trauma patients

“…Therefore, in most maxillofacial trauma cases, the airway is secured by nasotracheal intubation. However, nasotracheal intubation sometimes interferes with the surgical approach (9).…”