Wider application of prolonged nasotracheal intubation

Abstract

SummaryENCOURAGED by reports of the treatment of laryngotracheal obstruction with nasotracheal intubation (N.T.I.), we began in 1965 to use this method in patients presenting such problems. At the outset we decided to use unsterilized and siliconized P.V.C. tubes in order to avoid toxicity and to provide ‘boundary lubrication’. Some preliminary experiments on these matters are presented.We found that by using this approach the range of indications for N.T.I, could be greatly extended. Forty-three out of forty-six patients, most of whom had chronic narrowings, were treated satisfactorily. The fact that eleven patients with obstructions caused by previous endotracheal intubation were cured by further intubation is noteworthy.

Dilatation of Laryngeal and Tracheal Stenoses

“…In the literature, healing rates of about 70% -similar to those of reconstructive surgeryare reported [1,3,4,5,8]. A closer look, however, reveals that a number of patients surely would have regained health with drugs only or even without any therapy.…”

Congenital Subglottic Atresia

“…Our method of intubation depends on low toxicity of the intubation material which is not sterilized to avoid added toxicity. The tubes are siliconized to provide a low-friction surface in order to protect the mucous membrane [boundary lubrication, Bos et al, 1973].…”

“…1). On March 15, 1971, the cartilaginous obstruction was removed by direct laryngoscopy with biopsy forceps and the child was intubated nasotracheally [Bf.rkovits, 1971;Bos et al, 1973] with a siliconized PVC (Riisch) tube Ch. 16.…”

Acquired laryngeal stenosis in infants and children treated by laryngofissure and stenting

“…The consistency and the diameter of the stenosis were examined with Hegar dilators. The measured diameter was compared with the expected diameter, taken from a table with age-dependent endotracheal tube sizes [6]. Subsequently the stenosis was classified according to (Table 1) [lo].…”