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Nasotracheal intubation

Vinuta V Patil, Bala H Subramanya, N Kiranchand, S Bala Bhaskar, Srinivasalu Dammur
BACKGROUND AND AIMS: C-MAC(®) video laryngoscope (VL) with Macintosh blade has been found to improve Cormack-Lehane (C-L) laryngoscopic view as well as intubating conditions for orotracheal intubation. However, studies done on the performance of C-MAC(®) VL for nasotracheal intubation (NTI) are very few in number. Hence, we compared laryngoscopy and intubating conditions between Macintosh direct laryngoscope and C-MAC(®) VL for NTI. METHODS: Sixty American Society of Anesthesiologists Physical Status I, II patients, aged 8-18 years, posted for tonsillectomy surgeries under general anaesthesia with NTI were randomised, into two groups...
October 2016: Indian Journal of Anaesthesia
Ken Shohara, Tomoko Goto, Goro Kuwahara, Yoshitoyo Isakari, Tomomi Moriya, Tukasa Yamamuro
PURPOSE: Numerous techniques have been used to reduce epistaxis during nasotracheal intubation. Rhinometry can assess nasal patency in preoperative conditions. However, the possible role of rhinometry in routine nasotracheal intubation has not been studied. METHODS: One hundred and one patients undergoing dental and maxillofacial surgery that required general anesthesia and nasotracheal intubation were enrolled. We examined whether symmetry or any asymmetry in bilateral airflow patterns by condensation of the expiration, assessed by preoperative rhinometry on seated position, increased the incidence of epistaxis and the need for a nasogastric catheter to guide the endotracheal tube into the oropharynx...
October 13, 2016: Journal of Anesthesia
Ron O Abrons, Ryan A Vansickle, Jean-Pierre P Ouanes
Nasotracheal intubation can be both challenging and traumatic, especially in cases of atypical anatomy. We present a series of 3 such cases in which an endotracheal tube introducer (bougie) was used to facilitate successful, atraumatic, nasotracheal intubation via Seldinger technique. The technique described can guide a nasotracheal tube through narrow nasal passages, small pharyngeal spaces, and past acute laryngeal approach angles, all without transoral manipulation of the tube. The technique is easy to perform, uses a routine skill set, and can be advantageous in numerous clinical scenarios...
November 2016: Journal of Clinical Anesthesia
Yoshihiro Takasugi, Koichi Futagawa, Tatsuo Konishi, Daisuke Morimoto, Takahiko Okuda
PURPOSE: Most reported cases of nasopharyngeal laceration following impingement during nasotracheal intubation involved tube insertion via the right nostril. We postulated that recesses on the posterior wall of the nasopharynx might be associated with tube impingement. Using multiplanar imaging and clinical statistics, we evaluated whether anatomical variations in the recesses are related to successful intubation via the right nostril. METHODS: Using multiplanar computed tomography (CT) images of 97 patients, we investigated the locations of recesses relative to the mid-sagittal plane, nasal floor plane and posterior end of the nasal septum, and their shapes...
September 27, 2016: Journal of Anesthesia
Jan Florian Heuer, Sören Heitmann, Thomas A Crozier, Annalen Bleckmann, Michael Quintel, Sebastian G Russo
DESIGN: Prospective, randomized, clinical trial. SETTING: University hospital operation room. PATIENTS: 104 patients scheduled for elective dental or maxillofacial surgery were randomized to two groups: GlideScope® classic (GSc) and GlideScope® direct (GSd). INTERVENTIONS: We compared the video laryngoscopes GSc and GSd with each other and with direct laryngoscopy (DL) for nasotracheal intubation with regard to visualization of the glottis, intubation success rate, and required time for and ease of intubation...
September 2016: Journal of Clinical Anesthesia
Lei Heng, Ming-Yu Wang, Hou-Liang Sun, Shan-Shan Zhu
Anesthesia followed by placement in the prone position takes time and may result in complications. This study aimed to evaluate the feasibility of awake nasotracheal fiberoptic intubation and self-positioning followed by anesthesia induction in prone-positioned patients under general anesthesia.Sixty-two patients (ASA physical status I-II) scheduled for awake nasotracheal fiberoptic intubation and prone self-positioning before surgery under general anesthesia were selected. Patient preparation began with detailed preoperative counseling regarding the procedure...
August 2016: Medicine (Baltimore)
J W Steiner, D I Sessler, N Makarova, E J Mascha, P N Olomu, J W Zhong, C T Setiawan, A E Handy, B N Kravitz, P Szmuk
BACKGROUND: Brief periods of haemoglobin oxygen desaturation are common in children during induction of general anaesthesia. We tested the hypothesis that oxygen insufflation during intubation slows desaturation. METHODS: Patients 1-17 yr old undergoing nasotracheal intubation were enrolled and randomly assigned to one of three groups: standard direct laryngoscopy (DL); laryngoscopy with Truview PCD videolaryngoscope (VLO2); or laryngoscopy with an oxygen cannula attached to the side of a standard laryngoscope (DLO2)...
September 2016: British Journal of Anaesthesia
C Y Yen, C L Kuo, I H Liu, W C Su, H R Jiang, I G Huang, S Y Liu, S Y Lee
Classic cinch suture narrowing of the nasal alar base by medially suturing the bilateral nasolabial soft tissue with one long suture has a limited effect. The modified cinch method described in the present study anchors non-absorbable sutures to the bilateral lower border of the piriform rim and provides optimal direction, position, and stability. The sutures can be shortened and the strength kept stable while the surgical wounds heal. Separate bilateral sutures can also reduce interference and distortion from nasotracheal intubation and make the nasolabial profile more symmetrical...
June 27, 2016: International Journal of Oral and Maxillofacial Surgery
Zehra İpek Arslan, P Ozdal, D Ozdamar, H Agır, M Solak
We experienced a case of successful nasotracheal intubation using the X-Blade of the McGrath MAC in a 28-year-old woman with a 2.5-cm mouth opening. She had no teeth on the right side, her neck movement was limited, her mandibular protrusion was grade C, and her Mallampati could not be evaluated. Her tongue was fixed to the left wall during a previous surgery. We evaluated the awake glottic view using the McGrath MAC X-Blade and topical oral anesthesia. We obtained a Cormack-Lehane grade II view and then decided to administer general anesthesia...
October 2016: Journal of Anesthesia
Danica Popovik Monevska, Alberto Benedetti, Vladimir Popovski, Slave Naumovski, Aleksandar Grcev, Suzana Bozovic, Aleksandar Stamatoski
BACKGROUND: Coronoid process hyperplasia is an uncommon finding, characterized by an enlargement of the coronoid process, causing a mechanical obstacle by its interposing in the posterior portion of the maxilla or zygomatic arch. CASE PRESENTATION: The article presents a case report of a bilateral coronoid process hyperplasia in a 3-year-old girl demonstrated with inability to open the mouth and restricted jaw movement. Panoramic x-ray and 3-dimensional computed tomographic reconstruction showed bilateral elongation of the coronoid processes associated with deformation of the mandibular condyle with no involvement of the articular space...
June 15, 2016: Open Access Macedonian Journal of Medical Sciences
Jie Tang, Liwei Zhang, Junting Zhang, Zhen Wu, Xinru Xiao, Dabiao Zhou, Guijun Jia, Wang Jia
This study summarized clinical manifestations, surgical management, histological grading, and long-term outcome of jugular foramen meningiomas (JFMs). Retrospective study was performed in 22 consecutive patients with primary JFMs from January 2004 to October 2010, enrolling 10 men and 12 women with average age of 39.4 (14-57 years). The most common initial symptom is hearing disorder, followed by lower cranial nerve dysfunctions. The tumor was classified into type I (intracranial) in 1, type II (intracranial) in 15, type IV (intracranial-extracranial) in 6, and none type III (extracranial)...
October 2016: Neurosurgical Review
Min A Kwon, Jaegyok Song, Seokkon Kim, Seong-Mi Ji, Jeongho Bae
BACKGROUND: Various complications may occur during nasotracheal intubation. This may include epistaxis and damage to the nasopharyngeal airway. We tested the hypothesis that the use of fiberoptic bronchoscopy (FOB)-guided intubation is superior to endotracheal tube (ETT) obturated with an inflated esophageal stethoscope. METHODS: Patients were randomly assigned to 1 of 2 groups (n=22 each): either an FOB-guided intubation group or ETT obturated with an inflated esophageal stethoscope group...
August 2016: Journal of Clinical Anesthesia
Nina Sulen, Barbara Petani, Ivan Bacić, Domagoj Morović
Patients with mediastinal masses present unique challenge to anesthesiologists. Patients with anterior mediastinal masses have well documented cases of respiratory or cardiovascular collapse during anesthesia and in postoperative period. Masses in the posterior mediastinum have been traditionally regarded to carry a significantly lower risk of anesthesia related complications but cases of near fatal cardiorespiratory complications have been reported. We describe anesthetic management of a patient with posterior mediastinal mass compressing the trachea and the left main bronchus presented for left thoracotomy and tumor excision...
March 2016: Acta Clinica Croatica
Mohanavalli Singaram, Ilango Ganesan, Radhika Kannan, Rajesh Kumar
OBJECTIVES: Submental intubation has been advocated as an alternative to classical tracheostomy for certain indicated panfacial trauma surgeries. Surgeons should have various options for airway management in maxillofacial trauma patients. Most maxillofacial injuries involve occlusal derangements, which might require intraoperative occlusal corrections; hence, orotracheal intubation is not ideal. Maxillofacial surgeons generally prefer nasotracheal intubation; however, in cases with concomitant skull base fracture or nasal bone fracture, nasotracheal intubation might not be suitable; in these situations, tracheostomy is typically performed...
April 2016: Journal of the Korean Association of Oral and Maxillofacial Surgeons
Manuel Ángel Gómez-Ríos, Stephan Pinegger, María de Carrillo Mantilla, Lucia Vizcaino, Purísima Barreto-Calvo, Michael J Paech, David Gómez-Ríos, Beatriz López-Calviño
OBJECTIVE: Several devices can aid nasotracheal intubation when managing difficult airways. The McGrath MAC and Airtraq NT were compared with a Macintosh laryngoscope when studying the performance of anaesthetists with different levels of experience, in a manikin model of easy or difficult airway scenarios. METHODS: Sixty-three anaesthetists were recruited into a randomised trial in which each performed nasotracheal intubation with all laryngoscopes, in both scenarios...
May 2016: Brazilian Journal of Anesthesiology
Manuel Ángel Gómez-Ríos, Stephan Pinegger, María de Carrillo Mantilla, Lucia Vizcaino, Purísima Barreto-Calvo, Michael J Paech, David Gómez-Ríos, Beatriz López-Calviño
OBJECTIVE: Several devices can aid nasotracheal intubation when managing difficult airways. The McGrath MAC and Airtraq NT were compared with a Macintosh laryngoscope when studying the performance of anaesthetists with different levels of experience, in a manikin model of easy or difficult airway scenarios. METHODS: Sixty-three anaesthetists were recruited into a randomised trial in which each performed nasotracheal intubation with all laryngoscopes, in both scenarios...
May 2016: Revista Brasileira de Anestesiologia
Yukiko Matsuki, Nobuyuki Matsuura, Tatsuya Ichinohe
Application of nitrous oxide during anesthesia causes an increase in tracheal tube cuff pressure over time. The purpose of this study was to investigate the effect of an increase in cuff pressure on 3 types of tube (the Portex, Mallinckrodt, and Parker) commonly used for nasotracheal intubation. A cylindrical vessel was used to simulate a trachea. Cuff pressure was set at 0 cmH2O (R0) or 20 cmH2O (R20) at room temperature, or at 20 cmH2O (H20), 40 cmH2O (H40), 60 cmH2O (H60), or 80 cmH2O (H80) in 38°C hot water and pressure applied for 30 min...
2016: Bulletin of Tokyo Dental College
Vipin Kumar Goyal, Sohan Lal Solanki, Amrita U Parekh, Prakash Gupta
No abstract text is available yet for this article.
January 2016: Saudi Journal of Anaesthesia
Hyun Jin Min, Sang Ki Min, Young Ho Hong, Kyung Soo Kim
The authors experienced a case of severe epistaxis caused by accidental partial middle turbinectomy during nasotracheal intubation, which the patient had bilateral concha bullosa narrowing the nasal airway. Although anesthesiologist checked nasal airway through subjective symptoms and the size of both nostrils, they tend to overlook common anatomic variation, concha bullosa, and can injure turbinate structures. Therefore, preoperative computed tomography images should be carefully evaluated for the possibility of concha bullosa, which narrows nasal airway and induces the traumatic injury or epistaxis during nasotracheal intubation...
March 2016: Journal of Craniofacial Surgery
Koyu Ono, Tomoko Goto
No abstract text is available yet for this article.
April 2016: Journal of Anesthesia
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