Journal List > J Korean Assoc Oral Maxillofac Surg > v.36(3) > 1032386

Kim, Yun, Kim, Kang, and Choi: Computed tomography evaluation and pretreatment for a safe nasotracheal intubation, avoiding nasal cavity injuries

Abstract

Introduction

In a surgery of the oral cavity, nasotracheal intubation is often carried out to secure the surgical field. By passing a tracheal tube through the nasal cavity to the pharynx, the nasotracheal intubation can lead to complications that do not occur with oral intubation, such as nasal bleeding and submucosal aberration etc. The purpose of this study is to examine the method of CT evaluation and pretreatment for a safe nasotracheal intubation.

Materials and Methods

Among 30 patients who orthognathic surgery was performed at Chung-Ang University Hospital during the period August 2009 to October 2009, 30 patients were included. The 30 patients were divided into two groups; 15 patients intubated with CT evaluation with pretreatment, and the other 15 patients intubated with no pretreatment. We evaluated nasal bleeding of the two groups during nasotracheal intubation.

Results

CT evaluation with pretreatment group had a significantly lower incidence of nasal bleeding than the group with no pretreatment.

Conclusion

CT evaluation with pretreatment helps to minimize nasal bleeding during nasotracheal intubation.

References

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Fig. 1.
We have selected a total of three points, middle turbinate bone tip, inferior turbinate bone tip and a point of the septum. A triangle is formed by linking the points with a line, then a circumscribed circle is drawn around the triangle. We defined R1 as the radius of the circle.
jkaoms-36-197f1.tif
Fig. 2.
We have selected a total of three points, on each of the mucosa tip of middle nasal concha, inferior nasal concha, and septum. A triangle is formed by linking the points with a line, then a circumscribed circle is drawn around the triangle. We defined R2 as the radius of the circle.
jkaoms-36-197f2.tif
Fig. 3.
Effects of epinephrine pretreatment on the mucosa of the inferior nasal concha. A. Before E-L pretreatment. B. 3 minutes after epinephrine pretreatment.
jkaoms-36-197f3.tif
Table 1.
Patient characteristics
  Age (yr) Sex (M/F) Height (cm) Weight (kg)
Group 11 23.67 (4.47) 6/9 167.15 (8.82) 61.02 (12.45)
Group 22 25.46 (2.50) 2/13 165.32 (8.49) 53.56 (9.70)

(1: nasotracheal tube without pretreatment, 2: nasotracheal tube with pretreatment) (Age, Height, Weight: Values are mean (SD)) (M: male, F: female)

Table 2.
The incidences of pretreatment at Group 2
  Pretreatment
Submucosal inferior turbinectomy 2
Bosmin packing 13
No treatment 0
Total 15
Table 3.
The incidences of Nasal bleeding
  Group 1 Group 2
Nasal bleeding 11 31
No bleeding 4 12
Total 15 15

(1: chi square test. P=0.003)

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