J Korean Assoc Oral Maxillofac Surg.  2010 Jun;36(3):197-201. 10.5125/jkaoms.2010.36.3.197.

Computed tomography evaluation and pretreatment for a safe nasotracheal intubation, avoiding nasal cavity injuries

• Kim HL
• Yun KI
• Kim KS
• Kang H
• Choi YJ

• KMID: 2189947
• DOI: http://doi.org/10.5125/jkaoms.2010.36.3.197

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.
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.

Keyword

Intratracheal intubation; Intubation; Turbinate

MeSH Terms

Epistaxis
Humans
Incidence
Intubation
Intubation, Intratracheal
Mouth
Nasal Cavity
Orthognathic Surgery
Pharynx
Turbinates

Figure

• 

  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.

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  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.

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  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.

Reference

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