Retropharyngeal submucosal dissection due to nasotracheal intubation

Nasal intubation is used often by anaesthetists because it offers many advantages; however, rare complications do arise. A 67-year-old man was admitted to our otorhinolaryngology clinic for uvulopalatopharyngoplasty. Nasotracheal intubation was performed without difficulty. At the beginning of surgery, the surgeon noticed that the nasotracheal tube had penetrated the oropharyngeal mucosa through a channel in the retropharyngeal space.

The tube was left in place during surgery to prevent bleeding. After surgery, a vertical incision was made through the mucosa surrounding the tube from the inferior pouch up to the nasopharynx to prevent hematoma.

The patient was extubated without complication and discharged on the second day postoperative. The oropharyngeal mucosa was healed by the 15th day postoperative.

Nasal intubation tubes should be lubricated and inserted without force; the oropharynx should be examined carefully after intubation to rule out complications.