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Updated: Jun 22, 2026

The Flexible Rhino-Laryngoscope for Awake Nasotracheal Intubation
Published on: August 2, 2024
A modified lightwand-guided nasotracheal intubation technique for oromaxillofacial surgical patients
Kuang-I Cheng1, Ming-Chih Chang, Ta-Wei Lai
1Department of Anesthesiology, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University Hospital, Kaohsiung, 807, Taiwan.
Study Objective:
To investigate the efficiency of a double curve nasotracheal tube on lightwand-guided nasotracheal intubation.
Design:
Prospective, randomized, controlled trial.
Setting:
University medical center hospital.
Patients:
60 ASA physical status I and II patients undergoing oromaxillofacial surgery.
Interventions And Measurements:
Patients undergoing surgery with nasotracheal intubation and general anesthesia were randomly enrolled in the laryngoscopy group or the lightwand group. The same type of double curve nasotracheal tube was used in both groups. In the laryngoscopy group, intubation was assisted with a Macintosh No. 3 standard curved blade and Magill forceps. In the lightwand group, intubation was aided with a flexible lightwand device (without the inner stiff stylet). Intubation time was divided into two parts: Part one, from selected naris to oropharynx; Part two, from oropharynx into trachea. Part one, Part two, and total intubation time, hemodynamic responses to nasotracheal intubation, and adverse events or complications were recorded.
Main Results:
Total intubation times in the lightwand group and the laryngoscopy group were 22.8 +/- 8.0 sec vs 30.3 +/- 8.2 sec (P < 0.001), respectively. The lightwand group had comparable hemodynamic responses to those of the laryngoscopy group. Adverse events and complications were all self-limited, with similar occurrence in both groups.
Conclusion:
For patients undergoing oromaxillofacial surgery, modified lightwand-guided nasotracheal intubation is feasible with a double curve nasotracheal tube and is an efficient alternative technique.
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