A Novel Nebulization-Assisted Topicalization Device for Flexible Bronchoscopic-Guided Awake Nasotracheal Intubation:...

Area of Science:

• Anesthesiology
• Airway Management
• Otolaryngology

Background:

• Awake flexible bronchoscopic (FB)-guided nasotracheal intubation is crucial for managing difficult airways, particularly in maxillofacial surgery.
• Effective airway topicalization with local anesthetic (LA) is essential for patient comfort and procedural success.

Purpose of the Study:

• To present a novel device for effective airway topicalization during awake FB-guided nasotracheal intubation.
• To evaluate the safety and efficacy of this device in clinical cases.

Main Methods:

• A novel device integrating a nasal trumpet and nebulization chamber was used.
• The device delivered 4% lidocaine solution for topical anesthesia.
• The technique was applied in two patients undergoing awake FB-guided nasotracheal intubation.

Main Results:

• The novel device successfully achieved anesthesia of the nasal cavity, nasopharynx, and vocal cords.
• Awake FB-guided nasotracheal intubation was smooth and efficient in both patients.
• Adverse effects such as epistaxis, coughing, and discomfort were minimized.

Conclusions:

• This novel airway topicalization device facilitates successful awake FB-guided nasotracheal intubation.
• The technique offers a safe and effective method for managing difficult airways, reducing patient discomfort and procedural complications.