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Updated: Jan 9, 2026

Author Spotlight: Advancing Awake Nasotracheal Intubation with Flexible Video Rhino-Laryngoscopes
Published on: August 2, 2024
A Novel Nebulization-Assisted Topicalization Device for Flexible Bronchoscopic-Guided Awake Nasotracheal Intubation:
Devalina Goswami1, Sushmita Bairagi
1From the Department of Anaesthesiology, Pain and Critical Care, All India Institute of Medical Sciences, New Delhi, India.
Abstract:
Awake flexible bronchoscopic (FB)-guided nasotracheal intubation is often necessary for managing difficult airways, especially in maxillofacial surgeries. We present 2 cases used a novel device for airway topicalization with a local anesthetic (LA) solution. This device integrates a nasal trumpet with a nebulization chamber to deliver 4% lidocaine, effectively anesthetizing the nasal cavity, nasopharynx, and the vocal cords. This technique was successfully used in 2 patients, ensuring smooth and efficient awake FB-guided nasotracheal intubation while minimizing adverse effects such as epistaxis, coughing, or discomfort.
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