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Pathological changes associated with short-term nasal intubation

J E O'Connell1, D S Stevenson, M A Stokes

  • 1City Hospital NHS Trust, Birmingham.

Anaesthesia
|April 1, 1996
PubMed
Summary
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Nasotracheal intubation for dental procedures caused minor nasal bruising in over half of patients, primarily on the inferior turbinate. Pre-operative assessments did not predict intubation difficulty or nasal damage.

Area of Science:

  • Anesthesiology
  • Otorhinolaryngology
  • Medical Devices

Background:

  • Nasotracheal intubation is frequently used for dental extractions under general anesthesia.
  • Potential nasal complications can arise from nasotracheal intubation, impacting patient outcomes.
  • Understanding the incidence and location of nasal damage is crucial for patient safety.

Purpose of the Study:

  • To determine the incidence and anatomical sites of nasal damage after nasotracheal intubation.
  • To evaluate the effectiveness of pre-operative rhinoscopy in predicting intubation difficulty and nasal injury.

Main Methods:

  • Prospective investigation of 100 patients undergoing dental extractions with nasotracheal intubation.
  • Pre-operative patient questioning and anterior rhinoscopy for nasal assessment.

Related Experiment Videos

  • Post-operative examination for hemorrhage, mucosal tears, and structural damage (septum, turbinates).

    • Main Results:

    • Minor nasal bruising occurred in 54% of patients, predominantly on the inferior turbinate and adjacent septum.
    • Bruising involved the middle turbinate in two cases; no correlation found between intubation attempts and damage.
    • Pre-operative assessments failed to predict difficult intubations or identify patients with pre-existing septal deviation.

    Conclusions:

    • Short-term nasotracheal intubation is associated with low significant nasal morbidity.
    • Pre-operative anatomical assessment is unreliable for predicting nasal intubation difficulty or complications.