Comparing Video and Direct Laryngoscopy for Nasotracheal Intubation

This parallel group randomized controlled clinical trial compared intubation duration and success using video laryngoscopy (VL) versus direct laryngoscopy (DL) during routine nasotracheal intubation. Fifty patients undergoing oral and maxillofacial surgery under general anesthesia were randomly assigned into 2 groups receiving either VL or DL to facilitate nasotracheal intubation. The primary outcome was the amount of time required to complete nasotracheal intubation. The secondary outcomes included the success of first attempt at intubation and the use of Magill forceps. Results demonstrated a mean time to intubation of 142 seconds in the DL group and 94 seconds in the VL group (p = .011). First attempt intubation success was 92.0% in the VL group and 84.0% in the DL group (p = .34). The use of Magill forceps was significantly increased in the DL group (p = .007). VL for routine nasotracheal intubation in oral and maxillofacial surgery procedures results in significantly faster intubation times and decreased use of Magill forceps compared with traditional DL.

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Nasotracheal Intubation Using the Airtraq Versus Macintosh Laryngoscope: A Manikin Study

Anesthesia Progress ◽

10.2344/0003-3006-55.3.78 ◽

2008 ◽

Vol 55 (3) ◽

pp. 78-81 ◽

Cited By ~ 8

Author(s):

Yoshihiro Hirabayashi ◽

Norimasa Seo

Keyword(s):

Direct Laryngoscopy ◽

Macintosh Laryngoscope ◽

Nasotracheal Intubation ◽

Line Of Sight ◽

Intubation Time ◽

Analog Scale ◽

Magill Forceps ◽

The Mean ◽

Time Required ◽

Non Line Of Sight

Abstract The Airtraq laryngoscope is a new intubation device that provides a non–line-of-sight view of the glottis. We evaluated this device by comparing the ease of nasotracheal intubation on a manikin with the use of Airtraq versus the Macintosh laryngoscope with and without Magill forceps. Nasotracheal intubation on a manikin was performed by 20 anesthesiologists and 20 residents with the Airtraq or Macintosh laryngoscope. The mean (± SD) time required for nasotracheal intubation by the residents was significantly shorter with the Airtraq laryngoscope than with the Macintosh laryngoscope (16 ± 7 sec vs 22 ± 10 sec; P < .001), but no difference in intubation time was observed between Airtraq (15 ± 11 sec) and Macintosh (13 ± 6 sec) laryngoscopy by the anesthesiologists. The Magill forceps was used more frequently to facilitate intubation with the Macintosh laryngoscope than with the Airtraq laryngoscope in both groups of operators 7(P < .001). The Airtraq laryngoscope scored better on the visual analog scale than did the Macintosh laryngoscope in both groups of operators (P < .05). The Airtraq laryngoscope offers potential advantages over standard direct laryngoscopy for nasotracheal intubation.

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Effectiveness and safety of cuff inflation technique over conventional method of Magill forceps for Nasotracheal intubation under direct laryngoscopy: Randomized controlled trial

Indian Journal of Clinical Anaesthesia ◽

10.18231/j.ijca.2021.122 ◽

2021 ◽

Vol 8 (4) ◽

pp. 574-578

Author(s):

Ami Bhayani ◽

Apeksha Patwa

Keyword(s):

Endotracheal Tube ◽

Conventional Method ◽

Direct Laryngoscopy ◽

Nasotracheal Intubation ◽

T Test ◽

Cuff Inflation ◽

Hemodynamic Parameters ◽

Magill Forceps ◽

Intergroup Comparison ◽

Time Required

The aim of the study is to compare the effectiveness and safety of cuff inflation technique over conventional method of Magill forceps for Nasotracheal intubation NTI under direct laryngoscopy.After taking permission from institutional ethical committee, patients of 18-60 years of either sex of ASA grade I and ll were divided into groups of 40 each. In group C, cuff inflation technique and in group M, Magill forceps technique was used for navigating the endotracheal tube from oropharynx to glottic opening to achieve intubation. Parameters observed were time required for intubation, attempts of intubation, injury occurring to oropharyngeal structures during intubation and hemodynamic parameters. Cuff of endotracheal tube was assessed postoperatively for any leaksAnalysis of the data for the various parameters was done using paired t-test for intra-group comparison and student t-test for intergroup comparison and chi-square test was used for qualitative (non parametric) data.There was no significant difference in demographic parameters, time required for intubation, number of attempts for intubation and hemodynamic parameters, but trauma to oropharyngeal structures was more in group M (8/40) compared to group C (0/40). (p≤0.05) Trauma to cuff of endotracheal tube was seen in group M (1/40) while none in group C (0/40) which was statistically not significant (p≤0.05).Thus, Cuff inflation technique can be used as an effective alternative to Magill forceps for oropharyngeal navigation of endotracheal tube under direct laryngoscopy guided nasotracheal intubation in patients with normal airways.

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Olfactory Dysfunction After Oral and Maxillofacial Surgery

10.21203/rs.3.rs-690029/v1 ◽

2021 ◽

Author(s):

Yaxi Wang ◽

Hua Li ◽

Xuanping Huang ◽

Nuo Zhou

Keyword(s):

General Anesthesia ◽

Nasal Septum ◽

Rare Complication ◽

Nasotracheal Intubation ◽

Maxillofacial Surgery ◽

Olfactory Dysfunction ◽

Oral And Maxillofacial Surgery ◽

General Anesthetic ◽

Anesthetic Drugs ◽

Nasal Septum Deviation

Abstract Background: Although anesthesia can contribute to olfactory dysfunction, it is a rare complication after oral and maxillofacial surgery by general anesthesia.Cases presentation: In this study, we introduced 3 cases of patient suffering from anosmia (complete loss of smell), after oral and maxillofacial surgery by general anesthesia. We also investigated possible etiologies of anosmia. Conclusions: There are some evidences that anosmia is caused by nasotracheal intubation, which may cause OM injury and/or swing of the nasal septum in patients with nasal septum deviation. Olfactory dysfunction via general anesthetic drugs, however, may have a different etiology.

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Modified Retrograde Nasal Intubation: A New Airway Technique and Devices

Anesthesia Progress ◽

10.2344/anpr-68-02-03 ◽

2021 ◽

Vol 68 (2) ◽

pp. 107-113

Author(s):

Vernon H. Vivian ◽

Dip Anaes ◽

Tyson L. Pardon ◽

Andre A. J. Van Zundert

Keyword(s):

Clinical Practice ◽

Laryngeal Mask Airway ◽

Nasotracheal Intubation ◽

Maxillofacial Surgery ◽

Oral Route ◽

Oral And Maxillofacial Surgery ◽

Nasal Intubation ◽

Novel Technique ◽

Materials Used ◽

Airway Devices

Nasotracheal intubation remains an underused but invaluable technique for securely managing the airway during oral and maxillofacial surgery. In this article, we present a modified clinical technique that allows for the potential introduction into clinical practice of 2 new airway devices: a nasal laryngeal mask airway and an interchangeable oral/nasal endotracheal tube. We hypothesize that with the use of proper techniques, these devices can add new and safer alternatives for securing an airway by the nasal route. The advantage of this novel technique is that the airway is secured by the oral route prior to performing a modified retrograde nasal intubation, eliminating the danger of profuse epistaxis precipitating a “cannot intubate, cannot ventilate” scenario. In addition, the design and materials used in the components of the devices may minimize trauma. The authors aim to inform clinicians about the indications, physical characteristics, and insertion/removal techniques related to these new devices.

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A Prospective Study on Complications after Nasotracheal Intubation in Oral and Maxillofacial Surgery Patients

Korean Journal of Anesthesiology ◽

10.4097/kjae.2000.39.1.72 ◽

2000 ◽

Vol 39 (1) ◽

pp. 72 ◽

Cited By ~ 2

Author(s):

Hyun Jeong Kim ◽

Kwang Won Yum

Keyword(s):

Prospective Study ◽

Nasotracheal Intubation ◽

Maxillofacial Surgery ◽

Oral And Maxillofacial Surgery ◽

A Prospective Study

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Intubation concerns in maxillofacial trauma patients

Anaesthesia, Pain & Intensive Care ◽

10.35975/apic.v22i1.1199 ◽

2020 ◽

Author(s):

Kamran Khan ◽

Jawaria Bibi ◽

Muhammad Umar Qayyum

Keyword(s):

Nasotracheal Intubation ◽

Maxillofacial Surgery ◽

Maxillofacial Trauma ◽

Facial Trauma ◽

Oral And Maxillofacial Surgery ◽

Trauma Patients ◽

Nasal Intubation ◽

Trauma Centers ◽

Dental Hospital ◽

Low Rate

Introduction: In maxillofacial trauma the preferred intubation method for general anesthesia is nasotracheal intubation in most of the trauma centers. We conducted a retrospective study to review the utility of this method of intubation in maxillofacial trauma patients. We aimed to review the intra-operative and postoperative concerns and complications for nasotracheal intubation and effectiveness of this method of intubation in maxillofacial trauma patient. Methodology: This study included 56 patients of maxillofacial trauma, who were treated in our centre of Oral and Maxillofacial Surgery at Islamic International Dental Hospital, Islamabad in the period of two years, 1st January 2016 to 31st December 2017. Results: The study showed that nasal intubation is relatively more effective in isolated mandibular trauma patients. But there are difficulties regarding intubation in maxillary fractures and pan-facial trauma patients. Conclusion: Although nasotracheal method of intubation is difficult to attain in some cases, but still it is an effective method of intubation for majority of the maxillofacial trauma cases with very low rate of complications. Received: 30 Sep 2018Reviewed: 16 Nov 2018Accepted: 17 Nov 2018 Citation: Khan K, Bibi J, Qayyum MU. Intubation concerns in maxillofacial trauma patients Anaesth Pain & Intensive Care 2018;22 Suppl 1:S109-S112

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Nasotracheal intubation for airway management during anesthesia

Anesthesia and Pain Medicine ◽

10.17085/apm.21040 ◽

2021 ◽

Vol 16 (3) ◽

pp. 232-247

Author(s):

Dong Ho Park ◽

Chia An Lee ◽

Chang Young Jeong ◽

Hong-Seuk Yang

Keyword(s):

Intensive Care ◽

Airway Management ◽

Nasotracheal Intubation ◽

Maxillofacial Surgery ◽

Orotracheal Intubation ◽

Review Article ◽

Oral And Maxillofacial Surgery ◽

Nasal Airways ◽

Surgical Field ◽

Preventive Methods

Nasotracheal intubation is used as a basic method for airway management, along with orotracheal intubation under anesthesia and intensive care. It has become an effective alternative method to orotracheal intubation with increased benefits of offering better mobility and surgical field in oral and maxillofacial surgery and possibly in trauma and critically ill patients. Nasotracheal intubation is performed through a relatively narrow nasal cavity; therefore, additional precautions are needed. Accordingly, nasotracheal intubation methods have evolved over the years with accumulated clinical experience and improved instruments to facilitate safe intubation with reduced complications. Therefore, in this review article, we summarize the basic anatomy of the nasal airways to clarify the precautions, delineate the history and development of various methods and instruments, and describe the indications, contraindications, complications, and preventive methods of nasotracheal intubation.

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Molar Position and Surgical Time in Lower Third Molar Extraction

International Journal of Medical and Surgical Sciences ◽

10.32457/ijmss.2014.003 ◽

2018 ◽

Vol 1 (1) ◽

pp. 17-20

Author(s):

Sergio Olate ◽

Juan Alister ◽

David Thomas ◽

Ricardo Alveal ◽

Alejandro Unibazo

Keyword(s):

Maxillofacial Surgery ◽

Third Molar ◽

Aggressive Periodontitis ◽

Oral And Maxillofacial Surgery ◽

Oral Diseases ◽

Surgical Time ◽

Oral Infections ◽

Third Molar Extraction ◽

Time Required ◽

A Prospective Study

The aim of this research was to find the influence of lower third molar position in surgical time required for extraction of this molar. A prospective study was designed in patients at the Division of Oral and Maxillofacial Surgery at Universidad de La Frontera. Patients with ASA I and II and without oral diseases as aggressive periodontitis and oral infections were included. The third molar position was established in relation to Pedersen scale, Winter scale and Pell and Gregory scale, considering surgical time between the start of surgery and finalization of the procedure; data analyses was carried out with t test with statisticaldifferences when p<0.05. Surgical time of 12±9 minutes was registered, and this was statistically associated to dental position and difficulty observed. It is therefore concluded that the position of the molar has an influence on surgical time.

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