A comparison between the Disposcope endoscope and fiberoptic bronchoscope for nasotracheal intubation-A randomized controlled trial

Abstract

Background Nasotracheal intubation (NTI) is frequently performed in oral and maxillofacial surgeries. This study evaluated whether NTI is easier when guided by Disposcope endoscopy or fiberoptic bronchoscopy. Methods Sixty patients (30 per group) requiring NTI were randomly assigned to undergo fiberoptic bronchoscopy-guided (fibreoptic group) or Disposcope endoscope-guided (Disposcope group) NTI. Then, the NTI time were recorded. Epistaxis was recorded using direct laryngoscopy five minutes after completing NTI. Results The time to complete NTI was significantly longer in the fiberoptic group than the Disposcope group (38.4 sec vs 24.1 sec; mean difference, 14.2 sec; 95% CI, 10.4 to 18.1). In addition, Mild epistaxis (nasal bleeding) was observed in 8 patients in the fiberoptic group and 7 patients in the Disposcope group (26.7% vs 23.3%, respectively; relative risk, 1.2; 95% CI, 0.4 to 3.9). No moderate or severe epistaxis occurred in either group. Furthermore, there was no obvious nasal pain at any time point after extubation in the Disposcope group, and there was no significant difference between the two groups. Conclusion NTI can be completed successfully using either fiberoptic bronchoscopy or a Disposcope endoscope as a guide without any severe adverse reactions. However, compared to fiberoptic bronchoscopy, the Disposcope endoscope requires less transaction time.

Comparison with tube core and Magill forceps for nasotracheal intubation: a randomized controlled trial

“…Thermosoftening of the endotracheal tube should not be overlooked even if other effective methods, such as telescoping the endotracheal tube into a rubber catheter, have already been applied because it has the obvious advantages of reducing the incidence of epistaxis and improving the nasal passage of the endotracheal tube [3,15]. The wire-reinforced tracheal tube in our study is a soft endotracheal tube that contributes to reducing bleeding [9]. Therefore, simple thermosoftening treatment of the endotracheal tube has not been performed in the present research.…”

“…It was reported that the wire tube body of the Disposcope endoscope was rigid but could be bent along the radian of the nasal cavity, which bene tted NTI [9]. Another device, a video intubating stylet for NTI, which has a rigid intubating stylet with an adjustable distal portion, makes the process of NTI quicker and easier [18].…”

“…Another device, a video intubating stylet for NTI, which has a rigid intubating stylet with an adjustable distal portion, makes the process of NTI quicker and easier [18]. In those studies, the tube stylet was advanced through into the glottis easily by their levelling effect but did not increase the incidence of related complications [9,14,18]. Although the tube core has a malleable rigid body, it protects the nasal mucosa and the entire nasal passage during the operational process by wire-reinforced tracheal tube, with results similar to those in our previous study [9].…”

“…Softer tracheal tubes such as reinforced ones tend to move along the posterior pharyngeal wall rather towards the laryngeal inlet, and it is di cult to navigate them into the vocal cord without using Magill forceps [8]. It was reported that a rigid wire tube body bent along the radian of the nasal cavity could help the anaesthesiologist complete NTI [9] more easily. In another study, the use of a stylet resulted in signi cantly higher rst-attempt intubation success among patients undergoing endotracheal intubation compared with use of a bougie [10].…”

Comparison of a tube core and Magill forceps for nasotracheal intubation: a randomised controlled trial

“…Soft tracheal tubes, such as reinforced tubes, tend to move along the posterior pharyngeal wall rather than towards the laryngeal inlet, and they are di cult to navigate to the vocal cords without using Magill forceps [8]. A rigid wire tube body of a video stylet bent along the curve of the nasal cavity was reported to help anaesthesiologists complete NTI more easily [9]. However, not all institutions have visual devices.…”