Effective nasotracheal intubation using a modified transillumination technique

Abstract

Modification of the technique facilitated transillumination and placement of the ETT. The simplicity and high success rate of NTI by transillumination with the TL suggest our modified technique is a valuable alternative for NTI in patients with difficult airway.

Nasotracheal intubation in patients with limited mouth opening: a comparison between fibreoptic intubation and the Trachway®

“…Use of a fibreoptic intubation technique is considered the 'gold standard' for difficult laryngoscopy [2]; however, the flexible portion of the fibrescope is easily damaged, expensive to repair and this in turn may lead to a decrease in its routine use [3,4]. Although a lightwand-guided nasotracheal intubation technique has been developed [5][6][7][8], this blind technique may cause tissue damage and is not useful if illumination is sub-optimal, for example in the obese or patients with short necks [9].…”

Blind nasotracheal intubation is facilitated by neutral head position and endotracheal tube cuff inflation in spontaneously breathing patients

“…10 The success rate of this technique would have reached 98% (80/82) in our study, had the technique been adopted initially in all cases. A lighted stylet can reduce malposition, lateral or posterior, of the endotracheal tube which will be guided by transillumination at the anterior neck.…”

A modified lightwand-guided nasotracheal intubation technique for oromaxillofacial surgical patients

“…For patients breathing spontaneously, an inflated NTT cuff and a lighted NTT tip were sufficient for successful lightwand-guided nasotracheal intubation [9][10][11]. Favaro et al [12], using a single-curve NTT mounted on a lightwand (Trachlight) with the stylet in position, successfully performed lightwand-guided nasotracheal intubation in apneic patients. However, it is difficult for the lightwand with the stiff inner stylet in position to easily move in and out of the doublecurve NTT.…”