Possible association between successful intubation via the right nostril and anatomical variations of the nasopharynx during nasotracheal intubation: a multiplanar imaging study

Takasugi, Yoshihiro; Futagawa, Koichi; Konishi, Tatsuo; Morimoto, Daisuke; Okuda, Takahiko

doi:10.1007/s00540-016-2253-7

Cited by 19 publications

(21 citation statements)

References 16 publications

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“…First, data have shown that less epistaxis occurred during NTI and intubation was faster in the right than in the left nostril, an effect related to the anatomy of structures located on the posterior nasopharyngeal wall; thus, the right nostril should be chosen if patency appears to be equal on both sides of the nose [1,11,12]. It was also reported that measurement of the nasal flow rate is a useful clinical method for choosing which nostril to use for NTI [13].…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2019

Preprint

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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.

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Section: Discussionmentioning

confidence: 99%

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

et al. 2019

Preprint

View full text Add to dashboard Cite

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“…Previous studies have discussed many strategies to reduce the risk of epistaxis during NTI in clinical practice. First, data have shown that less epistaxis occurs during NTI and that intubation is faster in the right as opposed to the left nostril, which is related to the anatomy of the structures located on the posterior nasopharyngeal wall; thus, the right nostril should be selected if patency appears to be equal on both sides of the nose [1, 12, 13]. Measurement of the nasal flow rate has also been reported to be a useful clinical strategy for selecting which nostril to use for NTI [14].…”

Section: Discussionmentioning

confidence: 99%

A comparison between the Disposcope endoscope and fibreoptic bronchoscope for nasotracheal intubation: a randomized controlled trial

et al. 2019

BMC Anesthesiol

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Background Nasotracheal intubation (NTI) is frequently performed for oral and maxillofacial surgeries. This study evaluated whether NTI is easier when guided by Disposcope endoscopy or fibreoptic bronchoscopy. Methods Sixty patients (30 per group) requiring NTI were randomly assigned to undergo fibreoptic bronchoscopy-guided (fibreoptic group) or Disposcope endoscope-guided (Disposcope group) NTI. The NTI time, which was defined as the time from when the fibreoptic bronchoscope or aseptic suction catheter was inserted into the nasal cavity to the time at which the tracheal tube was correctly inserted through the glottis, was recorded. Epistaxis was evaluated by direct laryngoscopy five minutes after completing NTI and was scored as one of four grades according to the following modified criteria: no epistaxis, mild epistaxis, moderate epistaxis, and severe epistaxis. Results The time to complete NTI was significantly longer in the fibreoptic group than in the Disposcope group (38.4 s vs 24.1 s; mean difference, 14.2 s; 95% confidence interval (CI), 10.4 to 18.1). Mild epistaxis was observed in 8 patients in the fibreoptic group and in 7 patients in the Disposcope group (26.7% vs 23.3%, respectively; relative risk, 1.2; 95% CI, 0.4 to 3.9), though no moderate or severe epistaxis occurred in either group. Furthermore, no obvious nasal pain was reported by any of the patients at any time point after extubation ( P = 0.74). Conclusion NTI can be completed successfully using either fibreoptic bronchoscopy or Disposcope endoscope as a guide without any severe complications. However, compared to fibreoptic bronchoscopy, Disposcope endoscope requires less execution time (the NTI time). Trial registration This clinical research was registered at the Chinese Clinical Trial Registry ( www.chictr.org.cn , ChiCTR-IPR-17011462, date of registration, May 2017).

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“…Previous studies have discussed many strategies to reduce the risk of epistaxis during NTI in clinical practice. First, data have shown that less epistaxis occurred during NTI and intubation was faster in the right rather than the left nostril, which is related to the anatomy of the structures located on the posterior nasopharyngeal wall; thus, the right nostril should be selected if patency appears to be equal on both sides of the nose [1,12,13]. Measurement of the nasal flow rate has also been reported to be a useful clinical method for selecting which nostril to use for NTI [14].…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2019

Preprint

View full text Add to dashboard Cite

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 fibreoptic bronchoscopy. Methods: Sixty patients (30 per group) requiring NTI were randomly assigned to undergo fibreoptic bronchoscopy-guided (fibreoptic group) or Disposcope endoscope-guided (Disposcope group) NTI. Then, the NTI time, which was deﬁned as the time from when the fibreoptic bronchoscope or aseptic suction catheter was inserted into the nasal cavity to the time at which the tracheal tube was correctly inserted through the glottis, was recorded. Epistaxis was recorded using direct laryngoscopy ﬁve minutes after completing NTI and was scored as one of four grades according to the following modiﬁed criteria: no epistaxis, mild epistaxis, moderate epistaxis, and severe epistaxis. Results: The time to complete NTI was significantly longer in the fibreoptic group than that in the Disposcope group (38.4 sec vs 24.1 sec; mean difference, 14.2 sec; 95% confidence interval (CI), 10.4 to 18.1). In addition, mild epistaxis was observed in 8 patients in the fibreoptic group and in 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, no obvious nasal pain was reported at any time point after extubation in the two groups (P = 0.74). Conclusion: NTI can be completed successfully using either fibreoptic bronchoscopy or a Disposcope endoscope as a guide without any severe complications. However, compared to fibreoptic bronchoscopy, the Disposcope endoscope requires less execution time (the NTI time).

show abstract

Possible association between successful intubation via the right nostril and anatomical variations of the nasopharynx during nasotracheal intubation: a multiplanar imaging study

Cited by 19 publications

References 16 publications

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

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

A comparison between the Disposcope endoscope and fibreoptic bronchoscope for nasotracheal intubation: a randomized controlled trial

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

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