Repeated cuff rupture with nasal intubation: What we learn!!!

Kaloria, Narender; Goyal, Shilpa; Sethi, Priyanka; Bhatia, Pradeep

doi:10.4103/ija.ija_275_19

Cited by 3 publications

(4 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Various recommendations were made to manage challenging intubation in view of nasal spur. These include assessment of available radiographs and highlighting potential airway di culty to the anesthetist [6], palpation of the nasal cavity to identify bony protuberance [5], beroptic or laryngoscope guided intubation [7], preoperative clinical examination with illumination and nasal endoscopy [9]. Table 1 summarizes the key ndings from our review of the existing literature.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

The use of CBCT prior to Nasal Intubation for Orofacial Surgical Procedure

Ng,

Sng,

Loh

et al. 2023

Preprint

View full text Add to dashboard Cite

Purpose This case report presents an unusual case of multiple cuff leaks after successful nasotracheal tube placement, and the use of Cone beam Computed Tomography (CBCT) to identify the problem: a left nasal septal spur. We performed a literature review of similar cases and provided recommendations on the usage of CBCT for pre-operative assessment prior to nasotracheal intubation. Conclusion Anatomical variations in the nasal cavity may complicate the process of nasal intubation. Preoperative analysis should be done to identify and locate such anomalies, and to select a suitable nostril to circumvent anticipated anatomical roadblocks. This case report shows that the use of CBCT as a pre-operative tool to assess nasal anatomical variations – particularly in orthognathic patients, should be recommended as the standard of care prior to nasal intubation.

show abstract

Section: Discussionmentioning

confidence: 99%

“…A search in literature revealed sparse knowledge about cuff damage due to nasal spur, with the exceptions of only case reports as seen in Table 1 [5][6][7][8][9][10][11]. Six out of the seven cases performed multiple intubations attempts as the bony spur was not identi ed pre-operatively.…”

Section: Discussionmentioning

confidence: 99%

The use of CBCT prior to Nasal Intubation for Orofacial Surgical Procedure

Ng,

Sng,

Loh

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…Numerous case reports have described the management of ruptured tracheal tube cuffs during double lumen tube placement for thoracic surgery [ 4 , 5 , 6 , 7 , 8 ]. Management of the ruptured nasotracheal cuff using nasopharyngeal packing [ 9 ] to limit air leak for known difficult airways, or via application of retrievable finger cots or cut glove fingers to protect the tracheal tube cuff has also been described [ 10 , 11 ]. However, the application of a mobile body, even with retrieval sutures, is associated with the risk of aspiration or other complications [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

Protecting the tracheal tube cuff: a novel solution

Abel

Behrman

Samuels

2021

J Dent Anesth Pain Med

View full text Add to dashboard Cite

We describe the successful insertion of a nasotracheal tube following repeated cuff rupture. The patient was a 55-year-old woman with a history of nasal trauma and multiple rhinoplasties, who underwent elective Lefort I osteotomy and bilateral sagittal split osteotomy for correction of skeletal facial deformity. During fiberoptic bronchoscope-guided nasal intubation after the induction of general anesthesia, the tracheal tube repeatedly ruptured in both nares, despite extensive preparation of the nasal airways. We covered the cuff with a one-inch tape, intubated to the level of the oropharynx, pulled the tracheal tube out through the mouth, and removed the tape. The tracheal tube was then backed out to the level of the uvula, and was successfully advanced.

show abstract

“…[ 2 ] A rare cause of repeated cuff rupture in a case requiring nasal intubation due to restricted mouth opening was a nasal spur which was managed by submental intubation. [ 3 ]…”

mentioning

confidence: 99%