Two Other Simple Methods to Protect the Tracheal Cuff of a Double-Lumen Tube

Protecting the tracheal tube cuff: a novel solution

“…In this case, aberrant nasal cavity anatomy contributed to repeated rupture of endotracheal tube cuffs, as a large left concha bullosa was present and the contralateral nasal septal deviation with a sharp spur may have been a congenital response to middle turbinate pneumatization or secondary to the previous trauma and rhinoplasty. 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 ].…”

Use of the GlideScope®for double-lumen endobronchial intubation

“…This occurs frequently in the presence of upper teeth when using a double‐lumen endobronchial tube. We described in 1999 a technique to help minimise this problem, simply by inserting the tube in the mouth before the laryngoscope, and we use it successfully with the GlideScope as well .…”

Incidental tracheal cuff rupture during placement of double-lumen tubes, What to do?

“…[3] Fortier et al , told two other methods to protect the tracheal cuff. [4] First increase the curve of the endobronchial part of the DLT with the aid of the stylet included, such as a hockey stick, as for a difficult intubation. Thus, during the laryngoscopy, the DLT is placed in the airway, and the tracheal cuff is inserted inside the mouth without touching the teeth or the laryngoscope blade.…”