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Foreign Body Obstruction Preventing Blind Nasal Intubation
Simon Prior BDS, MS, PhD
Article Category: Research Article
Volume/Issue: Volume 53: Issue 2
Online Publication Date: Jan 01, 2006
DOI: 10.2344/0003-3006(2006)53[49:FBOPBN]2.0.CO;2
Page Range: 49 – 52

22-gauge catheter-over-needle, and a continuous infusion of normal saline was delivered. After discussion between the resident and attending dentist anesthesiologist, the decision was made to perform a blind nasal intubation. The patient was placed supine and the head was stabilized on a pediatric head cushion. The chin was elevated and unlabored spontaneous ventilation with sevoflurane was continued until an appropriate depth of anesthesia was attained for the planned nasal intubation. A 5.0-mm nasal RAE endotracheal tube that had been

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Intubation Risk Factors for Temporomandibular Joint/Facial Pain
Michael D. Martin DMD, MSD, MPH, MA, PhD,
 Kory J. Wilson BS,
 Brian K. Ross MD, PhD, and
 Karen Souter MD
Article Category: Research Article
Volume/Issue: Volume 54: Issue 3
Online Publication Date: Jan 01, 2007
DOI: 10.2344/0003-3006(2007)54[109:IRFFTF]2.0.CO;2
Page Range: 109 – 114

The performance of endotracheal intubation for general anesthesia has long been considered a risk factor for the development or exacerbation of temporomandibular joint dysfunction (TMD) including facial pain. A recent update of guidelines for the management of the difficult airway by the American Society of Anesthesiologists specifically recommends measures to evaluate temporomandibular joint (TMJ) function preoperatively. 1 , 2 However, the literature in this area is limited, with only a small number of published case reports, 3–9 and

Nasotracheal Intubation Using the Airtraq Versus Macintosh Laryngoscope: A Manikin Study
Yoshihiro Hirabayashi MD and
 Norimasa Seo MD
Article Category: Research Article
Volume/Issue: Volume 55: Issue 3
Online Publication Date: Jan 01, 2008
DOI: 10.2344/0003-3006-55.3.78
Page Range: 78 – 81

Nasotracheal intubation often is required for dental and oral surgery. Direct laryngoscopy with the Macintosh laryngoscope, including the use of Magill forceps, is the most widely used method for nasotracheal intubation. However, this method is somewhat difficult to master, especially by novice personnel who do not perform nasotracheal intubation frequently. The Airtraq laryngoscope (Prodol Meditec, Vizcaya, Spain) is a new intubation device that provides a view of the glottic opening without aligning the oral, pharyngeal, and

Submental Intubation in Cases of Panfacial Fractures: A Retrospective Study
Willian Caetano Rodrigues DDS, MSc,
 Willian Morais de Melo DDS, MSc, PhD,
 Rafael Santiago de Almeida DDS, MSc,
 Shajadi Carlos Pardo-Kaba DDS, PhD,
 Celso Koogi Sonoda DDS, MSc, PhD, and
 Elio Hitoshi Shinohara DDS, PhD
Article Category: Research Article
Volume/Issue: Volume 64: Issue 3
Online Publication Date: Jan 01, 2017
DOI: 10.2344/anpr-64-04-07
Page Range: 153 – 161

To achieve optimum reduction of bone fragments in panfacial fractures, most cases require perioperative intermaxillary fixation (IMF). Thus, patients often cannot be managed with standard orotracheal intubation. 3 Nasotracheal intubation would be a good alternative for airway management if the presence of the tube did not hamper the surgical reconstruction of the midface in cases of naso-orbital ethmoid (NOE) complex fractures. 4 Moreover, Le Fort fractures type II and III are frequently associated with skull base fractures involving the cribriform plate of the

Reducing Nasopharyngeal Trauma: The Urethral Catheter–Assisted Nasotracheal Intubation Technique
Allen Wong DDS,
 Paul Subar DDS, EdD,
 Heidi Witherell MD, and
 Konstantin J Ovodov MD
Article Category: Research Article
Volume/Issue: Volume 58: Issue 1
Online Publication Date: Jan 01, 2011
DOI: 10.2344/0003-3006-58.1.26
Page Range: 26 – 30

General anesthesia via endotracheal intubation for dental treatment may be performed from an oral or a nasal approach. 1 The obvious benefits of nasal intubation include improved working space in the oral cavity and the ability of the dentist to evaluate jaw relationships. Although it is generally safe, nasotracheal intubation is not without complications. The incidence of minor bruising to the mucosa overlying the inferior turbinates has been reported as high as 54%. 2 A search of the literature reveals epistaxis rates ranging from 18 to 66%. 3 – 8

Modified Retrograde Nasal Intubation: A New Airway Technique and Devices
Vernon H. Vivian MBChB,
 Dip Anaes (SA),
 Tyson L. Pardon MD, and
 Andre A. J. Van Zundert MD, PhD, EDRA
Article Category: Research Article
Volume/Issue: Volume 68: Issue 2
Online Publication Date: Jun 29, 2021
DOI: 10.2344/anpr-68-02-03
Page Range: 107 – 113

A century ago, in 1920, Magill and Rowbotham 1 pioneered the concept of nasotracheal intubation (NTI). By blindly inserting a red rubber oral tube with a lateral bevel through the nostril and using Magill forceps to direct the tube into the trachea, they provided a ground-breaking airway management solution for many surgical interventions requiring concurrent access to the oral and maxillofacial complex. NTI is a safe technique in skilled hands; however, the passage of a bevelled endotracheal tube (ETT) through the nasopharynx may

Figure 3; Lateral radiographs of the manikin taken during nasotracheal intubation. ETT indicates tip of an endotracheal tube; M, tip of the Macintosh blade; A, tip of the Airtraq; and *, vocal cords. (a) The endotracheal tube was nasally advanced in the pharynx before laryngoscopy. (b) Intubation with the Macintosh laryngoscope. The Macintosh laryngoscope significantly elevates the glottis; consequently, the nasally introduced tube slides upward and then downward in sequence. To align the tube tip with the glottic inlet, the Magill forceps is often used. (c) Intubation with the Airtraq. The Airtraq laryngoscope preserves the configuration of the airway in its original position. Pushing the nasally introduced tube allows it to advance smoothly into the glottic inlet.
Yoshihiro Hirabayashi and
 Norimasa Seo
Figure 3
Figure 3

Lateral radiographs of the manikin taken during nasotracheal intubation. ETT indicates tip of an endotracheal tube; M, tip of the Macintosh blade; A, tip of the Airtraq; and *, vocal cords. (a) The endotracheal tube was nasally advanced in the pharynx before laryngoscopy. (b) Intubation with the Macintosh laryngoscope. The Macintosh laryngoscope significantly elevates the glottis; consequently, the nasally introduced tube slides upward and then downward in sequence. To align the tube tip with the glottic inlet, the Magill forceps is often used. (c) Intubation with the Airtraq. The Airtraq laryngoscope preserves the configuration of the airway in its original position. Pushing the nasally introduced tube allows it to advance smoothly into the glottic inlet.

Dual Bougie Technique for Nasotracheal Intubation
Rasjesh Mahajan MD,
 Parvaiz Ahmed MD,
 Firdose Shafi MD, and
 Rishab Bassi MD
Article Category: Research Article
Volume/Issue: Volume 59: Issue 2
Online Publication Date: Jan 01, 2012
DOI: 10.2344/11-09.1
Page Range: 85 – 86

In the case of unanticipated difficult airway, nasotracheal intubation can prove hazardous. Epistaxis is a common complication of nasotracheal intubation if a large, unsoftened tube is used, and the blood can interfere with visualization and securing of the airway with conventional techniques. Piepho et al 1 advocate to “ look before you leap ” prior to nasotracheal intubation, ie, to assess the airway by direct laryngoscopy prior to passing a tracheal tube through the nares. The tracheal tube should be passed through nares only in patients with Cormack

Comparing Video and Direct Laryngoscopy for Nasotracheal Intubation
Brett J. King DDS,
 Ira Padnos MD,
 Kenneth Mancuso MD, and
 Brian J. Christensen DDS, MD
Article Category: Research Article
Volume/Issue: Volume 67: Issue 4
Online Publication Date: Dec 31, 2020
DOI: 10.2344/anpr-67-02-08
Page Range: 193 – 199

Nasotracheal intubation is a common method for securing an airway during surgical procedures involving the orofacial complex. The placement of a nasotracheal tube is often more challenging than oral intubation, especially for providers who are in training or those with less experience, even for patients with normal airway anatomy. Video laryngoscopy is an adjunctive technique in anesthesia that utilizes a camera at the tip of the laryngoscope blade, which provides an indirect view of the glottis and surrounding structures during intubation

Application of Gum Elastic Bougie to Nasal Intubation
Hirofumi Arisaka MD, DDS, PhD,
 Shigeki Sakuraba MD, PhD,
 Munetaka Furuya DDS, PhD,
 Kazutoshi Higuchi DDS,
 Hitoshi Yui DDS,
 Shuya Kiyama MD, PhD, and
 Kazu-ichi Yoshida DDS, PhD
Article Category: Research Article
Volume/Issue: Volume 57: Issue 3
Online Publication Date: Jan 01, 2010
DOI: 10.2344/0003-3006-57.3.112
Page Range: 112 – 113

In conventional nasal intubation, a tracheal tube is gently introduced into the nostril, followed by direct laryngoscopy. If the glottis cannot be visualized or the tube does not enter the glottis, the patient's head may be extended or flexed, or use of Magill forceps may be required. 1 However, despite multiple attempts, occasionally the tube cannot be passed into the trachea because the tip of the nasotracheal tube does not advance anteriorly into the larynx and trachea but courses posteriorly into the esophagus, or it could be