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Reducing Nasopharyngeal Trauma: The Urethral Catheter–Assisted Nasotracheal Intubation Technique
Allen WongDDS,
Paul SubarDDS, EdD,
Heidi WitherellMD, and
Konstantin J OvodovMD
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

technique can be more challenging than the oral approach. The number of cases requiring nasal intubation is growing in the population of patients with special needs. The approach described in this paper is intended to provide an alternative technique to assist in the nasal intubation process. It has been observed that this technique is associated with less nasopharyngeal trauma and bleeding in children. 9 , 10 Avoidance of nasopharyngeal trauma in the airway is preferable from both the surgeons' and the anesthesiologists' perspectives, as perioperative laryngospasm and

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Alternative Transoral Application of Nasopharyngeal Airways
Robert MatsuiDDS, MSc,
Michelle WongDDS, MSc, and
Brian WatersDDS
Article Category: Research Article
Volume/Issue: Volume 67: Issue 1
Online Publication Date: Jan 01, 2020
DOI: 10.2344/anpr-66-03-04
Page Range: 39 – 44

Dental treatment for spontaneously ventilating patients using total intravenous anesthesia to provide deep sedation/nonintubated general anesthesia (DS/GA) often requires concurrent use of airway adjuncts to maintain airway patency. A nasopharyngeal airway (NPA) is often the preferred airway adjunct in nonintubated DS/GA dental cases because the Guedel oropharyngeal airway (OPA) or the flexible laryngeal mask airway may impede intraoral access. However, in patients who have findings of obesity; mandibular retrognathia or hypoplasia

Sevoflurane-Based General Anesthesia Induction via Nasopharyngeal Endotracheal Tube Prior to Definitive Airway Control in Pediatric Oral Tumors
Preet Mohinder SinghMD, DNB, MNAMS,
S. RajeshwariMD,
Anuradha BorleMD, DNB, MNAMS, and
Valluvan RangasamyMD
Article Category: Research Article
Volume/Issue: Volume 62: Issue 3
Online Publication Date: Jan 01, 2015
DOI: 10.2344/12-00037R1.1
Page Range: 118 – 121

anesthetic plan. The pediatric airway itself is more demanding than that of adults, and intraoral masses add to the complexity of this situation. We describe 2 such cases of intraoral tumors where airway access was not possible using conventional management protocols. We describe the innovative use of a prewarmed, softened polyvinyl chloride (PVC) endotracheal tube (ETT) inserted nasally like a nasopharyngeal airway to bypass the oral obstruction prior to the induction of anesthesia. CASE 1 A 4-year-old, 14-kg male child diagnosed with

Figure 3; Positioning of oropharyngeal (A) versus nasopharyngeal (B) airways.
Daniel E. Becker and
Daniel A. Haas
Figure 3
Figure 3

Positioning of oropharyngeal (A) versus nasopharyngeal (B) airways.

Figure 6 ; Sagittal view demonstrating oral placement of a nasopharyngeal airway (bite-block not shown) and nasal hood setup.
Robert Matsui,
Michelle Wong, and
Brian Waters
<bold>Figure 6</bold>
Figure 6

Sagittal view demonstrating oral placement of a nasopharyngeal airway (bite-block not shown) and nasal hood setup.

Figure 4.; End-Tidal CO2: NPA vs ETT Comparison of end-tidal CO2 measurements obtained throughout the study. ETT, endotracheal tube; NPA, nasopharyngeal airway.
Rebecca R. Rafla,
Mark A. Saxen,
Juan F. Yepes,
James E. Jones, and
LaQuia A. Vinson
Figure 4.
Figure 4.

End-Tidal CO2: NPA vs ETT

Comparison of end-tidal CO2 measurements obtained throughout the study. ETT, endotracheal tube; NPA, nasopharyngeal airway.

Figure 5.; Respiratory Rate: NPA vs ETT Comparison of respiratory rate measurements obtained throughout the study. ETT, endotracheal tube; NPA, nasopharyngeal airway.
Rebecca R. Rafla,
Mark A. Saxen,
Juan F. Yepes,
James E. Jones, and
LaQuia A. Vinson
Figure 5.
Figure 5.

Respiratory Rate: NPA vs ETT

Comparison of respiratory rate measurements obtained throughout the study. ETT, endotracheal tube; NPA, nasopharyngeal airway.

Figure 1 ; Extraoral sizing of an oral placement of a nasopharyngeal airway measured from the angle of the mandible to the labial commissure (marked with a permanent marker).
Robert Matsui,
Michelle Wong, and
Brian Waters
<bold>Figure 1</bold>
Figure 1

Extraoral sizing of an oral placement of a nasopharyngeal airway measured from the angle of the mandible to the labial commissure (marked with a permanent marker).

Figure 7 ; Critical upper airway anatomy and possible placements of the inferior end of an oral placement of a nasopharyngeal airway (regions indicated by “x”).
Robert Matsui,
Michelle Wong, and
Brian Waters
<bold>Figure 7</bold>
Figure 7

Critical upper airway anatomy and possible placements of the inferior end of an oral placement of a nasopharyngeal airway (regions indicated by “x”).

Figure 2 ; Oral placement of a nasopharyngeal airway, buccal to a bite-block. Note that the supplemental oxygen line in place only, no capnography sample line, adjustable flange is placed as a reference at the labial commissure.
Robert Matsui,
Michelle Wong, and
Brian Waters
<bold>Figure 2</bold>
Figure 2

Oral placement of a nasopharyngeal airway, buccal to a bite-block. Note that the supplemental oxygen line in place only, no capnography sample line, adjustable flange is placed as a reference at the labial commissure.