Nasal position of nasotracheal tubes: a retrospective analysis of intraoperatively generated three-dimensional X-rays during maxillofacial surgeryReport as inadecuate




Nasal position of nasotracheal tubes: a retrospective analysis of intraoperatively generated three-dimensional X-rays during maxillofacial surgery - Download this document for free, or read online. Document in PDF available to download.

European Journal of Medical Research

, 19:55

First Online: 17 October 2014Received: 19 February 2014Accepted: 03 October 2014

Abstract

BackgroundThe aim of this retrospective investigation was to evaluate the position of the nasotracheal tube in the nose and to show its anatomical relationship with the maxillary sinus ostium.

MethodsFifty data sets from patients who had undergone endonasal intubation were analyzed for tube positioning. There was a drop-out of eight data sets due to missing information concerning tube size and mode. Tube positioning was determined at the maxillary sinus ostium in the intraoperatively generated three-dimensional X-ray data sets. The type of tube, the tube size, and the presence of maxillary sinusitis were analyzed 30 minutes after intubation.

ResultsThe tube was positioned in the middle nasal meatus in 35 83.3% patients and not in the middle nasal meatus in 7 16.7% patients. The difference in comparison with equal distribution was significant P <0.001. The test value was 83.3; the 95% confidence interval of the test value was 68.6 to 93.0%. Maxillary sinusitis was diagnosed as a chance finding in 17% of patients n =7.

ConclusionsThe majority of nasal tubes are positioned in the middle nasal meatus. This result can be part of the answer to the question of the causal relationship between position of the breathing tube and the onset of maxillary sinusitis. The indications for prolonged nasotracheal intubation instead of orotracheal intubation or early tracheostomy should be considered carefully.

KeywordsIntubation Nasotracheal tube Maxillary sinusitis AbbreviationsICUIntensive care unit

iInferior nasal meatus

mMiddle nasal meatus

miJunction betwee the inferior and the middle nasal meatuses

MRPMulti-plane reconstruction

VAPVentilator-associated pneumonia

xffiberoptic intubation

xofwithout fiberoptic intubation

Electronic supplementary materialThe online version of this article doi:10.1186-s40001-014-0055-7 contains supplementary material, which is available to authorized users.

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Author: Lili Plümer - Gerhard Schön - Jan Klatt - Henning Hanken - Rainer Schmelzle - Philipp Pohlenz

Source: https://link.springer.com/



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