NASOTRACHEAL INTUBATION
Nasotracheal intubation is commonly performed in surgical procedures involving the oral cavity, face, or the oropharynx.
INDICATIONS
Fractured mandible
Surgery involving
Oral cavity
Face
Oropharynx​
If an oral endotracheal tube hinders surgical access
Neck injury or cervical spinal disease
Intraoral pathology
CONTRAINDICATIONS
Coagulopathy
Impedement of the nasotracheal region (polyps, abscesses, foreign bodies)
Fracture at the base of the skull
Transphenoidal surgeries may leave a defect in the skull, increasing the risk for perforation with a nasal tube
Lefort 2 & 3 fractures- disruption of cribriform plate
ADVANTAGES
Eliminates the possibility of the patient biting the tube
Less cervical spine movement compared to oral tracheal intubation​
DISADVANTAGES
A smaller tube results in increased resistance
Longer intubation time
Increased risk of bleeding
Risk for bacteremia, sinusitis, otitis
POSSIBLE COMPLICATIONS
Bleeding
Sinusitis
Bacteremia
Otitis
Damage to mucosa
Creation of false passage
Damage to nasal polyps
Nasal necrosis
SUPPLIES
Nasal tube
Lubricating Jelly
Nasal airway
Topical vasoconstrictor
Forceps
