4. Discussion
sinusitis, perforation, bacteremia, epistaxis, tube obstruction
SINUSITIS, AIDS, CAVITY, EPISTAXIS, COMPLICATIONS
When we compared the results of the two groups, the total intubation time was shorter in the SC group than in the NG group. However, there were no differences in the number of intranasal manipulations, navigability, or epistaxis. These results suggest that the suction-catheter-guided method is useful for nasotracheal intubation. Using a suction catheter as a guiding device can shorten the time required to complete nasotracheal intubation without additional side effects relative to the previously reported nasogastric tube-guided method.During conventional nasotracheal intubation, complications such as epistaxis, nasotracheal tube obstruction, bacteremia, perforation of the pyriform fossa, sinusitis, etc., may occur as the intubation tube passes through the nasopharynx [Numerous techniques have been tried to reduce the potential damage that can be caused by nasotracheal intubation [During nasotracheal intubation, the insertion time from the nostril to the oral cavity was shorter in the SC group than NG group. Moreover, the total intubation time was also shorter in the SC group than in the NG group. These results may be attributed to the physical characteristics of the materials of the two guiding aids. It is presumed that the suction catheter is thinner and more rigid than the nasogastric tube (When the nasotracheal tube passes through the nasal cavity, it passes either through the lower pathway between the floor of the nose and the inferior turbinate or the upper pathway between the inferior turbinate and the middle turbinate. It is known that complications occurring during nasotracheal intubation are more likely when passing via the upper pathway where major structures, such as the middle turbinate and the cribriform plate, are located. To avoid these structures, it is safe for the nasotracheal tube to enter via the lower pathway [This study has several limitations. First, nasotracheal intubation is a procedure that is highly dependent on the experience and skill of the practitioners. To reduce the variation of procedures among practitioners, one anesthesiologist performed all the intubations in this study. Hence, this may limit the generalizability of our results. To validate this technique, further studies are warranted. Second, we did not check whether the guidance aids were in the upper and lower pathways in the nasal cavity. We checked the position of the nasotracheal tube after intubation was completed. Thus we cannot exclude the possibility that the nasotracheal tube may have moved when the aid was removed from the nasotracheal tube. Lastly, since it is not possible to distinguish whether the epistaxis was caused by the aid or the nasotracheal tube, it is not known which aid is less invasive.