Computed Tomography-Guided Nasotracheal Intubation Procedure

Background: Nasotracheal intubation can lead to severe complications like epistaxis with excessive bleeding. The advancement difficulty of the tube faced during nasal intubation is one of the fundamental causes of this condition. The present study aimed to evaluate the effectiveness of Computed tomography-guided nasotracheal intubation in predicting tube advancement difficulty and preventing epistaxis.

Material and Methods: 60 maxillofacial surgery patients were included in the study. The space where the tube will be passed in the internal nasal valve region was measured horizontally (distance between inferior concha and septum) and vertically (distance between inferior concha and hard palate) by Computed Tomography. The patients were divided into two groups, 'easy' (n=28) or 'difficult' (n=32), according to the effort required to advance the tube through the nasal passage.

ROC analysis was performed, and cut-off values were determined to reveal the distance values at which difficulty may be experienced while advancing the tube. The cut-off values were 1.09 cm and 0.39 cm for the vertically and horizontally distances, respectively.

Completed

Looking for future studies?

Notify Me

Key information

Conditions

Computed Tomography-guided Nasotracheal Intubation Epistaxis Hemorrhage Nose Diseases Otorhinolaryngologic Diseases Pathologic Processes Pathological Conditions, Signs and Symptoms Respiratory Tract Diseases Signs and Symptoms Signs and Symptoms, Respiratory The Space Where the Tube Will be Passed in the Internal Nasal Valve Region

Age range

18 year–65 year

Sex eligibility

All sexes

Study type

Observational

Primary location

SEHER Orbay Yaşlı

Kayseri, 38039, Turkey (Türkiye)

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

Aged 18 to 65 who underwent bimaxillary orthognathic surgery
defined as ASA (American Society of Anesthesiology) I or II

Exclusion criteria

The lack of preoperative CT scans
airways evaluated and considered difficult by the anesthesiologist
airways assessed and considered not appropriate for right angle endotracheal (RAE) tube with7.0 mm internal diameter
history of sinusitis or head trauma
anticoagulant therapy

Treatment and study plan

computed tomography-guided nasotracheal intubation

Procedure

Before intubation, the lower part of the nasal valve region, aka the narrowest area of the nasal passage, was measured by calculating the distance between the anterior border of the inferior concha and the septal cartilage

Primary outcomes

Investigation of the relationship between internal nasal valve measurements and nasal advancement of the intubation tube

Time frame: during intubation procedure

The measurements were carried out from the coronal sections at 0.25 intervals. Before intubation, the lower part of the nasal valve region, aka the narrowest area of the nasal passage, was measured by calculating the distance between the anterior border of the inferior concha and the septal cartilage. Additionally, using the same section of the CT image, the distance between the inferior concha and the hard palate was measured

Sponsors and collaborators

Lead sponsor

TC Erciyes University

Other

Registry information

Official study title

Effectiveness of Computed Tomography-Guided Nasotracheal Intubation Procedure on Predicting Tube Advancement Difficulty and Preventing Epistaxis: A Prospective Case-control Study

Important dates

Study start: 2019
Primary completion: 2021
Study completion: 2022
First posted: Sep 2, 2022
Registry last updated: Sep 2, 2022

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

Published trials that share one or more normalized conditions with this study.

Completed