Semirigid Cervical Collar and Nasotracheal Intubation by Glidescope in Cervical Spine Surgery

Clinically used cervical orthoses can effectively limit cervical spine motion in all direction and provide protection. Among them, the restriction by Miami semirigid collar was superior, with the least tissue-interface pressure of neck. It is one of the most used semirigid collars for patients' protection in the operating theatre. However, the presence of the semirigid collar was shown to result in a poorer view at laryngoscopy, possibly due to a reduction in mouth opening. Nasotracheal intubation is sometimes applied in cervical spinal surgeries for those receiving anterior approach for a higher cervical spine (C3) level, and/ or combined with a short neck, or due to surgeon's preference. Glidescope minimizes cervical movements during laryngoscopy, facilitates nasotracheal intubation than direct laryngoscopy and requires less technical skill than fiberoptic tracheal intubation. The investigation was to assess the effect of cervical collar on nasotracheal intubation and potential hazard factors of prolonged time for nasotracheal intubation with Gildescope in patients scheduled for elective cervical spinal surgery.

Inclusion criteria

• elective cervical spine surgery
• scheduled for nasotracheal intubation
• not requiring orthosis for prophylactic protection

Exclusion criteria

• Risk of pulmonary aspiration of gastric contents
• Pathology of the nasal cavity
• Abnormal coagulation function
• Extensive and severe cord compression
• Refused to sign informed consent.