Nasotracheal tube stenting by nelaton catheter in paediatric dental surgery

Background:

Nasotracheal intubation is associated with many complications such as epistaxis and nasal cavity injury. Stenting the endotracheal tube with appropriate sized nelaton catheter may decrease these complications. In this study we compared stenting the endotracheal tube by nelaton catheter with ordinary intubation technique.

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Methods:

Eighty paediatric patients who were scheduled for elective dental surgery (restoration surgery) were randomly divided into two groups according to the nasotracheal intubation technique. In the first group endotracheal tube was stented with appropriate size nelaton catheter which was removed immediately after tube passage to the oropharynx. In the second group nasotracheal intubation was done by the ordinary technique without tube stenting. Evaluation of the resistance during nasal intubation, incidence and severity of epistaxis and nasal cavity injury were done.

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Results:

Nasotracheal intubation was smooth in 80% of patients with stented tube compared to 40% in the non-stented tube. Epistaxis was found in 22.5% of patients with stented tubes compared to 85% of patients with non-stented tubes. Histopathology of tube contents after extubation showed blood cells in 32.5% in stented tubes and 92% in the non-stented ones. Adenoid tissue was found in5% of patients with stented tubes and 37.5% of patients with non-stented tubes.

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Conclusion:

Stenting the endotracheal tube with nelaton catheter facilitates nasotracheal intubation and decreases the incidence and severity of epistaxis and nasal cavity injury.