Frederick Mihm, M.D.

Publication Details

  • Determination of the site of tracheal tube impingement during nasotracheal fibreoptic intubation ANAESTHESIA Marfin, A. G., Iqbal, R., Mihm, F., Popat, M. T., Scott, S. H., Pandit, J. J. 2006; 61 (7): 646-650


    This study examines the incidence and site of tracheal tube impingement during nasotracheal fibreoptic intubation, and the efficacy of anticlockwise tube rotation to overcome the problem. Forty-three patients underwent fibreoptic-assisted nasotracheal intubation using a preformed nasal tube, and a second fibrescope was used to observe any obstruction to passage of the tracheal tube. Impingement occurred in 10 cases, with the most common site being the right arytenoid cartilage. Rotation resulted in successful intubation in all 10 cases, but proximal rotation did not always result in an equal degree of rotation at the tube tip. We conclude that the site of impingement for nasotracheal intubation with preformed nasal tubes is located at the posterior structures of the laryngeal inlet and that anticlockwise rotation is a simple and effective solution.

    View details for DOI 10.1111/j.1365-2044.2006.04652.x

    View details for Web of Science ID 000238914200005

    View details for PubMedID 16792609

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