O'Connell J E, Stevenson D S, Stokes M A
City Hospital NHS Trust, Birmingham.
Anaesthesia. 1996 Apr;51(4):347-50. doi: 10.1111/j.1365-2044.1996.tb07746.x.
In order to define the incidence and anatomical site of nasal damage following nasotracheal intubation, we investigated 100 consecutive patients undergoing dental extractions under general anaesthesia. Patients were questioned pre-operatively about the physiological function of their noses and examined by anterior rhinoscopy for anatomical abnormalities. Examinations were repeated postoperatively, looking specifically for haemorrhage, mucosal tears and septal and turbinate disruption. Minor bruising was common (54%) and most frequently involved mucosa overlying the inferior turbinate and adjacent septum. In two cases bruising involved the middle turbinate. There was no relationship between the number of attempts at intubation and subsequent damage. Pre-operative otolaryngological assessment failed to identify those patients who subsequently proved difficult or impossible to intubate nasally and incorrectly predicted difficulty in 11 patients who had pre-existing deviation of the nasal septum. In conclusion, short-term nasotracheal intubation was not associated with significant nasal morbidity, and pre-operative anatomical assessment failed to identify those in whom nasal intubation proved difficult or impossible.
为了确定经鼻气管插管后鼻损伤的发生率及解剖部位，我们对100例连续接受全身麻醉下拔牙手术的患者进行了调查。术前询问患者鼻子的生理功能，并通过前鼻镜检查有无解剖异常。术后再次进行检查，特别留意出血、黏膜撕裂以及鼻中隔和鼻甲的损伤情况。轻微瘀斑很常见（54%），最常累及下鼻甲及相邻鼻中隔表面的黏膜。有两例瘀斑累及中鼻甲。插管尝试次数与后续损伤之间没有关联。术前耳鼻喉科评估未能识别出那些后来经证实经鼻插管困难或无法插管的患者，并且错误地预测了11例已有鼻中隔偏曲患者的插管困难情况。总之，短期经鼻气管插管与显著的鼻部并发症无关，术前解剖评估未能识别出经鼻插管困难或无法插管的患者。
