title: The effect of nasotracheal intubation on the paranasal sinuses. A prospective study of 434 intensive care patients.
abstract: A total of 434 patients admitted to the intensive care unit for mechanical ventilation were followed prospectively to investigate the influence of a nasotracheal tube on the paranasal sinuses. Twenty-five patients died before the examination was completed. The rest were examined for clinical symptoms of sinusitis. If sinusitis was suspected or the patients were intubated for 5 days or more, an x-ray of the sinuses was performed. In patients intubated for less than 5 days (N = 357), sinusitis was clinically suspected in three, but radiographically verified in only one. In patients intubated for 5 days or more (N = 47), 23 (49%) had affection of the paranasal sinuses. Patients needing a nasotracheal tube should be examined for sinusitis if they are intubated for more than 5 days or if unexplained fever, sepsis or purulent nasal secretion develops. If the suspicion is confirmed, the nasotracheal tube should be removed.
authors.affiliation: Department of Anaesthesiology, University Hospital of Aarhus, Denmark.
authors.forename: J
authors.initials: J
authors.lastname: Pedersen
authors.forename: B A
authors.initials: BA
authors.lastname: Schurizek
authors.forename: N C
authors.initials: NC
authors.lastname: Melsen
authors.forename: B
authors.initials: B
authors.lastname: Juhl
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003422:Critical Care; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D010254:Paranasal Sinus Diseases / Q000453:epidemiology / Q000209:etiology*; D011446:Prospective Studies