title: A new technique to reduce epistaxis and enhance navigability during nasotracheal intubation.
abstract: BACKGROUND
  Epistaxis is the most common complication of nasotracheal intubation. We compared endotracheal tubes (ETT) obturated with an inflated esophageal stethoscope with normal ETTs with regard to the prevention of epistaxis and navigability, both with and without thermosoftening.
  
  
  METHODS
  Dental surgical patients requiring nasotracheal intubation were randomly allocated into 1 of 4 groups (n = 50 each): Group 1, nonthermosoftened ETTs; Group 2, nonthermosoftened ETTs obturated with an inflated esophageal stethoscope; Group 3, thermosoftened ETTs; and Group 4, thermosoftened ETTs obturated with an inflated esophageal stethoscope. Navigability of ETTs through the nasal cavity and postintubation epistaxis were evaluated.
  
  
  RESULTS
  Navigability of ETTs through the nasal cavity was the worst in Group 1 (P = 0.001). Epistaxis was the most severe in Group 1, similar between Groups 2 and 3, and the least severe in Group 4 (P < 0.001).
  
  
  CONCLUSIONS
  The use of esophageal stethoscope-obturated ETTs was effective, and comparable to thermosoftening, in preventing epistaxis associated with nasotracheal intubation. Thermosoftened, obturated ETTs were more effective than simple thermosoftened ETTs in reducing epistaxis.
authors.affiliation: Department of Dental Anesthesiology and Dental Research Institute, Seoul National University School of Dentistry, Seoul, Korea.
authors.forename: Kwang Suk
authors.initials: KS
authors.lastname: Seo
authors.forename: Jae-Hun
authors.initials: JH
authors.lastname: Kim
authors.forename: Sol Mon
authors.initials: SM
authors.lastname: Yang
authors.forename: Hyun Jeong
authors.initials: HJ
authors.lastname: Kim
authors.forename: Jae-Hyon
authors.initials: JH
authors.lastname: Bahk
authors.forename: Kwang Won
authors.initials: KW
authors.lastname: Yum
mesh_terms: D000328:Adult; D004844:Epistaxis / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects* / Q000295:instrumentation* / Q000379:methods; D008297:Male; D008875:Middle Aged; D009296:Nasal Cavity / Q000502:physiology; D019023:Stethoscopes