title: Reliability of assessment of nasal flow rate for nostril selection during nasotracheal intubation.
abstract: OBJECTIVE
  To evaluate the reliability of assessments of nasal flow rate for improved nostril selection for nasotracheal intubation.
  
  
  METHODS
  Prospective, randomized, double-blinded study.
  
  
  METHODS
  Operating room of a university-affiliated hospital.
  
  
  METHODS
  118 ASA physical status 1 and 2 patients, aged 18-65 years, scheduled for elective maxillofacial and oral surgery requiring nasotracheal intubation.
  
  
  METHODS
  Patients were randomized to the left or right nostril groups. Forced vital capacity (FVC) and forced expiratory volume in one second (FEV(1)) through the mouth and each nostril were measured before anesthesia induction.
  
  
  METHODS
  The relationship between the rate of airflow through the selected nostril and frequency of epistaxis and navigability of the nasotracheal tube were evaluated.
  
  
  RESULTS
  There were no significant differences in the frequency of epistaxis and degree of navigability of the tracheal tube between the left and right nostril groups. In both nostril groups, patients who suffered epistaxis showed significantly less FEV(1) and FEV(1)/FVC values than did patients without epistaxis (P < 0.05). In addition, in both groups patients who passed the tube easily showed significantly higher FEV(1) and FEV(1)/FVC values than did patients who passed the tube with resistance or failed tube passage (P < 0.05).
  
  
  CONCLUSIONS
  Measurement of nasal flow rate is a useful clinical method for choosing a nostril for nasotracheal intubation.
authors.affiliation: Department of Anesthesiology and Pain Medicine, and Institute of Clinical Research, Chonbuk National University Medical School and Hospital, Jeonju, Jeonbuk 561-712, Republic of Korea.
authors.forename: Hyung-Sun
authors.initials: HS
authors.lastname: Lim
authors.forename: Deokkyu
authors.initials: D
authors.lastname: Kim
authors.forename: Jeongwoo
authors.initials: J
authors.lastname: Lee
authors.forename: Ji-Seon
authors.initials: JS
authors.lastname: Son
authors.forename: Jun-Rae
authors.initials: JR
authors.lastname: Lee
authors.forename: Seonghoon
authors.initials: S
authors.lastname: Ko
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000768:Anesthesia, General / Q000379:methods; D004311:Double-Blind Method; D004844:Epistaxis / Q000209:etiology; D005260:Female; D005541:Forced Expiratory Volume / Q000502:physiology; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009296:Nasal Cavity / Q000502:physiology*; D019647:Oral Surgical Procedures; D011446:Prospective Studies; D014797:Vital Capacity / Q000502:physiology; D055815:Young Adult