Air leakage due to the cuff hanging on the vocal cords during nasotracheal intubation: a case report
유승화, 감명환, 박세웅, 김현정, 서광석,
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유승화 ( Ryoo Seung-Hwa ) - Seoul National University School of Dentistry Department of Dental Anesthesiology
감명환 ( Karm Myong-Hwan ) - Seoul National University School of Dentistry Department of Dental Anesthesiology
박세웅 ( Park Se-Ung ) - Seoul National University Dental Hospital Department of Dental Anesthesiology
김현정 ( Kim Hyun-Jeong ) - Seoul National University School of Dentistry Department of Dental Anesthesiology
서광석 ( Seo Kwang-Suk ) - Seoul National University School of Dentistry Department of Dental Anesthesiology
Abstract
Nasotracheal intubation is commonly performed under general anesthesia in oral and maxillofacial surgery. For the convenience of surgery, nasal Ring-Adair-Elwyn (RAE) tubes are mainly used. Because the nasal RAE tubes were bent in an “L” shape, the insertion depth was limited. Particularly, it is necessary to accurately determine the appropriate depth of the RAE tubes in children. Several types of nasal RAE tubes are used in the medical market, which vary in material and length. We performed endotracheal intubation using a nasal RAE tube for double-jaw surgery, but air leakage persisted even when the air pressure in the cuff was increased. When checked with a laryngoscope, it was confirmed that the tube was pushed out, and the cuff was caught on the vocal cords, causing air leakage. Since inserting the tube deeply did not solve the problem, replacing it with a nasal RAE tube (Polar™, Preformed Tracheal Tube, Smith Medical, Inc., USA) did not cause air leakage; thus, we reported this case.
키워드
Cuff Leak; Intubation; Nasotracheal; Oral and Maxillofacial Surgery; Ring?Adair?Elwyn Tube; Vocal
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