Modified glove fingers as an aid for safely navigating endotracheal tube through the nasal cavity and nasopharynx in difficult nasotracheal intubation

Abstract

A young female patient scheduled for orthognathic surgery under general anesthesia encountered obstacles during nasotracheal intubation in which the cuff of the nasal endotracheal tube was linearly lacerated and the tube tip impacted against the retropharyngeal wall. Repeated episodes of the event happened rendering the intubation unsuccessful. A technique using modified glove fingers was applied, which successfully protected the cuff from shearing by the sharp nasal crista and redirected the tube tip away from the retropharyngeal wall. It is a simple and applicable technique during nasotracheal intubation to prevent cuff damage and potential retropharyngeal dissection.