Epistaxis during nasotracheal intubation: a comparison of nostril sides

Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons
Takuro SanukiJunichiro Kotani

Abstract

It is commonly believed that for preventing epistaxis during nasotracheal intubation (NTI), the right nostril should be used. However, there is no real evidence as to which nostril should be used. In this study, we tested our hypothesis that epistaxis during NTI is more frequent and severe using the left nostril rather than the right, provided that patency appears equal on both sides of the nose. A total of 54 patients who were scheduled for elective oral surgery, in which NTI was indicated to optimize the surgical approach, were recruited into this study. The nostril used for NTI was chosen randomly. Epistaxis occurred significantly more frequently (44.4%) when the left nostril was used for NTI than when the right nostril was used (11.1%; P = .014). Although there were no statistical differences in the incidence of mild epistaxis between the 2 nostrils (P = .467), severe epistaxis was significant more frequent with the left (22.2%) than with the right nostril (0.0%; P < .023). Our data show that epistaxis during NTI is more frequent and severe with the left nostril than the right. Hence, when deciding which nostril to use for NTI, the right nostril should be used if patency appears equal on both sides of the nose.

References

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Jul 21, 2009·Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons·Takuro SanukiJunichiro Kotani

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Citations

May 23, 2012·Journal of Clinical Anesthesia·Hyung-Sun LimSeonghoon Ko
Jul 20, 2016·Journal of the Korean Association of Oral and Maxillofacial Surgeons·Ravi Raja KumarAuswaf Ahsan
Jan 20, 2018·Journal of Dental Anesthesia and Pain Medicine·Hyuk KimKwang-Suk Seo
Jun 1, 2016·Journal of Dental Anesthesia and Pain Medicine·Seong In ChiKwang-Suk Seo
Aug 30, 2018·Anesthesiology Research and Practice·Cattleya ThongrongPornthep Kasemsiri
Oct 4, 2020·European Journal of Anaesthesiology·Dongwook WonTae Kyong Kim
Nov 17, 2020·Journal of Dental Anesthesia and Pain Medicine·Seung-Hyun RheeKwang-Suk Seo
Jan 23, 2021·The Journal of Craniofacial Surgery·Juan Pablo Alister HerdenerRodrigo Fariña

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