New Device for Securing Nasotracheal Intubation Tube During Oral and Maxillofacial Surgery.

Abstract

Since 2018, we have been using a 3D printer to fabricate a proprietary device for fixing nasotracheal tubes. The aim of this retrospective study was to investigate the impact of this nasotracheal intubation (NTI) fixation device. It has been used in 335 patients undergoing general anesthesia for oral and maxillofacial surgeries. No necrosis or permanent tissue damage was observed, and none of the patients developed complications requiring treatment. No unintentional tube-related incidents such as extubation, dislocation of the tube, or disconnection between the tube and the artificial respiration circuit occurred either. This fixation device offers three advantages: safety, no impediment to surgery, and minimal invasiveness. Of these, safety is the most important. The high degree of immobilization it offers makes it possible to prevent injury to the nasal ala when the tracheal tube is tugged to the cranial side. There is also a high degree of immobilization at the connection site between the tracheal tube and anesthesia circuit, making it possible to prevent disconnection due to intraoperative pressure. In addition, safety during fixation is less likely to differ depending on the degree of proficiency of the individual anesthesiologist. The presence of a groove through which the sampling tube of the capnometer can be passed makes it possible to prevent the problem of flexion of the sampling tube, rendering detection impossible during surgery. Thus, use of this fixation device offers the potential to improve immobilization of the tracheal tube and increase intraoperative safety. However, there remain several problems that need to be addressed with this novel device. Further improvements aimed at enhancing safety are planned, therefore.