Retropharyngeal submucosal dissection due to nasotracheal intubation
N. Bozdogan*, M. Sener*, H. Yavuz**, C. Yilmazer**, A. Turkoz* and G. Arslan*
*Department of Anesthesiology and Reanimation, **Department of Otolaryngology Head and Neck Surgery, Baskent University Faculty of Medicine, Ankara, Turkey
Nasotracheal intubation; complication; retropharyngeal dissection; submucosal channel; vertical incision
179 - 181
Retropharyngeal submucosal dissection due to nasotracheal intubation (Case report). Problem: Nasal intuba- tion is used often by anaesthetists because it offers many advantages; however, rare complications do arise. A 67-year- old man was admitted to our otorhinolaryngology clinic for uvulopalatopharyngoplasty. Nasotracheal intubation was performed without difficulty. At the beginning of surgery, the surgeon noticed that the nasotracheal tube had penetrated the oropharyngeal mucosa through a channel in the retropharyngeal space. Methodology: The tube was left in place during surgery to prevent bleeding. After surgery, a vertical incision was made through the mucosa surrounding the tube from the inferior pouch up to the nasopharynx to prevent hematoma. Result: The patient was extubated without complication and discharged on the second day postoperative. The oropharyn- geal mucosa was healed by the 15th day postoperative. Conclusion: Nasal intubation tubes should be lubricated and inserted without force; the oropharynx should be examined carefully after intubation to rule out complications.
Vol. 4, 2008, 3rd trimester

Retropharyngeal submucosal dissection due to nasotracheal intubation