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Usefulness of lateral cephalometric radiography for successful blind nasal intubation: a prospective study

Authors
  • Ito, Kana1, 1
  • Kamura, Ayaka1
  • Koshika, Kyotaro1
  • Handa, Toshiyuki1
  • Matsuura, Nobuyuki1
  • Ichinohe, Tatsuya1
  • 1 . , (Japan)
Type
Published Article
Journal
Journal of Dental Anesthesia and Pain Medicine
Publisher
The Korean Dental Society of Anesthsiology
Publication Date
Nov 24, 2022
Volume
22
Issue
6
Pages
427–435
Identifiers
DOI: 10.17245/jdapm.2022.22.6.427
PMID: 36601136
PMCID: PMC9763822
Source
PubMed Central
Keywords
Disciplines
  • Original Article
License
Unknown

Abstract

Background This study aimed to investigate the relationship between pharyngeal morphology and the success or failure of blind nasotracheal intubation using standard lateral cephalometric radiography and to analyze the measurement items affecting the difficulty of blind nasotracheal intubation. Methods Assuming a line perpendicular to the Frankfort horizontal (FH) plane, the reference point (O) was selected 1 cm above the posterior-most end of the hard palate. A line passing through the reference point and parallel to the FH plane is defined as the X-axis, and a line passing through the reference point and perpendicular to the X-axis is defined as the Y-axis. The shortest length between the tip of the uvula and posterior pharyngeal wall (AW), shortest length between the base of the tongue and posterior pharyngeal wall (BW), and width of the glottis (CW) were measured. The midpoints of the lines representing each width are defined as points A, B, and C, and the X and Y coordinates of each point are obtained (AX, BX, CX, AY, BY, and CY). For each measurement, a t-test was performed to compare the tracheal intubation success and failure groups. A binomial logistic regression analysis was performed using clinically relevant items. Results The items significantly affecting the success rate of blind nasotracheal intubation included the difference in X coordinates at points A and C (Odds ratio, 0.714; P-value, 0.024) and the ∠ABC (Odds ratio, 1.178; P-value, 0.016). Conclusion Using binomial logistic regression analysis, we observed statistically significant differences in AX-CX and ∠ABC between the success group and the failure group.

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