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Nasotracheal Intubation with Parker Flex-Tip Versus Preformed Nasal Endotracheal Tubes for Children Undergoing Adenotonsillectomy.

Abstract
The design of the endotracheal tube might be an important factor in the incidence of injurious complications during nasotracheal intubation.


Aim of the work
Primary aim: to compare the parker flex tip (PFT) and the preformed nasal
(PNT) tubes regarding the ease of insertion during nasotracheal intubation in children undergoing
adenotonsillectomy. Secondary aim: to verify the incidence of traumatic complications of both
types of tubes during nasotracheal intubation in children undergoing adenotonsillectomy.


Patients and methods
100 patients aged between 4 and 10 years ASA physical status I-II
scheduled for adenotonsillectomy were divided into two groups; Group PFT: Patients were nasally
intubated using the parker flex-tip endotracheal tube, Group PNT: Patients were nasally intubated
using the preformed nasal tube. Ease of insertion of the ETT, degree of trauma and the time of
intubation was measured.


Results
ETT was easily inserted without any resistance in 24% of patients of the PFT group
versus 12% of patients in the PNT group. ETT could not be passed through the right or left nostrils
in 20% of patients of the PNT group relative to only 4% of patients of the PFT group. Incidence of
trauma to the nasal mucosa was significantly higher in patients of the PNT group than patients of
the PFT group. Duration of intubation was statistically significantly longer among patients of the
PNT group than patients of the PFT group.


Conclusions
It seems that the flexible tapered tip of the PFT tube has led to easier
insertion through the nasal passages as well as less trauma to the nasal mucosa in children having
nasopharyngeal pathology in the form of adenoids. At the same time, the duration of intubation was
less in the PFT group relative to the control group in spite of the more familiarity of the investigator
with the standard portex tube.