• Kishiko Nakai, Masatoh Kitayama, Hidetomo Niwa, Eiji Hashiba, Morito Wada, and Kazuyoshi Hirota.
• Department of Anesthesiology, Hirosaki University Graduate School of Medicine, Hirosaki 036-8563.
• Masui. 2010 Oct 1;59(10):1315-7.

AbstractWe report a case of surgical vertical-section of the nasoendotracheal tube during operation, resulting in intra-operative ventilatory difficulties. The patient was a 32-year-old female, scheduled for Maxillo-Mandibular osteotomy under general anesthesia. She was intubated with I.D. 6.0 mm non-kinking tube via left nasal cavity. Forty minutes into a maxillar osteotomy, sudden tracheal tube leak sound was noticed by surgeon. Ten more minutes later, ventilation became difficult, and laryngeal packing was done temporarily. We tried to exchange the nasotracheal tube with Airway Scope, but not with endotracheal tube exchanger, because there was a possibility of complete tube section or difficult extubation from nasal cavity. We could examine the larynx whether it was with edema or not, and two tracheal tubes at the same time. Therefore, we performed tube exchange smoothly and safely. The extubated tracheal tube had serious cut on cuff inflation line made by surgical maneuver. In the case of suspected laryngeal edema or tracheal tube injury, use of Airway Scope for tube exchange may be a safe and reliable method.

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