Nasotracheal Intubation in Management of Delayed Decannulation

Abstract

Nasotracheal intubation was used in the attempted decannulation in eight cases of delayed decannulation. Radiological and endoscopic evaluation indicated that posterior displacement of the anterior tracheal wall above the tracheal stoma was the cause of the delay. In all cases, the tracheotomy cannula was removed under anesthesia and a nasotracheal tube was inserted temporarily. Good communication between surgical and anesthetic staff and the facilities of an intensive care unit were indispensable. Decannulation was achieved in six cases. Temporary nasotracheal intubation in patients with posterior displacement of the anterior tracheal wall will splint the wall until extubation is feasible.