{"title":"血凝块阻塞鼻气管,危及生命:病例报告。","authors":"Dajeong Lee, Chan Yong Park, Sang Wha Kim","doi":"10.20408/jti.2023.0084","DOIUrl":null,"url":null,"abstract":"<p><p>The nasotracheal tube (NTT) is frequently used in oral and maxillofacial surgery and is generally considered a safe means of protecting the airway while ensuring an adequate surgical field. The most common complication associated with NTT is epistaxis, and only a few cases of foreign body obstruction have been reported. In this case report, the authors aimed to highlight the potential for NTT obstruction following surgery. A 24-year-old female patient, who underwent mandibuloplasty and rhinoplasty at a local clinic, was referred to our hospital patient due to dyspnea and edema on her right mandibular angle. Even with NTT, patient continued to experience mild dyspnea and tachypnea, so a T-piece was applied. However, tachycardia accompanied by a sudden worsening of dyspnea was observed, and bag-valve-mask ventilation was initiated promptly. But oxygen saturation remained unimproved, so an emergency cricothyroidotomy was performed. After 4 hours, the patient's condition stabilized. Upon examination, the previously inserted NTT was identified, and a blood clot approximately 10 cm long at the NTT tip was discovered, causing lumen obstruction. The obstructions of NTT can lead to serious or life-threatening consequences if left unobserved or ignored. Therefore, when a patient with an NTT complains of dyspnea, clinicians should promptly investigate the possibility of partial NTT obstruction to ensure the airway's security.</p>","PeriodicalId":52698,"journal":{"name":"Journal of Trauma and Injury","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11495948/pdf/","citationCount":"0","resultStr":"{\"title\":\"Life-threatening nasotracheal tube obstruction by a blood clot: a case report.\",\"authors\":\"Dajeong Lee, Chan Yong Park, Sang Wha Kim\",\"doi\":\"10.20408/jti.2023.0084\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>The nasotracheal tube (NTT) is frequently used in oral and maxillofacial surgery and is generally considered a safe means of protecting the airway while ensuring an adequate surgical field. The most common complication associated with NTT is epistaxis, and only a few cases of foreign body obstruction have been reported. In this case report, the authors aimed to highlight the potential for NTT obstruction following surgery. A 24-year-old female patient, who underwent mandibuloplasty and rhinoplasty at a local clinic, was referred to our hospital patient due to dyspnea and edema on her right mandibular angle. Even with NTT, patient continued to experience mild dyspnea and tachypnea, so a T-piece was applied. However, tachycardia accompanied by a sudden worsening of dyspnea was observed, and bag-valve-mask ventilation was initiated promptly. But oxygen saturation remained unimproved, so an emergency cricothyroidotomy was performed. After 4 hours, the patient's condition stabilized. Upon examination, the previously inserted NTT was identified, and a blood clot approximately 10 cm long at the NTT tip was discovered, causing lumen obstruction. The obstructions of NTT can lead to serious or life-threatening consequences if left unobserved or ignored. Therefore, when a patient with an NTT complains of dyspnea, clinicians should promptly investigate the possibility of partial NTT obstruction to ensure the airway's security.</p>\",\"PeriodicalId\":52698,\"journal\":{\"name\":\"Journal of Trauma and Injury\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11495948/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Trauma and Injury\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.20408/jti.2023.0084\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/9/3 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Trauma and Injury","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.20408/jti.2023.0084","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/9/3 0:00:00","PubModel":"Epub","JCR":"","JCRName":"","Score":null,"Total":0}
Life-threatening nasotracheal tube obstruction by a blood clot: a case report.
The nasotracheal tube (NTT) is frequently used in oral and maxillofacial surgery and is generally considered a safe means of protecting the airway while ensuring an adequate surgical field. The most common complication associated with NTT is epistaxis, and only a few cases of foreign body obstruction have been reported. In this case report, the authors aimed to highlight the potential for NTT obstruction following surgery. A 24-year-old female patient, who underwent mandibuloplasty and rhinoplasty at a local clinic, was referred to our hospital patient due to dyspnea and edema on her right mandibular angle. Even with NTT, patient continued to experience mild dyspnea and tachypnea, so a T-piece was applied. However, tachycardia accompanied by a sudden worsening of dyspnea was observed, and bag-valve-mask ventilation was initiated promptly. But oxygen saturation remained unimproved, so an emergency cricothyroidotomy was performed. After 4 hours, the patient's condition stabilized. Upon examination, the previously inserted NTT was identified, and a blood clot approximately 10 cm long at the NTT tip was discovered, causing lumen obstruction. The obstructions of NTT can lead to serious or life-threatening consequences if left unobserved or ignored. Therefore, when a patient with an NTT complains of dyspnea, clinicians should promptly investigate the possibility of partial NTT obstruction to ensure the airway's security.