PDF(Pubmed)
Abstract：
Nasotracheal intubation (NTI) plays an important role in pediatric airway management, offering advantages in specific situations, such as oral and maxillofacial surgery and situations requiring stable tube positioning. However, compared to adults, NTI in children presents unique challenges owing to anatomical differences and limited space. This limited space, in combination with a large tongue and short mandible, along with large tonsils and adenoids, can complicate intubation. Owing to the short tracheal length in pediatric patients, it is crucial to place the tube at the correct depth to prevent it from being displaced due to neck movements, and causing injury to the glottis. The equipment used for NTI includes different tube types, direct laryngoscopy vs. video laryngoscopy, and fiberoptic bronchoscopy. Considering pediatric anatomy, the advantages of video laryngoscopy have been questioned. Studies comparing different techniques have provided insights into their efficacy. Determining the appropriate size and depth of nasotracheal tubes for pediatric patients remains a challenge. Various formulas based on age, weight, and height have been explored, including the recommendation of depth-mark-based NTI. This review provides a comprehensive overview of NTI in pediatric patients, including the relevant anatomy, equipment, clinical judgment, and possible complications.
摘要：
经鼻气管插管(NTI)在小儿气道管理中起着重要作用,在特定情况下提供优势，如口腔颌面手术和需要稳定的管定位的情况。然而,与成年人相比，由于解剖差异和有限的空间，儿童NTI提出了独特的挑战。这个有限的空间，结合大舌头和短下颌骨，以及大扁桃体和腺样体，会使插管复杂化。由于儿科患者的气管长度短，将管子放置在正确的深度是至关重要的，以防止它由于颈部运动而移位，对声门造成伤害.用于NTI的设备包括不同的管类型，直接喉镜与视频喉镜,和纤维支气管镜检查.考虑到儿科解剖学，视频喉镜的优势受到质疑。比较不同技术的研究提供了对其功效的见解。确定适合儿科患者的鼻气管导管的适当尺寸和深度仍然是一个挑战。基于年龄的各种公式，体重,高度已经被探索过了，包括基于深度标记的NTI的建议。这篇综述提供了儿科患者NTI的全面概述，包括相关的解剖学，设备,临床判断,和可能的并发症。
