Clinical Application of Nasotracheal Intubation: A Narrative Review

Nasotracheal intubation is commonly used in clinical practice for procedures requiring general anesthesia, mechanical ventilation, and emergency treatment of critically ill patients. It provides a good surgical field and operating space for maxillofacial surgeries, offers an artificial airway for long-term mechanically ventilated patients in the intensive care unit, and presents a new method for emergency and difficult airway intubation patients. Compared to orotracheal intubation, nasotracheal intubation has advantages such as minimal stimulation to the throat, good patient tolerance, easy fixation, facilitation of oral care, and longer duration of placement. However, it requires higher technical skill from the operator and has a higher incidence of complications like epistaxis and sinusitis, which have restricted its widespread application. From the early blind intubation method to the current direct laryngoscopy, video laryngoscopy, and fiberoptic bronchoscopy, the success rate of nasotracheal intubation has gradually increased while the incidence of complications has decreased. In this review article, we summarize the common methods, advantages and disadvantages of nasotracheal intubation, as well as the research progress on related complications and coping strategies, aiming to enhance the application of this technology in clinical practice.