Microlaryngeal Tube PVC Cuff

About Microlaryngeal Tube PVC Cuff

Intubation with north pole endotracheal tube is done in patients planned for oral surgery. The common indication for this being, oral cancer and facial fracture requiring intermaxillary fixation. Most of these patients fall in the category of difficult intubation and hence difficult extubation. Problem during extubation is further accentuated because of edema in and around the surgical field. There are chances of bleeding into the airway at the time of extubation as well. We expect upper airway obstruction during extubation in these patients.

We, at our institution withdraw the north pole tube and leave a measured length (from tip of the nose to ear lobule) in situ. This serve many purpose.1. North pole tube at this point of time, becomes a nasopharyngeal airway with gas monitoring. Oxygen delivery is better, as we can deliver very high FiO2 directly into the oropharynx.2. If there is bleeding into the airway requiring reintubation, the same tube can be advanced into the trachea.3. At the time of shifting to the recovery room, machine end of the tube is cut near the nostril and left in situ, till the patient is fully awake.

By using this technique, we can avoid the complications associated with nasopharyngeal airway insertion in this subgroup of patients. At the same time, we have better control of situation at the time of extubation by adequate monitoring (capnograph) and better oxygen supplementation.