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LETTER TO EDITOR
Year : 2010  |  Volume : 54  |  Issue : 1  |  Page : 74 Table of Contents     

Prevention of aspiration of nasopharyngeal airway


1 Staten Island University Hospital, New York, USA
2 Kings County Hospital, New York, USA

Date of Web Publication9-Mar-2010

Correspondence Address:
Paul J Grube
Department of Anesthesia, Staten Island University Hospital, Staten Island, NY 10305
USA
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0019-5049.60511

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How to cite this article:
Grube PJ, Fan D, Pothula VR, Vonfrolio CT, Tsang D, Hoffman D. Prevention of aspiration of nasopharyngeal airway. Indian J Anaesth 2010;54:74

How to cite this URL:
Grube PJ, Fan D, Pothula VR, Vonfrolio CT, Tsang D, Hoffman D. Prevention of aspiration of nasopharyngeal airway. Indian J Anaesth [serial online] 2010 [cited 2020 Mar 31];54:74. Available from: http://www.ijaweb.org/text.asp?2010/54/1/74/60511

Sir,

Nasopharyngeal airway (NPA) [Figure 1] is an airway accessory used to prevent upper airway obstruction by tongue and helps in nasotracheal suctioning. It is the least invasive method of safely managing upper airway obstruction. There are several cases of nasopharyngeal airway aspiration reported in literature. [1],[2],[3]

Although rare, NPA aspiration can occur. Several factors contribute to NPA aspiration. First, the NPA model can be very supple, lubricated and with a particularly thin flexible flange that is unable to stop distal migration once started. Second, the patient may have rubbed his/her nose briefly prior to the incident. This may initiate the event possibly combined with a more "nasal" breathing from maxillary occlusion to further advance airway. Finally, perhaps the nasal passage itself may have dilated somewhat from the more rigid nasotracheal tube used during surgery, thus facilitating passage of the airway that was of appropriate diameter and length.

NPA aspiration can be prevented by use of barriers to distal migration, safety pins and endotracheal tube connectors; placement of NPAs in the nasal passage opposite that used for intubation may also be of value. NPA aspiration can be prevented by encircling 1-cm wide elastopore tape at the proximal end of the nasopharyngeal airway and securing it to the external nose in the same way as a nasotracheal tube is secured [3],[4],[5]

 
   References Top

1.Milam MG, Miller KS. Aspiration of an artificial nasopharyngeal airway. Chest 1988;93:223-4.  Back to cited text no. 1  [PUBMED]    
2.Mobbs PA. Retained nasopharyngeal airway. Anesthesia 1989;44:447.  Back to cited text no. 2      
3.Yokoyama T, Yamashita K, Manabe M. Airway obstruction caused by nasal airway. Anesth Analg 2006;103:508-9.  Back to cited text no. 3  [PUBMED]    
4.Beattie C. The modified nasal trumpet maneuver. Anesth Analg 2002;94:467-9.  Back to cited text no. 4  [PUBMED]    
5.Mahajan R, Kumar S, Gupta R. Prevention of aspiration of nasopharyngeal airway. Anesth Analg 2007;104:1313.  Back to cited text no. 5  [PUBMED]    


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