When the insertion of endotracheal tubes(ETTs) through the nostril, The tubemay be encountered some resistance. Forcing ETT into the nasal cavity develop mucosal and soft tissue injuries and subsequent epistaxis during passage of the tube even when vasoconstrictors and/or a lubricated tube are employed. Therefore, We determined whether balloon dilation technique(BDT) reduces the incidence of epistaxis and increases the ease of the tube advancement in the nasal cavity during nasotracheal intubation.

Sixty adult patients who scheduled for maxillofacial surgery were divided into two groups, BDT(n=30) and non BDT(n=30). The BDT group received an armored tube, which a 14 Fr-all-silicone Foley catheter insert through the tube, while non BDT group received a plain armored tube. All patients in both groups was inserted ETTs by conventional nasotracheal insertion techniques.

The BDT group had a signifieantly lower incidence of epistaxis(0/30 vs 8/30 : p<0.05) and provided a significantly easier passage in the nasal cavity than non BDT group (difficult tube advancement in the nasal cavity, 3/30 vs 17/30 : p<0.05).

The BDT helps to make an easy and smooth passage of the tube and to prevent epistaxis during nasotracheal tube insertion. This study indicates that nasotracheal intubation using BDT is an easily learned, safe, effective and atraumatic method.