Abstract
Nasal bridle is a feeding tube retaining device that is now increasingly used worldwide. While common complications tend to be minor, it is important to remain vigilant for newer adverse events. We hereby delineate the case of an elderly female who required nasoenteric feeding tube following simultaneous liver-kidney transplantation. Nasal bridle placement was warranted owing to her significant frailty and poor mentation. Due to her extreme agitation during the procedure, bridle insertion could not be completed. Upon removal of the probe, unprompted detachment of the magnetic tip was noted. Radiological workup revealed the dislodged magnet in the sphenoid sinus. Subsequently, she underwent an uneventful endoscopic sinus surgery, resulting in successful retrieval of the magnet. This paper highlights the spontaneous magnet avulsion from a bridling system and serves the purpose of community awareness regarding this unusual procedural complication. Additionally, we aim to evaluate the efficacy of the nasal bridle, further accentuating its advantages and possible complications.
Highlights
In 1980, McGuirt and Strout first described securing nasoenteric tubes by employing a nasal bridle [1]
We describe an unusual complication pertaining to spontaneous magnet detachment from the probe of a nasal bridle, requiring a subsequent sinus surgery for its removal
These protocols primarily outline the indications for bridle placement, such as the frequency of feeding tube dislodgement, further positing that bridle placement must be considered in patients who have pulled out the nasoenteric tube at least three times within one week
Summary
In 1980, McGuirt and Strout first described securing nasoenteric tubes by employing a nasal bridle [1]. Gunn et al modified the retaining device by introducing a magnetic system along with 1/8-inch umbilical tape [2]. The bridle is inserted using magnets attached to the distal ends of the catheter and probe. After inserting the catheter into one nostril and the probe into the other, the magnets come in contact posterior to the vomer bone, forming a loop or ‘’bridle’’ of tape around the bone. The ends of a feeding tube are securely connected with the tape. This device has been used to maintain the short-term nutrition supplementation in patients who are at risk for accidental dislodgement of the standard nasoenteric tubes
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