Abstract

The goal of endotracheal intubation during oral and maxillofacial surgery procedures is to provide safe and effective ventilatory support for the administration of the anesthetic gases. However, intraoperative movement of the endotracheal tube can be responsible for potentially serious complications. ’ Movement of the tube and cuff against the nasal, tracheal, laryngeal, or vocal cord mucosa during repositioning of the head may create trauma to tissue with resultant edema, laceration, ulceration, and possible extubation. Toung* has demonstrated that the tip of a secured endotracheal tube can move as much as 2.2 cm during flexion and extension of the neck. Movement can also cause separation of the endotracheal tube from the nasal connector beneath the head drape and pressure necrosis of the nasal tip or forehead skin (Figs. I, 2). Several innovative ideas and instruments’* have been designed to reduce the risk of these complica-

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