Video Laryngoscope Improves Nasotracheal Intubation in Maxillofacial Surgery: A Randomized Clinical Trial

<strong>Objectives</strong> Nasotracheal intubation may be required to secure the airway in oral and maxillofacial surgery. This study was aimed to evaluate the effectiveness of the video laryngoscope compared to the Macintosh laryngoscope in nasotracheal intubation for maxillofacial surgery. <strong>Materials and Methods </strong> We performed a randomized trials which compared the video laryngoscope with the Macintosh laryngoscope for nasotracheal intubation in the adult population. Patients were randomised to nasotracheal intubation by direct laryngoscopy using the Macintosh laryngoscope (Group M) or the video laryngoscopy (Group V). To compare the two groups, we used the modified nasotracheal intubation difficulty scale (NIDS), the evaluation of the three steps of nasotracheal intubation, the Cormack and Lehane score, the glottic opening percentage scale (POGO) and noticed the complications in each group. <strong>Results </strong> We studied 62 patients (31 patients per group). The total duration of intubation, oropharynx-glottis time, and glottis-trachea time were significatively lower for group V (p = 0.001, p = 0.007, and p=0.008 respectively). We also found a significant difference between the 2 groups on the NIDS (p=0.001, higher score in group M), the POGO with (p=0.002, lower in group M), the Cormack and Lehane score (p=0.034, higher in group V). The use of Magill's forceps was less in group V (p=0.002). The two groups were comparable with respect to nose-oropharynx time (p = 0.068), epistaxis and hoarseness (respectively, p = 0.43 and p = 0.74). <strong>Conclusions</strong> Nasotracheal intubation for maxillofacial surgery appears to be easier and faster with a video laryngoscope.