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Participants are randomly assigned to two groups: one group undergoes nasotracheal intubation using a videolaryngoscope, while the other group undergoes nasotracheal intubation using a flexible bronchoscope. The primary outcome is the first-attempt success rate, assessed at the time of tracheal tube placement. Additional outcomes include the degree of subglottic injury upon extubation, and the incidence and severity of sore throat and hoarseness at 1 hour and 24 hours postoperatively, as well as overall intubation success rates.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Videolaryngoscope Group | Experimental |
| |
| Flexible Bronchoscope Group | Active Comparator |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Macintosh videolaryngoscope | Device | Used to perform nasotracheal intubation under general anesthesia. The Macintosh videolaryngoscope is introduced orally to visualize the glottis, and a preformed nasotracheal tube is inserted through the nostril. |
| Measure | Description | Time Frame |
|---|---|---|
| First-attempt success rate of nasotracheal intubation | The proportion of patients in whom nasotracheal intubation is successfully completed on the first attempt, comparing the videolaryngoscope group with the flexible bronchoscope group. | At the time of tracheal intubation |
| Measure | Description | Time Frame |
|---|---|---|
| Degree of subglottic injury | Graded from 0 to 3 using a flexible bronchoscope. Higher scores mean a worse outcome (more severe subglottic injury). | At the time of extubation |
| Postoperative sore throat severity |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Seoul National University Hospital | Seoul | South Korea |
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| Flexible bronchoscope | Device | Used to perform nasotracheal intubation under general anesthesia. The bronchoscope is inserted through a lubricated nasotracheal tube and advanced into the trachea. |
|
Assessed using the Numeric Rating Scale (0-10) at 1 and 24 hours after surgery.
| 1 hour and 24 hours postoperatively |
| Incidence of postoperative hoarseness | Presence or absence of hoarseness evaluated at 1 hour and 24 hours postoperatively. | 1 hour and 24 hours postoperatively |
| Cormack-Lehane grade | Grading recorded during intubation to evaluate glottic exposure. | At the time of tracheal intubation |
| Changes in blood pressure | Changes in blood pressure recorded before and after tracheal intubation. | Within 5 minutes before and after intubation |
| POGO score | Visualization scores recorded during intubation to evaluate glottic exposure. The score ranges from 0% (no glottic visualization) to 100% (full view of the glottis). Higher scores indicate a better outcome (better visualization). | At the time of tracheal intubation |
| Changes in heart rate | Changes in heart rate recorded before and after tracheal intubation. | Within 5 minutes before and after intubation |
| Changes in saturation | Changes in SpO₂ recorded before and after tracheal intubation. | Within 5 minutes before and after intubation |
| Changes in bispectral value | Changes in BIS values recorded before and after tracheal intubation. | Within 5 minutes before and after intubation |