Fibrescope versus videolaryngoscope for nasotracheal intubation
Research type
Research Study
Full title
Flexible Fiberscope versus Video Laryngoscope for Nasotracheal Intubation – A Randomised Comparison
IRAS ID
343162
Contact name
Cyprian Mendonca
Contact email
Sponsor organisation
University Hospitals Coventry and Warwickshire NHS Trust
Duration of Study in the UK
1 years, 2 months, 31 days
Research summary
Nasotracheal intubation (placing a breathing tube in the windpipe via the nostril) is necessary for several maxillo-facial and dental procedures, allowing surgical access to the oral cavity. Traditionally, a nasal tube is inserted blindly into the most patent nostril and externally manipulated. A video laryngoscope (rigid camera device) is then inserted in the mouth and used to visualise and guide the passage of the tube into the trachea. This approach can be associated with difficulty passing the tube and nasal trauma.
There have been randomized studies using curve-tipped suction catheters and bougies as intubating aids showing a reduced incidence of nasal trauma, as compared with direct passage of tube through the nose. However, as these devices are also blindly inserted through the nasal passage, the device itself can cause some degree of trauma. Using a fiberscope (flexible camera scope) allows assessment of the patency of nasal passages and advancement the fiberscope under vision. With this technique, the breathing tube is advanced (railroaded) over the fiberscope. Therefore, we hypothesise that fibreoptic-assisted nasotracheal intubation is likely to reduce nasal trauma and bleeding. We are not aware of any study comparing fiberscopes and video laryngoscopy for nasotracheal intubation under general anaesthesia. Comparing the efficacy of these devices could help reduce the incidence of nasopharyngeal trauma, post operative epistaxis (nosebleed), patient discomfort and improve first-attempt success rate.
The primary outcome is incidence and severity of nasal bleeding and secondary outcomes are laryngoscopy time, intubation time, first-attempt success rate and smoothness of nasal intubation.
REC name
London - Riverside Research Ethics Committee
REC reference
25/LO/0806
Date of REC Opinion
10 Nov 2025
REC opinion
Favourable Opinion