Nasotracheal intubation is frequently selected for oral surgical procedures. We experienced a case with pressure sores formed form a nasotracheal tube in which the sores cicatrized, causing nostril stenosis. The patient was a 59-year-old man who had undergone bilateral temporomandibular joint (TMJ) mobilization and bilateral coronoidectomy for bilateral TMJ ankyloses. The anesthesia time was 12 hours. Upon extubation, pressure sores with reddening were observed on the nare. An ointment was applied, and the patient was discharged from the hospital. Three months later at a regular checkup after oral surgery, the patient complained of nostril stenosis. The patient was referred to the Department of Plastic Surgery and a nasal prosthesis was inserted ; widening of the nasal cavity was subsequently observed 1 month later.
Factors affecting pressure sore formation include long operations, a male gender, pressure on the nare exerted by the intubation tube, and skin humidity. In addition to these factors, the patient had a history of diabetes mellitus and atopic eczema, which might have increased the risk of pressure sore formation and delayed healing. Tube fixation or dressing applications can be useful for preventing sore formation from the exertion of pressure on the nare. Furthermore, the Department of Plastic Surgery or Otolaryngology should be consulted promptly when sore formation is observed upon extubation to prevent the development of severe conditions.
