Perforation of the Nasal Septum Identified during a Preoperative Otorhinolaryngology Consultation : A Case Report

Abstract

  Airway maintenance by nasal intubation is often required during oral surgery, but nasal intubation can cause various complications including bleeding associated with damage to the nasal mucosa and obstruction of the tracheal tube. Therefore, an examination to screen for nose symptoms and paranasal malformation or stenosis, etc., is needed prior to surgery, and a careful anesthesia plan should be created.

  We identified a nasal septum perforation during a preoperative otorhinolaryngology consultation performed using CT imaging. Subsequently, a safe nasal tracheal intubation was successfully performed while confirming the nasal septum perforation. The patient was a 54-year-old woman, and a tongue segmental resection was planned.

  The patient’s history included a nasal septum reconstruction because of an empyema 20 years earlier. As a result of the preoperative medical examination of the nasal septum, an oval perforation in the nasal septum was identified. Nasal septum perforations typically result from injury or pressure, such as during an operation.

  While performing the nasal tracheal intubation in the present patient, we examined the nasal cavity, larynx and vocal cords for further abnormalities in detail. Careful preoperative planning in cooperation with the otorhinolaryngology department and the use of CT imaging may be important when a nasal abnormality is suspected.