PEDIATRICS Vol. 55 No. 6 June 1975, pp. 884-887
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Cosmetic Nasal Deformities Complicating Prolonged Nasotracheal Intubation in Critically III Newborn Infants

Richard J. Baxter M.B.1, John D. Johnson M.D.1, Boyd W. Goetzman M.D.1, and Alvin Hackel M.D.1

1 Departments of Anesthesia and Pediatrics, and the Center for Premature Infants, Stanford University School of Medicine, Stanford, California

Complications following prolonged endotracheal intubation in neonates have been widely reported.1-4 With increasing intact survival of infants who have received prolonged ventilatory assistance, these complications assume greater importance. This report concerns the particular complication of cosmetic nasal deformities secondary to nasotracheal intubation in critically ill newborn infants. A high incidence of this complication has not been previously reported.

The secure fixation of endotracheal tubes in neonates for long periods of ventilatory assistance is difficult. Techniques for fixation of both orotracheal and nasotracheal tubes2,6,7 have been described. Those utilizing adhesive tape are not entirely satisfactory. Secretions invariably dampen the tape, rendering the fixation ineffective.