The Internet Journal of Anesthesiology™ ISSN: 1092-406X

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The Modified Nasal Trumpet: Should it be a Standard?

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Jesse H. Aron M.D.
Department of Anesthesiology
SUNY Upstate Medical University

Sumena Thongrod M.D.
Department of Anesthesiology
SUNY Upstate Medical University

Xiuli Zhang M.D.
Department of Anesthesiology
SUNY Upstate Medical University

Citation: J. H. Aron, S. Thongrod & X. Zhang : The Modified Nasal Trumpet: Should it be a Standard? . The Internet Journal of Anesthesiology. 2008 Volume 15 Number 2

To the Editor

The modified nasal trumpet, as described by Dr Charles Beattie(¹), involves cutting a fenestration, or “Murphy Eye”, on the convex side of the airway. Our group first made use of this modification when placing nasal trumpets for pediatric upper endoscopy procedures. We had previously noticed, by direct observation of the endoscope in the oral pharynx, the beveled opening of the nasal trumpet completely occluded by soft tissue or saliva. We often felt it necessary to move the nasal trumpet or replace it to prevent a potential hypoxic episode. Unfortunately, moving the nasal trumpet sometimes stimulated the patient which interrupted the procedure.

The modified nasal trumpet provides a degree of confidence that if the beveled end is obstructed, the nasal trumpet does not have to be moved or replaced. (picture A). Nasal trumpets are excellent airway assistance devices for patients with apnea, large tongues, and difficult airways (²). The addition of a “Murphy eye” does not diminish the integrity of the nasal trumpet and can be provide an additional level of user confidence that the patient is receiving adequate ventilation.

Picture A: Modified Nasal Trumpet in Posterior Pharynx (Note obstructed beveled end)

References

1. Beattie C,The Modified Nasal Trumpet Maneuver. Anesthesia and Analgesia 2001; 94:467-9. (s)

2. Metz S, Beattie C, A Modified Nasal Trumpet to facilitate fiberoptic intubation. British Journal of Anesthesiology 2003;90(3):388-91 (s)

This article was last modified on Fri, 13 Feb 09 13:15:41 -0600

This page was generated on Sat, 20 Mar 10 16:03:21 -0500, and may be cached.


	The Internet Journal of Anesthesiology™ ISSN: 1092-406X \| Home \| Editors \| Current Issue \| Archives \| Instructions for Authors \| Disclaimer \| Share with others \| The Modified Nasal Trumpet: Should it be a Standard? Read printer friendly Subscribe in a reader Share with others Jesse H. Aron M.D. Department of Anesthesiology SUNY Upstate Medical University Sumena Thongrod M.D. Department of Anesthesiology SUNY Upstate Medical University Xiuli Zhang M.D. Department of Anesthesiology SUNY Upstate Medical University Citation: J. H. Aron, S. Thongrod & X. Zhang : The Modified Nasal Trumpet: Should it be a Standard? . The Internet Journal of Anesthesiology. 2008 Volume 15 Number 2 To the Editor The modified nasal trumpet, as described by Dr Charles Beattie(¹), involves cutting a fenestration, or “Murphy Eye”, on the convex side of the airway. Our group first made use of this modification when placing nasal trumpets for pediatric upper endoscopy procedures. We had previously noticed, by direct observation of the endoscope in the oral pharynx, the beveled opening of the nasal trumpet completely occluded by soft tissue or saliva. We often felt it necessary to move the nasal trumpet or replace it to prevent a potential hypoxic episode. Unfortunately, moving the nasal trumpet sometimes stimulated the patient which interrupted the procedure. The modified nasal trumpet provides a degree of confidence that if the beveled end is obstructed, the nasal trumpet does not have to be moved or replaced. (picture A). Nasal trumpets are excellent airway assistance devices for patients with apnea, large tongues, and difficult airways (²). The addition of a “Murphy eye” does not diminish the integrity of the nasal trumpet and can be provide an additional level of user confidence that the patient is receiving adequate ventilation. Picture A: Modified Nasal Trumpet in Posterior Pharynx (Note obstructed beveled end) References 1. Beattie C,The Modified Nasal Trumpet Maneuver. Anesthesia and Analgesia 2001; 94:467-9. (s) 2. Metz S, Beattie C, A Modified Nasal Trumpet to facilitate fiberoptic intubation. British Journal of Anesthesiology 2003;90(3):388-91 (s) This article was last modified on Fri, 13 Feb 09 13:15:41 -0600 This page was generated on Sat, 20 Mar 10 16:03:21 -0500, and may be cached.
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