Abstract • Seventy-two infants were treated with nasal continuous positive airway pressure for one day to five weeks, and nasal deformities developed in none. One hundred thirty-six infants were treated with nasotracheal tubes and eight (6%) were found to have nasal deformities. There was a strong correlation between duration of intubation and birth weight and the presence of deformities. In no infant receiving ventilation therapy for less than six days did nasal deformities develop. The incidence of nasal deformities in infants weighing less than 1,000 g was 50%, whereas in infants heavier than 1,000 g it was 2.4%. No infant had clinical symptoms suggestive of subglottic stenosis during the first year of life. The data do not support the use of routine tracheostomy in newborn infants even after prolonged intubation. (Am J Dis Child 134:954-957, 1980) References 1. Strong RM, Passy V: Endotracheal intubation: Complications in neonates . Arch Otolaryngol 103:329-335, 1977.Crossref 2. Joshi VV, Mandavia SG, Stern L, et al: Acute lesions induced by endotracheal intubation . Am J Dis Child 124:646-649, 1972. 3. Schild JP, Wuilloud A, Kollberg H, et al: Tracheal perforation as a complication of nasotracheal intubation in a neonate . J Pediatr 88:631-632, 1976.Crossref 4. Aplin CE, Smith M, Harrison R, et al: Acquired tracheoesophageal fistula in a premature infant . J Pediatr 91:983-984, 1977.Crossref 5. Touloukian RJ, Beardsley GP, Ablow RC, et al: Traumatic perforation of the pharynx in the newborn . Pediatrics 59:1019-1022, 1977. 6. Saunders BS, Easa D, Slaughter RJ: Acquired palatal groove in neonates: A report of two cases . J Pediatr 89:988-989, 1976.Crossref 7. Duke PM, Coulson JD, Santos JI, et al: Cleft palate associated with prolonged orotracheal intubation in infancy . J Pediatr 89:990-991, 1976.Crossref 8. Boice JB, Krous HF, Foley JM: Gingival and dental complications of orotracheal intubation . JAMA 236:957-958, 1976.Crossref 9. Sinclair JC: Problems associated with prolonged nasotracheal intubation . Problems of Neonatal Intensive Care Units . Columbus, Ohio, Ross Laboratories, 1969, pp 69-80. 10. Jung AL, Thomas GK: Stricture of the nasal vestibule: A complication of nasotracheal intubation in newborn infants . J Pediatr 85:412-414, 1974.Crossref 11. Baxter RJ, Johnson JD, Goetzman BW, et al: Cosmetic nasal deformities complicating prolonged nasotracheal intubation in critically ill newborn infants . Pediatrics 55:884-887, 1975. 12. Verhoog-Bloembergen MPJ, Leader GL: Long-term nasotracheal intubation . Int Anesth Clin 12:241-257, 1974.Crossref 13. Berry FA Jr, Blankenbaker WL, Ball CG: A comparison of bacteremia occurring with nasotracheal and orotracheal intubation . Anesth Analg 52:873-876, 1973. 14. Choffat JM, Goumaz CF, Guex JC: Laryngotracheal damage after prolonged intubation in the newborn infant , in Stetson JB, Swyer PR (ed): Neonatal Intensive Care . St Louis, Warren H Green Inc, 1976, pp 253-270. 15. Pettett G, Merenstein GB: Nasal erosion with nasotracheal intubation . J Pediatr 87:149-150, 1975. 16. Gregory GA: Respiratory care of newborn infants . Pediatr Clin North Am 19:311-324, 1971. 17. Heroy JH, MacDonald MG, Mazzi E, et al: Airway management in the premature infant . Ann Otol Rhinol Laryngol 87:1-7, 1978. 18. Filston HC, Johnson DG, Crumrine RS: Infant tracheostomy: A new look with a solution to the difficult cannulation problem . Am J Dis Child 132:1172-1176, 1978.
American Journal of Diseases of Children – American Medical Association
Published: Oct 1, 1980