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British Journal of Anaesthesia, 2003, Vol. 91, No. 4 601-604
© 2003 The Board of Management and Trustees of the British Journal of Anaesthesia

Case Reports

Intracranial placement of a nasotracheal tube after transnasal trans-sphenoidal surgery

M. Paul*, M. Dueck, S. Kampe, F. Petzke and A. Ladra

Department of Anaesthesiology, University of Cologne, Joseph-Stelzmann-Str. 9, D-50931 Cologne, Germany

Corresponding author. E-mail: m.paul@uni-koeln.de

Intracranial misplacement of a tracheal tube during attempted nasotracheal intubation is a rare, usually lethal complication. Such incidents are associated with fractures of the face and base of the skull. We report inadvertent intracranial placement of a nasotracheal tube in a patient who had 2 weeks previously undergone transnasal trans-sphenoidal surgery for a pituitary tumour. One should be aware that transnasal trans-sphenoidal surgery leaves a bony defect in the skull, which is susceptible to perforation by nasally introduced tubes.

Br J Anaesth 2003; 91: 601–4


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