Objectives. During anesthesia emergence, patients are extubated and the upper airway can become vulnerable to obstruction.\nNasal trumpets can help prevent obstruction. However, we have found no manuscript describing how to place nasal trumpets after\nnasal surgery (septoplasties or septorhinoplasties), likely because (1) the lack of space with nasal splints in place and (2) surgeons\nmay fear that removing the trumpets could displace the splints. The objective of this manuscript is to describe how to place nasal\ntrumpets even with nasal splints in place. Materials and Methods.The authors describe techniques (Double Barrel Technique and\nModified Double Barrel Technique) that were developed over three years ago and have been used in patients with obstructive sleep\napnea (OSA) and other patients who had collapsible or narrow upper airways (i.e., morbidly obese patients). Results. The\ntechnique described in the manuscript provides a method for placing one long and one short nasal trumpet in a manner that helps\nprevent postoperative upper airway obstruction. The modified version describes a method for placing nasal trumpets even when\nthere are nasal splints in place. Over one-hundred patients have had nasal trumpets placed without postoperative oxygen\ndesaturations. Conclusions.The Double Barrel Technique allows for a safe emergence from anesthesia in patients predisposed to\nupper airway obstruction (such as in obstructive sleep apnea and morbidly obese patients). To our knowledge, the Modified\nDouble Barrel Technique is the first description for the use of nasal trumpets in patients who had nasal surgery and who have nasal\nsplints in place.
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