Abstract: Objective To evaluate the use of nasotracheal intubation guided by fiberoptic laryngoscopy for anesthesia in patients with obstructive sleep apnea hypopnea syndrome(OSAHS). Methods A total of 70 patients with OSAHS, who were scheduled for surgeries under general anesthesia, were equally divided into a nasotracheal intubation group and a video laryngoscope group. Outcomes measured and compared between the two groups included first-attempt intubation success rate, total intubation time, extent of pharyngeal damage and bleeding, extent of posterior pharyngeal wall damage, active bleeding from the nasal cavity during the procedure, postoperative adhesions of the nasal cavity, and rhinobyon. Results In the nasotracheal intubation group, all patients were successfully intubated on the first attempt. The mean total intubation time was 32.34 s±6.13 s, with all positions correct and without requiring anesthesia adjustment. In contrast, in the video laryngoscope group, 5(14%)patients required reintubation; however, all were successfully performed on the second attempt. The mean total intubation time was 56.54 s±23.75 s. The total intubation time was significantly better in the nasotracheal intubation than in the video laryngoscope group(P<0.05). No nasal cavity or pharyngeal mucosal membrane damage occurred postoperatively. In addition, there was no postoperative worsening of nasal obstruction. While intubating patients, 3 had active bleeding. Postoperatively, adhesions of the nasal cavity occurred in 3 patients, while posterior pharyngeal wall damage occurred in 3 patients in the video laryngoscope group. Conclusion Nasotracheal intubation guided by fiberoptic laryngoscopy is a safe and effective option for patients with OSAHS, which may be used as a first-line option.

Key words: Sleep apnea-hypopnea, obstructive, Nasotracheal intubation, Fiberoptic laryngoscopy