Nasotracheal intubation with a standard cuffed orotracheal-style tube is planned. Which nostril is generally preferred and why?
- A Right nostril, because the tube bevel faces the nasal septum and reduces turbanate trauma ✓
- B Left nostril, because it gives a shorter straighter path to the glottis
- C Either nostril equally, since anatomy is symmetrical
- D Left nostril, because the right maxillary sinus ostium is higher
Correct answer: A. Right nostril, because the tube bevel faces the nasal septum and reduces turbanate trauma
Explanation
The bevel of a conventional tube faces left, so passing the tube through the right nostril directs the bevel against the flat medial wall of the turbinate area rather than catching on the septum or turbinates, reducing epistaxis and mucosal injury. Anatomy relevant to nasal intubation is not symmetrical: the right nasal cavity tends to have a larger cross-sectional area in most people, which further supports the right-sided route and makes options B and D indefensible.
Reference: Miller's Anesthesia, 9th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.