Foreman PM, Harrigan MR, Griessenauer CJ, Loukas M, Tubbs RS.Access to the carotid artery bifurcation: Cadaveric study with application to nasotracheal intubation as a technique to improve access to a high carotid artery bifurcation.Br J Neurosurg. 2015;29(6):865-7. doi: 10.3109/02688697.2015.1071331.
Carotid endarterectomy (CEA) is a common and efficacious surgical procedure for the prevention of ischemic stroke due to atherosclerosis of the internal carotid artery (ICA). A high common carotid artery bifurcation can make CEA technically difficult due to limited carotid artery exposure. A cadaveric study was performed to evaluate the efficacy of nasotracheal intubation for improving access to a high carotid artery bifurcation. Based on this study, nasotracheal intubation does not improve access to a high carotid artery bifurcation as compared with orotracheal intubation.