The most common complication of nasotracheal intubation?

• A. Sinusitis
• B. Bleeding
• C. Nasal trauma
• D. Pneumothorax

Answer: (B)

During nasotracheal intubation, the nasal mucosa is easily irritated because it’s thin and highly vascular. The most common complication arises from this mucosal trauma: epistaxis, or nasal bleeding, which can occur with even gentle passage of the tube or suctioning. Using lubricant, topical vasoconstrictors, and careful technique helps minimize this risk.

Other issues can occur but are less frequent. Nasal trauma can happen but often presents with bleeding as the primary sign, sinusitis may develop later due to disruption of drainage pathways, and pneumothorax is uncommon and typically related to other factors rather than the procedure itself.