From the Research
A Nasopharyngeal Airway (NPA) is typically inserted through the right nostril in most patients. This recommendation is based on the anatomical structure of the nasal passages and nasopharynx. When inserting an NPA, healthcare providers should first assess both nostrils for patency and choose the more patent (open) nostril if there's a noticeable difference. However, the right nostril is generally preferred because the bevel of most NPAs is designed to follow the natural curve of the right nasal passage, which facilitates easier insertion and proper positioning. Additionally, the right nostril often provides a more direct path to the nasopharynx in many individuals. If insertion through the right nostril is difficult or contraindicated (such as in cases of trauma, obstruction, or anatomical abnormality on that side), the left nostril can be used as an alternative. Proper lubrication of the NPA and gentle technique are essential regardless of which nostril is selected for insertion.
The provided studies do not specifically address the insertion of NPAs through a particular nostril, but they do discuss airway management practices and the use of NPAs in various clinical settings 1, 2, 3, 4. For example, a study published in 2024 compared the efficacy of oropharyngeal and nasopharyngeal airways in maintaining oxygenation during painless fiberoptic bronchoscopy, but it did not provide guidance on nostril selection for NPA insertion 4. Another study from 2023 discussed out-of-hospital airway management practices, including the use of NPAs, but it also did not address nostril selection 1.
In the absence of specific guidance from the provided studies, the recommendation to insert an NPA through the right nostril is based on general medical knowledge and anatomical considerations. It is essential to prioritize proper technique and patient comfort when inserting an NPA, regardless of which nostril is chosen.
Some key points to consider when inserting an NPA include:
- Assessing both nostrils for patency before insertion
- Choosing the more patent nostril if there's a noticeable difference
- Using proper lubrication and gentle technique to facilitate insertion and minimize discomfort
- Being prepared to use the left nostril as an alternative if insertion through the right nostril is difficult or contraindicated.
By following these guidelines and using clinical judgment, healthcare providers can ensure safe and effective insertion of NPAs in their patients.