Jones tube exchange
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Transcript
This is Richard Allen at the University of Iowa.
This video demonstrates the exchange of a Jones tube.
Examination of the tube in the nose shows that it is too long and is obstructed by the nasal septum. A Quickert-Dryden probe is placed though the tube, and the tube can be removed over the probe. This probe is very useful in this situation as it does not have a central attachment, as seen in a Bowman probe, which would obstruct the removal of the tube over the probe. A shorter tube is then placed over the probe and can be advanced through the passage way into the nose. Externally, the Jones tube appears to be situated well. Intranasally, the tube appears to be in an appropriate position and is no longer obstructed by the nasal septum.
The tube will be fixated for the early post-operative period with a 6-0 Vicryl suture. The suture is placed as a noose around the tube and tied. The suture is double armed and each arm is then placed transcutaneous though the medial lower lid. This will prevent displacement in the early post-operative period. I do not use permanent sutures to fixate the tube unless the patient has issues with tube displacement. If that were the case, a purse string suture would be place around the conjunctiva and the knot would be buried medial to the tube.
