Cuff inflation failure of a reinforced nasotracheal tube resulting from occlusion of the embedded inflation lumen.

We report a rare case of cuff inflation failure in a reinforced nasotracheal tube, despite the pilot balloon being fully inflated. This failure was attributed to the compression of the inflation channel within the tube's wall, leading to a peritubal air leak and inadequate ventilation. Videolaryngoscopic assessment revealed air bubbles around the tube near the vocal cords, while the cuff remained deflated. The endotracheal tube was replaced using an airway exchange catheter, which improved ventilation. Although previous literature mentions cuff inflation failures due to kinked pilot tubing or pilot balloon defects, this case showed no visible kinks. Cuff inflation was achieved without difficulty initially, but further testing revealed that applying selective pressure to the segment of the inflation channel running through the endotracheal tube's wall obstructed cuff inflation. A defect in the tube may have allowed this section of the inflation channel to become compressed within the nasal passages.