The results of 458 prolonged nasotracheal intubations are described in 435 infants and young children up to 5 years of age after open heart surgery, in whom the upper airway was normal. No deaths occurred which could be attributed to the technique, and no tubes became obstructed. Sub-glottic stenosis did not occur when a loose-fitting endotracheal tube was used, and stridor after extubation was rare. If necessary, the technique can be used with safety for several weeks.