목적: Nasogastric tube (NGT) placement poses risks during swallowing if the tube passes through the pyriform sinus on the midline or opposite side of the pharynx from the nostril through which it was inserted. This condition, known as intrapharyngeal NGT crossing, can lead to complications due to contact of the tube with the epiglottis or mechanical interference with swallowing. The development of a simple method for detection of intrapharyngeal NGT crossing is required. This study was performed to determine the incidence of intrapharyngeal NGT crossing and to examine whether visually checking the course of the tube in the oropharynx would allow detection of this condition. 방법:We analyzed the data of 101 patients with an indwelling NGT who underwent videoendoscopic examination of swallowing (n = 462) at our hospital between April 2020 and December 2022, to clarify the incidence of intrapharyngeal NGT crossing. In addition, we examined the correlations between the course of the NGT in the oropharynx and intrapharyngeal NGT crossing, NGT size, and the side of the nostril through which the tube was inserted. 결과:Intrapharyngeal NGT crossing occurred in 56 (55.4%) of a total of 101 cases, with no crossing in the remaining 45 (44.6%). We visually checked the course of the NGT in the oropharynx relative to the nasal entrance and found that no crossing occurred in 44 of 48 cases (92%) when the tube remained on the same side, while crossing occurred in all 15 cases when the tube passed on the opposite side and in 37 of 38 cases (97%) when it was positioned medially. The incidence of intrapharyngeal NGT crossing differed significantly according to the course of the tube in the oropharynx (same side vs. median/opposite side, P < 0.001). Intrapharyngeal NGT crossing occurred significantly less often when the tube was inserted from the left nostril (19/47 40.4%) compared to the right (38/54 70.4%). 결론:Visually checking the course of the NGT in the oropharynx allowed us to predict intrapharyngeal NGT crossing. This method may be useful for reducing complications associated with NGT placement in clinical practice.