Z Nyárády1, F Sári, L Olasz, J Nyárády. 1. Department of Dentistry, Oral and Maxillofacial Surgery, University Pécs, Hungary. zoltan.nyarady@aok.pte.hu
Abstract
BACKGROUND: In 1986 Altemir described a method of submental endotracheal intubation in order to avoid tracheostomy in maxillofacial trauma cases where short-term intermaxillary fixation was required. His method has become widely established for airway maintenance in midfacial fractures. CASE: We present a 21-year-old male patient with cleft lip and palate on the left side. The patient underwent Le Fort I maxillary osteotomy. Nasal intubation was impossible due to nasal malformation. In this case we used submental endotracheal intubation for airway maintenance. We introduced new methods: a sterile nylon guiding tube and our new "2-2-2 rule" incision to make the procedure easier. RESULTS: The occlusion could be checked easily. There were no complications during and after the operation. The submental wound healed nicely. DISCUSSION: The described case shows that the technique is easy to use compared to "alternative" intubation methods. Submental scarring is acceptable. We recommend the technique for orthognathic use.
BACKGROUND: In 1986 Altemir described a method of submental endotracheal intubation in order to avoid tracheostomy in maxillofacial trauma cases where short-term intermaxillary fixation was required. His method has become widely established for airway maintenance in midfacial fractures. CASE: We present a 21-year-old male patient with cleft lip and palate on the left side. The patient underwent Le Fort I maxillary osteotomy. Nasal intubation was impossible due to nasal malformation. In this case we used submental endotracheal intubation for airway maintenance. We introduced new methods: a sterile nylon guiding tube and our new "2-2-2 rule" incision to make the procedure easier. RESULTS: The occlusion could be checked easily. There were no complications during and after the operation. The submental wound healed nicely. DISCUSSION: The described case shows that the technique is easy to use compared to "alternative" intubation methods. Submental scarring is acceptable. We recommend the technique for orthognathic use.