Mohanavalli Singaram1, Ilango Ganesan2, Radhika Kannan2, Rajesh Kumar1. 1. Department of Dentistry, ESIC Medical College and Postgraduates Institute of Medical Sciences and Research (PGIMSR), Chennai, India. 2. Department of Anesthesiology, ESIC Medical College and Postgraduates Institute of Medical Sciences and Research (PGIMSR), Chennai, India.
Abstract
OBJECTIVES: Submental intubation has been advocated as an alternative to classical tracheostomy for certain indicated panfacial trauma surgeries. Surgeons should have various options for airway management in maxillofacial trauma patients. Most maxillofacial injuries involve occlusal derangements, which might require intraoperative occlusal corrections; hence, orotracheal intubation is not ideal. Maxillofacial surgeons generally prefer nasotracheal intubation; however, in cases with concomitant skull base fracture or nasal bone fracture, nasotracheal intubation might not be suitable; in these situations, tracheostomy is typically performed. However, the possible complications of tracheostomy are well known. Due to trauma situations and to avoid the complications of tracheostomy, submental intubation would be an ideal alternative procedure in selected maxillofacial trauma surgery patients. This study aimed to evaluate the safety and usefulness of a submental intubation technique for panfacial trauma surgery. Moreover, we intended to share our experience of submental intubation and to recommend this simple, safe procedure for certain panfacial trauma surgeries. MATERIALS AND METHODS: In five panfacial trauma patients, we performed submental intubation for airway management; the mean time required for the procedure was only eight minutes. RESULTS: We were able to execute this procedure safely in a short time without any intraoperative or postoperative complications. CONCLUSION: Submental intubation is a safe and simple technique for airway management in indicated panfacial trauma surgery patients.
OBJECTIVES: Submental intubation has been advocated as an alternative to classical tracheostomy for certain indicated panfacial trauma surgeries. Surgeons should have various options for airway management in maxillofacial traumapatients. Most maxillofacial injuries involve occlusal derangements, which might require intraoperative occlusal corrections; hence, orotracheal intubation is not ideal. Maxillofacial surgeons generally prefer nasotracheal intubation; however, in cases with concomitant skull base fracture or nasal bone fracture, nasotracheal intubation might not be suitable; in these situations, tracheostomy is typically performed. However, the possible complications of tracheostomy are well known. Due to trauma situations and to avoid the complications of tracheostomy, submental intubation would be an ideal alternative procedure in selected maxillofacial trauma surgery patients. This study aimed to evaluate the safety and usefulness of a submental intubation technique for panfacial trauma surgery. Moreover, we intended to share our experience of submental intubation and to recommend this simple, safe procedure for certain panfacial trauma surgeries. MATERIALS AND METHODS: In five panfacial traumapatients, we performed submental intubation for airway management; the mean time required for the procedure was only eight minutes. RESULTS: We were able to execute this procedure safely in a short time without any intraoperative or postoperative complications. CONCLUSION: Submental intubation is a safe and simple technique for airway management in indicated panfacial trauma surgery patients.
Authors: Kerry-Ann D Williams; Maha Tariq; Maitri V Acharekar; Sara Elena Guerrero Saldivia; Sumedha Unnikrishnan; Yeny Y Chavarria; Adebisi O Akindele; Ana P Jalkh; Aziza K Eastmond; Chaitra Shetty; Syed Muhammad Hannan Ali Rizvi; Joudi Sharaf; Lubna Mohammed Journal: Cureus Date: 2022-07-30