Submental Intubation - An alternative airway control

Abstract

Objectives: In patients who require intubation for maxillofacial reconstruction, submental intubation is an alternative to a traditional tracheostomy. Various different methods of intubation are suitable for facial trauma cases. A choice often has to be made between orotracheal and nasotracheal intubation when surgical access to the nasal or oral cavity is necessary. This work presents our current experience using submental intubation in the airway management of facial trauma patients. Submental intubation provides intraoperative airway control, avoids use of nasal route, with minimal complications. Submental intubation allows intraoperative dental occlusion and is an acceptable option, especially when long term postoperative ventilation is not planned. Materials & Methods: From July 2015 to February 2017, 13 patients from craniomaxillofacial trauma benefited from submental intubation. All the patients were males and the ages ranged from 19 to 35 years (mean, 27 years). Results: In all the patients, the submental intubation permitted simultaneous reduction and fixation of all fractures and intraoperative control of the dental occlusion without interference from the tube during the operation. There was no intra-operative complication. No post-operative complications were reported. The intraoral and submental accesses healed with minimal scarring in all patients Conclusion: Submental intubation is a simple, secure and effective procedure for operative airway control in major maxillofacial surgeries

Keywords

• intubation
• submental
• maxillofacial injury
• operative complications