Submental Intubation Technique for Airway during Surgery of Midfacial and Panfacial Traumatic Injuries: A Descriptive Study
Abstract
Submental intubation is a method for airway without trachiotomy. This study was conducted with the aim to evaluate the frequency, indications, and outcomes of airway management by submental intubation in maxillofacial trauma patients and comparison with tracheostomy regarding its advantages and disadvantages.40 patients with maxillofacial injuries were selected for submental intubation who required tracheostomy/ retromolar intubation in a 2 year period (2013–2015). Submental intubation permitted reduction and fixation of all the fractures without the interference of the tube during surgical procedure in all of the patients. It avoids retromolar intubation/ tracheostomy and its disadvantages.Thus,Submental intubation is a simple, safe, with low morbidity technique for operative airway management in maxillofacial trauma patients when there are fractures involving the nasal region and concomitant dental occlusion disturbances who required retromolar intubation/ tracheostomy for airway management during surgery.
Keywords
Download Options
Introduction
It has been almost three decades since the submental intubation technique was first proposed by Hernández Altemir1 for managing airway in complex maxillofacial injuries. The term transmylohyoid oroendotracheal intubation was first coined by Gadre and Kushte.2, 3 Road traffic accidents have been the most frequent cause of facial fractures. Studies in the last decade have shown that road traffic accidents are the most common cause of injuries in India.4,5 Securing an airway in complex maxillofacial injuries is always a challenging job for an anaesthetist and an oral and maxillofacial surgeon. The two most frequent route used to secure airway in these injuries are the oroendotracheal and the nasotracheal. Sometimes patients are also managed by tracheostomy.
Method of orotracheal intubation impedes any manoeuvres for reduction and stabilization of jaws and intermaxillary fixation. In most fractures, this is an essential guide to optimal fracture reduction and fixation. 6,7
In this study, patients of complex maxillofacial trauma in which this technique was employed avoiding a tracheotomy and result of this technique was observed and discussed.
Conclusion
Hence, it is concluded that the submental intubation is a simple, safe, and alternative technique of intubation to tracheostomy in cases of maxillofacial trauma.