Korean J Anesthesiol.  2002 Oct;43(4):507-510. 10.4097/kjae.2002.43.4.507.

Submental Intubation with a Reinforced Tube for an Intubating Laryngeal Mask Airway (ILMA)

• Park HD
• Kim KJ
• Kim HJ
• Ha JY

• KMID: 2033625
• DOI: http://doi.org/10.4097/kjae.2002.43.4.507

Abstract

Nasotracheal intubation, when performed after craniomaxillofacial trauma, may result in the passage of the tube into the cranium, causing significant brain damage. Orotracheal intubation may be preferred, but interferes with the placement of intermaxillary fixation. To avoid these problems, a tracheostomy may be an alternative but it carries significant morbidity. The submental route for endotracheal intubation has been proposed as an alternative to a tracheostomy in the surgical management of craniomaxillofacial trauma. Ideally, this maneuver is performed by using a reinforced tube. Unfortunately, however, some reinforced tracheal tubes are manufactured with nondetachable connectors. Removing them forcefully may be possible, but they will then stay dangerously loose after reconnection. We report a case in which a standard oral Ring-Adair-Elwyn (RAE) tube and reinforced tube for ILMA was used so not to be loose after the reconnection.

Keyword

Intubating laryngeal mask airway; reinforced tube; Ring-Adair-Elwyn tube; submental intubation

MeSH Terms

Brain
Intubation*
Intubation, Intratracheal
Laryngeal Masks*
Skull
Tracheostomy