Korean J Anesthesiol.  2002 Sep;43(3):375-378. 10.4097/kjae.2002.43.3.375.

Submental Orotracheal Intubation for Maxillofacial Surgery: A case report

• Lim HK
• Kim TJ
• Lee CS
• Lee HS
• Park HJ
• Chung CK

• KMID: 2238984
• DOI: http://doi.org/10.4097/kjae.2002.43.3.375

Abstract

Airway management for patients who have suffered multiple facial fractures and skull base fractures is complicated. Nasal intubation can interfere with centralization and stabilization of nasal fractures and may lead to cranial intubation. Restoring the dental occlusion by means of intraoperative maxillo- mandibular fixation is a prerequisite to the corrrect anatomical reduction of multiple facial fractures. This fixation precludes oral endotracheal intubation. In the past, it has been overcome by a tracheostomy. Complications of a tracheostomy include infection, hemorrhage, subcutaneous emphysema, pneumothorax, pneumomediastinum, recurrent laryngeal nerve damage, tracheal stenosis, and tracheoesophageal fistula. The technique of submental intubation was originally described by Altemir. This technique provide secure airway, an unobstructed intraoral airway field. and allows maxillomandibular fixation while avoiding the drawbacks and complications of naso-endotracheal intubation or tracheostomy. With this technique, the multiple facial fractures were corrected successfully.

Keyword

Airway; maxcillofacial surgery; submental intubation

MeSH Terms

Airway Management
Dental Occlusion
Hemorrhage
Humans
Intubation*
Intubation, Intratracheal
Jaw Fixation Techniques
Mediastinal Emphysema
Pneumothorax
Recurrent Laryngeal Nerve
Skull Base
Subcutaneous Emphysema
Surgery, Oral*
Tracheal Stenosis
Tracheoesophageal Fistula
Tracheostomy