Indication for and technical refinements of submental intubation in oral and maxillofacial surgery

Meyer, Christophe; Valfrey, J.; Kjartansdóttir, Thordis Helga; Wilk, A; Barriere, Philippe

doi:10.1016/j.jcms.2003.07.005

Cited by 71 publications

(61 citation statements)

References 30 publications

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“…multi trauma patients with severe neurological damage, major thoracic trauma patients for whom repeated surgeries are anticipated, in these cases tracheostomy should remain in the standard procedure. The same applies to patient presenting with severe trauma wound of the floor of the mouth [2,6]. Submental intubation should be chosen whenever possible, as is easy, takes little time and follow-up is simple.…”

Section: Resultsmentioning

confidence: 99%

“…Finally concerning the procedure, it should not be attempted to intubate the second tube directly through the submental tube even under the cover of a temporary orotracheal intubation as the 180 degree curve of the pathway imposed by the direction of the tunnel and the tongue will be so difficult to negotiate that it make intubation and ventilation of patient impossible [2].…”

Section: Discussionmentioning

confidence: 99%

“…The submental intubation was maintained during patient's recovery and extubation was carried out by pulling the tube through the skin and finally placing the sutures [2,9].…”

Section: Modementioning

confidence: 99%

“…Another solution is to change the position of tube during the operation, which involves a supplementary anaesthetic risk [2]. Hernandez Altemir (1986) proposed submental intubation as an alternative to these classic method's.…”

Section: Introductionmentioning

confidence: 99%

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Submental intubation: our experience

Navaneetham¹,

Thangaswamy

Rao

2010

J. Maxillofac. Oral Surg.

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Introduction Airway management for patients who suffered midfacial fractures is complicated. In maxillofacial injuries, a choice has often to be made between different ways of intubation when surgical access to both the nasal and oral cavities is necessary. Submental intubation technique is an alternative to nasoendotracheal intubation and tracheostomy in the management of patients with severe midfacial fractures. This procedure is simple to do and has a low morbidity. Material Submental intubation-paramedian technique has been used in 15 cases from

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…The submental intubation was maintained during patient's recovery and extubation was carried out by pulling the tube through the skin and finally placing the sutures [2,9].…”

Section: Modementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Submental intubation: our experience

Navaneetham¹,

Thangaswamy

Rao

2010

J. Maxillofac. Oral Surg.

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“…For fractures that do not involve occlusion, such as nasal, zygoma, naso-orbito-ethmoidal, etc., oral intubation is indicated while for fractures that involve occlusion, such as mandibular and Lefort fractures, nasal intubation is indicated as oral intubation would interfere with occlusion. However, under certain circumstances, such as persistent cerebrospinal fluid leakage and panfacial fractures where the surgeon needs to evaluate occlusion during surgery, nasotracheal intubation is not recommended and it is in these cases that sub-mental intubation is indicated [1].…”

Section: Introductionmentioning

confidence: 99%

Sub-mental Intubation in Oral and Maxillofacial Trauma Patients

Shivpuri

2014

Indian J Surg

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Oral and maxillofacial surgical procedures present a unique set of problems for both the surgeon and the anesthesiologist as achieving dental occlusion is one of the most important aims of the treatment. Sub-mental intubation is a reliable and safe method of alternative airway management in maxillofacial surgery. This article presents the technique of sub-mental intubation along with a brief comparison with other techniques.

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A new modification for safer submental orotracheal intubation

et al. 2011

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In patients in whom a tracheal tube cannot be inserted through the nostrils due to multiple facial trauma or hypoplasty of the nose, submental orotracheal intubation (SOI) is performed to avoid tracheostomy. We report a new modification for SOI to minimize the risk of apnea. A 20-year-old man was scheduled for sagittal split ramus osteotomy. As the patient had severe hypoplasia of the nose, SOI was planned. Following orotracheal intubation with a spiral tube (first tube), a submental tunnel was surgically created. A second tube that had been confirmed, in advance, to snugly fit into the proximal end of the first tube was passed into the submental tunnel via a polypropylene cylinder and connected between the first tube and the breathing circuit. After careful withdrawal of the second tube through the submental tunnel, the first tube was directly connected to the breathing circuit after removal of the second tube. Although this technique requires additional time, apnea time is minimal even in patients in whom withdrawal of the tracheal tube through the submental tunnel takes time, because the second tube forms a link between the first tube and the breathing circuit, making it possible to ventilate the patient throughout the procedure.

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Indication for and technical refinements of submental intubation in oral and maxillofacial surgery

Cited by 71 publications

References 30 publications

Submental intubation: our experience

Submental intubation: our experience

Sub-mental Intubation in Oral and Maxillofacial Trauma Patients

A new modification for safer submental orotracheal intubation

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