Submental intubation in craniomaxillofacial surgery

Submental intubation using laparoscopic trocar in zygomaticomaxillary complex fracture surgery in Korea: a case report

“…Obstruction, collapse, kinking, or displacement of endotracheal tube could lead to fatal hypoxia. Other complications include potential risk of skin infection, abscess in the mouth floor, and injury of the marginal mandibular and lingual nerves and of salivary glands [1,11]. A reinforced tube is used to prevent kinking and collapse of the endotracheal tube.…”

“…The reason for performing submental intubation is that facial trauma patients may also have a fracture at the base of the skull, and it is important to determine dental malocclusion during oral surgery. In addition, nasotracheal intubation is not possible in patients with basilar fracture, and in zygomaxillary complex fracture surgery, the surgeon and anesthesiologist share the intraoral space, making it difficult to manage the airway through the mouth during surgery [1]. Therefore, after securing an airway by orotracheal intubation, airway management is performed through submandibular intu-bation or tracheostomy.…”

Submandibular approach for orotracheal intubation in Oral and Maxillofacial Surgery and Traumatology

“…Orotracheal intubation techniques with a submental or submandibular approach represent a low-risk alternative to avoid Research, Society and Development, v. 10, n. 12, e49101220158, 2021 (CC BY 4.0) | ISSN 2525-3409 | DOI: http://dx.doi.org/10.33448/rsd-v10i12.20158 elective tracheostomy (Anwer et al, 2007;Banerjee et al, 2021;Emara et al, 2019;Grando & Puricelli, 1997;Grando & Puricelli, 2004;Grando & Puricelli, 2018;Hassanein, & Abdel Mabood, 2017;Jung et al 2020;Katsnelson et al, 1994;Lim, Parumo & Shanmuhasuntharam, 2018;Martins, Castro, Ferraz, & Simões, 2020;Mishra et al, 2020;Puricelli, 2003;Puricelli, 2005;Ramaraj et al, 2019;Stoll et al, 1994;Surman, Duffy, Anwar, Basyuni, & Santhanam, 2021;Jun et al, 2020). It is also noteworthy that these alternatives require a shorter operative time than elective tracheostomy (Emara et al 2019).…”

“…Even if its primary indication is associated with the surgical treatment of trauma (Anwer et al, 2007;Banerjee et al, 2021;Hassanein, & Abdel Mabood, 2017;Kaiser et al, 2018;Martins et al, 2020;Mishra et al 2020;Puricelli, 2005), the literature shows its use expanded for cases of orthognathic surgery, tumour resections and others (Goh, Loh, & Loh, 2020;Mishra et al, 2020). The technique takes less operative time than tracheostomy (Emara et al, 2019;Faraj et al, 2013;Goh et al, 2020;Surman et al, 2021) and presents low complication rates (around 7% of cases), the most common being superficial skin infection in the region of externalisation of the tube, hypertrophic scar and damage to the endotracheal tube itself ( de Toledo, Bueno, Mesquita, & Amaral, 2013;Goh et al, 2020). Different devices have been suggested, especially to facilitate the externalisation of the orotracheal tube, making the technique faster and easier and reducing the risk of complications.…”