Submental intubation is a viable alternative to tracheostomy in facial trauma

Martins, Inês; Castro, Mafalda; Ferraz, Pedro; Simões, I.

doi:10.1136/bcr-2020-235537

Cited by 2 publications

(3 citation statements)

References 3 publications

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“…Compared with tracheostomy, this method facilitates airway management in patients with skull base fracture during zygomaticomaxillary complex fracture surgery. Tracheostomy also facilitates airway management but is more invasive and has complications such as surgical emphysema, tracheal erosion, hemorrhage, dysphagia, decannulation, and scarring [2,10].…”

Section: Discussionmentioning

confidence: 99%

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

Lee

Hong

et al. 2023

J Trauma Inj

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Submental intubation is an effective alternative technique for airway management in patients with maxillofacial trauma. Compared with tracheostomy, it is less invasive, but has risks associated with potential airway compromise such as hypoxia due to tube obstruction, collapse, and kinking. To shorten procedure time and ensure a reinforced tube lumen, we used a laparoscopic trocar as a new device for submental intubation. A 54-year-old male patient sustained a zygomaticomaxillary complex fracture and was scheduled to undergo open reduction and internal fixation. We performed intraoral intubation and made a small 1-cm incision at the submandibular midline. After dissection of the tissue from the incision site, a reinforced tube was passed using a 12-mm laparoscopic trocar. The procedure took about 5 minutes, and apnea time from disconnecting the breathing circuit and passing through the internal lumen of the trocar until it was reconnected to the ventilator was 1 minute 5 seconds. Using a laparoscopic trocar for submental intubation can reduce the time required for dissection, prevent luminal occlusion complications due to soft tissues or blood clots in the endotracheal tube, and decrease soft tissue damage.

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Section: Discussionmentioning

confidence: 99%

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

Lee

Hong

et al. 2023

J Trauma Inj

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“…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).…”

Section: Discussionmentioning

confidence: 99%

“…The submental route for endotracheal intubation proposed by Hernández Altemir (1986) has been employed and revisited by numerous authors. 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).…”

Section: Discussionmentioning

confidence: 99%

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

Puricelli

Ponzoni

2021

RSD

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Introduction: Submandibular tracheal intubation is a technique that can be applied in Oral and Maxillofacial Surgery and Traumatology, as well as other surgical specialties. Its main advantages are helping in the surgical manipulation of the middle facial skeleton and jaw and allowing the intraoperative control of dental occlusion. The technique is an alternative to elective tracheostomy. Objective and case report: The article presents the treatment of an adult patient, with sequelae of multiple fractures in the face due to a car accident, with endotracheal intubation using submandibular approach. Final considerations: In large surgical manipulations of the face, the submandibular approach for tracheal intubation allows a faster, facilitated anatomical access with a lower risk of damage to adjacent structures when compared to other pathways. It also guarantees excellent cervical mobility, the possibility of wide manipulation and the use of occlusion as a guide for surgical intervention.

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Submental intubation is a viable alternative to tracheostomy in facial trauma

Cited by 2 publications

References 3 publications

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

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

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

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