Submental/submandibular intubation: a journey from past to future

Abstract

In 1986, Altemir published the first article on submental intubation as an alternative to tracheostomy for managing difficult airways. This review provides an overview of submental/submandibular intubation, covering its development, techniques, and clinical outcomes. Initially devised to address difficult airways in oral and maxillofacial surgery, the technique has since evolved. Recent advancements include focused surgical incisions, ultrasound-guided imaging, and the use of improved procedural tools like the Seldinger technique. Clinical trials have demonstrated that submental/submandibular intubation is generally more efficient and quicker than tracheostomy in trauma patients. One of its key advantages is the absence of visible scarring, along with a less invasive recovery process. However, the technique has some limitations, including risks of infection, bleeding, and scarring, which require further investigation to optimize its application. While submental/submandibular intubation remains a valuable method for managing difficult airways, ongoing refinement and evaluation are necessary to maximize its clinical utility. This technique presents an excellent alternative in specific surgical scenarios and offers a simplified solution where other intubation methods may be unfeasible.