International Journal of Medical and Dental Sciences

Submental Endotracheal Intubation for Maxillofacial Surgery: A Report of Two Cases


Affiliations

  • Babcock University Teaching Hospital, Department of Oral and Maxillofacial Surgery, Dental Unit, Ilishan–Remo, Ogun, Nigeria
  • Babcock University Teaching Hospital, Department of Anaesthesia, Ilishan–Remo, Ogun, Nigeria
  • Babcock University Teaching Hospital, Department of Oral and Maxillofacial Surgery, Dental Unit, Ilishan-Remo, Ogun, Nigeria

Abstract

The technique of submental endotracheal intubation has been established as a safe alternative to tracheostomy and can be utilized when oro-tracheal and naso-tracheal routes of intubation are not ideal for orofacial surgical intervention. The technique is simple and avoids the complications of tracheostomy. We present 2 cases of adults with orofacial injuries requiring surgery. Both cases were managed using the submental method of intubation and the procedure was well tolerated. There were no perioperative complications and patients were discharged on the fifth postoperative day.

Keywords

Maxilloficial, Submental, Trauma, Intubation

Subject Discipline

Maxillofacial surgery; anaesthesia, endotracheal intubation

Full Text:

References

Green JD, Moore UJ. A Modification of submental intubation. BJA. 1996; 77:789. https://doi.org/10.1093/bja/77.6.789

Taiwo OA, Ibikunle AA, Braimah RO, Suleiman MK. Submental intubation in paediatric oral and maxillofacial surgery: Review of the literature and report of four cases. Afr J Paediatr Surg. 2015; 12(4): 296–300. https://doi.org/10.4103/0189-6725.172584 PMid:26712300 PMCid: PMC4955467

Biju P, Mohan A. Biomechanic of cranio-maxillofacial trauma. J Maxillofac Oral Surg. 2012; 11(2):224–230. https://doi.org/10.1007/s12663-011-0289-7 PMid:23730074 PMCid:PMC3386400

Adeyemo WL, Ogunlewe MO, DesaluI, Akanmu ON, Ladeinde AL. Submental/ Transmylohyoid intubation inmaxillofacial surgery: Report of two cases. Nigerian Journal of Clinical Practice. 2011; (14)1:98–101. https://doi.org/10.4103/1119-3077.79266 PMid:21494002

Altermir FH. The submental route for endotracheal intubationa new technique. Journal of Oral and Maxillo Facial Surgery. 1986; 14:64–5. https://doi.org/10.1016/S03010503(86)80261-2

Stoll P, Galli C, Wachter R, Bahr W. Submandibular endotracheal intubation in panfacial fractures. Journal of Clinical Aneasthesia. 1994; 6:83–6. https://doi.org/10.1016/09528180(94)90127-9

Lee SS, Huang HS, Wu SH, Sun IF, Chu KS, Lai CS, Chen YL. A review of intraoperative airway management for midface facial bone fracture patients. Ann Plast Surg. 2009; 63:162–6. https://doi.org/10.1097/SAP.0b013e3181855156 PMid:19542879

Dutta A, Kumar V, Saha SS, Sood J, Khazanchi RK. Retromolar tracheal tube positioning for patients undergoing faciomaxillary surgery. Can J Anaesth. 2005; 52:341. https://doi.org/10.1007/BF03016082 PMid:15753518

Taiwo AO, Ibikunle AA, Braimah RO. Airway management with submental orotracheal intubation in maxillofacial surgery: Our experience and literature review. Niger J Surg Res. 2016; 17:38–42. https://doi.org/10.4103/1595-1103.194218

Caubi AF, Vasconcelos BCE, Vasconcellos RJH, Morais HHA, Rocha NS. Submental intubation in oral maxillofacial surgery: Review of the literature and analysis of 13 cases. Med Oral Patol Oral Cir Bucal. 2008; 13(3):197–200.

Meyer C, Valfrey J, Kjartansdortir T, Wilk A, Barriere P. Indications for and technical refinements of submental intubation in oral and maxillofacial surgery. Journal of Cranio-Maxillofacial Surgery. 2003; 31(6):383–8. https:// doi.org/10.1016/j.jcms.2003.07.005 PMid:14637068

Faraj JH, Al Khalil M, Darwish AZ, Faraj I, El Zenati H, Eltiraifi Y. Submandibular intubation. Qatar Medical Journal. 2012:.2. Available from: http://dx.doi.org/10.5339/ qmj.2012.2.21 https://doi.org/10.5339/qmj.2012.2.21

Savitha KS, Kujur AR, Vikram MS, Joseph S. A modified submental orotracheal intubation. Anesth Essays Res. 2016 Jan-Apr; 10(1):132–5. https://doi.org/10.4103/02591162.165518 PMid:26957708 PMCid:PMC4767081

Cipnano A, Mao ML, Hon HH, Vazquez D, Stawicki SP, Sharpe RP, Evans DC. An overview of complications associated with open and percutaneous tracheostomy procedures. Int J W Illn Inj Sc. 2015; 5(3):170–88.

Caron G, Paquin R, Lessard MR, Trepanier CA, Landry PE. submental endotracheal intubation: An alternative to tracheostomy in patients with midfacial and panfacial fractures. J Trauma. 2000; 48:235–40. https://doi.org/10.1097/00005373-200002000-00007 PMid:10697080

Leandro LFL, Guevara HAG, Marinho K, Rivero CS, Lopez MAL. Intubación submental: Experiencia con 30casos. Rev Esp Cir Oral Maxilofac. 2015; 37:132–7. https://doi.org/10.1016/j.maxilo.2013.12.001

Helm M, Gries A, Mutzbauer T. Surgical approach in difficult airway management. best practice and research. Clinical Anaesthesiology. 2005; 19(4):623–40. PMid:16408538

Drolet P, Giraid M, Poirier J, Grenier Y. Facilitating submental endotrachial intubation with an endotracheal tube exchanger. Anaesthesia and Analgesia. 2000; 90:222–3. https://doi.org/10.1097/00000539-200001000-00044

Macinnis E, Baig M. A modification submental approach for oral endotracheal intubation. International Journal of Oral and Maxillofacial Surgery. 1999; 28:344–6.

https://doi.org/10.1034/j.1399-0020.1999.285280506.x

Chandu A, Smith ACH, Gebert R. Submental intubation an alternative to short-term tracheostomy. Anaesth, Intensive Care. 2000; 28:193–5. PMid:10788973

Paetkai DJ, Stranc MF, Ong BY. Submental intubation for maxillofacial surgery. Anaesthesiology. 2000; 92:9–12.


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