Submental intubation versus tracheostomy in maxillofacial trauma patients

Affiliations


Abstract

Purpose: To evaluate the indications and outcomes of airway management by submental intubation or tracheostomy in patients with maxillofacial trauma, and to describe the technique of submental intubation in detail and discuss its latest refinements.

Patients and methods: Of 356 patients admitted from January 2004 through September 2007 with maxillofacial trauma, 222 were operated on under general anesthesia. Eight patients underwent urgent or elective tracheostomy; 8 patients underwent submental intubation.

Results: Seven patients with submental intubation were extubated at the end of the procedure. One patient received elective tracheostomy 3 days later. We did not encounter any complications in the tracheostomy group, while 1 case of slight damage to the endotracheal tube occurred in the submental intubation group.

Conclusions: Submental endotracheal intubation is a simple technique with very low morbidity and can replace tracheostomy in selected cases of maxillofacial trauma without indication for prolonged ventilation support.


Similar articles

Submental intubation in complex craniomaxillofacial trauma.

Davis C.ANZ J Surg. 2004 May;74(5):379-81. doi: 10.1111/j.1445-1433.2004.02995.x.PMID: 15144261

A retrospective analysis of submental intubation in maxillofacial trauma patients.

Lima SM Jr, Asprino L, Moreira RW, de Moraes M.J Oral Maxillofac Surg. 2011 Jul;69(7):2001-5. doi: 10.1016/j.joms.2010.10.017. Epub 2011 Mar 2.PMID: 21367502

Submental endotracheal intubation in concurrent orthognathic surgery: a technical note.

Nyárády Z, Sári F, Olasz L, Nyárády J.J Craniomaxillofac Surg. 2006 Sep;34(6):362-5. doi: 10.1016/j.jcms.2006.04.003. Epub 2006 Jul 24.PMID: 16860564

Transmylohyoid orotracheal intubation: case series and review.

Badjate SJ, Shenoi SR, Budhraja NJ, Ingole P.J Clin Anesth. 2012 Sep;24(6):460-4. doi: 10.1016/j.jclinane.2011.12.007.PMID: 22986317 Review.

Defining the role for submental intubation.

Eisemann B, Eisemann M, Rizvi M, Urata MM, Lypka MA.J Clin Anesth. 2014 May;26(3):238-42. doi: 10.1016/j.jclinane.2013.09.009. Epub 2014 May 9.PMID: 24813811 Review.


Cited by

Submental intubation versus tracheostomy in maxillofacial fractures.

Emara TA, El-Anwar MW, Omara TA, Anany A, Elawa IA, Rabea MM.Oral Maxillofac Surg. 2019 Sep;23(3):337-341. doi: 10.1007/s10006-019-00771-4. Epub 2019 May 16.PMID: 31093795 Clinical Trial.

A Simple and Reliable Submental Intubation Technique for Maxillofacial Fractures.

Oshima N, Shiraishi T, Kawauchi T, Oba J, Sato D, Fujiki M, Ozaki M, Takushima A, Harii K.J Craniofac Surg. 2018 Oct;29(7):1952-1955. doi: 10.1097/SCS.0000000000004628.PMID: 30113420 Free PMC article.

Airway management in a patient with Crouzon syndrome proposed to orthognathic surgery.

Fernandes M, Eufrásio A, Bonifácio J, Marcelino J.BMJ Case Rep. 2018 May 30;2018:bcr2017219371. doi: 10.1136/bcr-2017-219371.PMID: 29848516 Free PMC article.

A Randomized Control Trial of Awake Oral to Submental Conversion versus Asleep Technique in Maxillofacial Trauma.

Ali S, Athar M, Ahmed SM, Siddiqi OA, Badar A.Ann Maxillofac Surg. 2017 Jul-Dec;7(2):202-206. doi: 10.4103/ams.ams_10_17.PMID: 29264286 Free PMC article.

Anterior Submandibular Approach for Transmylohyoid Endotracheal Intubation: A Reappraisal with Prospective Study in 206 Cases of Craniomaxillofacial Fractures.

Bhola N, Jadhav A, Kala A, Deshmukh R, Bhutekar U, Prasad GSV.Craniomaxillofac Trauma Reconstr. 2017 Dec;10(4):255-262. doi: 10.1055/s-0037-1607063. Epub 2017 Sep 27.PMID: 29109835 Free PMC article.


KMEL References