Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2003 Nov;13(4):189-195.
doi: 10.1055/s-2004-817694.

Submental Orotracheal Intubation: An Alternative to Tracheotomy in Transfacial Cranial Base Surgery

Federico Biglioli  1 , Pietro Mortini, Mario Goisis, Alessandro Bardazzi, Nicola Boari
Affiliations

Submental Orotracheal Intubation: An Alternative to Tracheotomy in Transfacial Cranial Base Surgery

Federico Biglioli et al. Skull Base. 2003 Nov.

Abstract

This retrospective study evaluated the safety and efficacy of submental intubation not only for trauma treatment but also for oncological cranial base surgery. The medical records of 24 patients who underwent submental intubation from 1996 to 2002 were reviewed. There were 6 procedures for craniofacial trauma, 12 transmaxillary approaches to the clivus for clivus chordomas, and 6 transmaxillary approaches to the cranial base for chondrosarcomas. Time required for intubation, accidental extubation, postoperative complications, and the healing of intraoral and submental scars were evaluated. The submental orotracheal intubation was completed successfully in all patients. No accidental extubations or tube injuries occurred. The mean time required for intubation was 5 minutes. The only complication was one case of superficial infection of the submental wound. The intraoral and submental accesses healed with minimal scarring in all patients. Submental orotracheal intubation is a useful and safe technique for airway management of craniomaxillofacial traumas and during transfacial approaches to the cranial base. It avoids the complications associated with tracheostomy. It also permits considerable downward retraction of the maxilla after a Le Fort I osteotomy and is associated with good clival exposure. Furthermore, it does not interfere with maxillomandibular fixation at the end of the surgery.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Preoperative Magnetic Resonance (MR).
Figure 2
Figure 2
Intraoperative view of the submental intubation.
Figure 3
Figure 3
Surgical access to the clivus. Large arrow: exposure of the lesion. Small arrow: maxilla dislocated downward.
Figure 4
Figure 4
Postoperative view of patient.
Figure 5
Figure 5
Surgical scar.
Figure 6
Figure 6
Postoperative dental occlusion.
Figure 7
Figure 7
Postoperative MR.
Figure 8A
Figure 8A
Illustration showing anterior view of submental intubation.
Figure 8B
Figure 8B
Illustration showing lateral view of submental intubation.
See this image and copyright information in PMC

References

    1. Caron G, Pasquin R, Lessard M, Trepanier C, Landry PE. Submental endotracheal intubation: an alternative to tracheostomy in patients with midfacial and panfacial fractures. J Trauma. 2000;48:235–240. - PubMed
    1. Hall D. Nasotracheal intubation with facial fractures. JAMA. 1989;261:1198.
    1. Schultz RC. Nasotracheal intubation in the presence of facial fractures. Plast Reconstr Surg. 1990;86:1046. - PubMed
    1. Muzzi DM, Losasso TJ, Cucchiara RF. Complications from a nasopharyngeal airway in a patient with a basilar skull fractures. Anesthesiology. 1991;74:366–372. - PubMed
    1. Bahr W, Stoll P. Nasal intubation in the presence of frontobasal fractures. J Oral Maxillofac Surg. 1992;50:445–451. - PubMed