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. 2011 May;55(3):299-304.
doi: 10.4103/0019-5049.82685.

Submental intubation in patients with panfacial fractures: A prospective study

Premalatha M Shetty  1 , Santosh Kumar Yadav, Madhusudan Upadya
Affiliations

Submental intubation in patients with panfacial fractures: A prospective study

Premalatha M Shetty et al. Indian J Anaesth. 2011 May.

Abstract

Submental intubation is an interesting alternative to tracheostomy, especially when short-term postoperative control of airway is desirable with the presence of undisturbed access to oral as well as nasal airways and a good dental occlusion. Submental intubation with midline incision has been used in 10 cases from October 2008 to March 2010 in the Department of Oral and Maxillofacial Surgery, Manipal College of Dental Sciences, Mangalore. All patients had fractures of the jaws disturbing the dental occlusion associated with fracture of the base of the skull, or/and a displaced nasal bone fracture. After standard orotracheal intubation, a passage was created by blunt dissection with a haemostat clamp through the floor of the mouth in the submental area. The proximal end of the orotracheal tube was pulled through the submental incision. Surgery was completed without interference from the endotracheal tube. At the end of surgery, the tube was pulled back to the usual oral route. There were no perioperative complications related to the submental intubation procedure. Average duration of the procedure was less than 6 minutes. Submental intubation is a simple technique associated with low rates of morbidity. It is an attractive alternative to tracheotomy in the surgical management of selected cases of panfacial trauma.

Keywords: Airway management; panfacial fractures; submental intubation.

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Conflict of interest statement

Conflict of Interest: None declared

Figures

Figure 1
Figure 1
Anesthetizing the local area
Figure 2
Figure 2
Incision placed and tunnelling done on the medial side of mandible to approach the floor of mouth
Figure 3
Figure 3
Submental exit and stabilization of endotracheal tube with adhesive tape and sutures
Figure 4
Figure 4
Schematic view of the tube position
Figure 5
Figure 5
Incision for submental intubation healed without scarring/keloid/fistula
See this image and copyright information in PMC

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