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. 2013 Winter;25(70):17-22.

Submental intubation in maxillofacial trauma patients

Amin Rahpeyma  1 , Saeedeh Khajeh Ahmadi
Affiliations

Submental intubation in maxillofacial trauma patients

Amin Rahpeyma et al. Iran J Otorhinolaryngol. 2013 Winter.

Abstract

Introduction: To describe a modified technique for submental intubation in severely traumatized maxillofacial patients and to evaluate complications arising from the procedure.

Materials and methods: Submental intubation was performed in twelve patients with maxillofacial trauma ,from 2007-2012, which were operated under general anesthesia for treatment of facial fractures.

Results: The patients ranged in age from 14 to 39 years. No complications due to submental intubation, such as infection, hypertrophic scarring, lingual nerve injury, hematoma, bleeding, ranula formation, or orocutaneous fistula, were observed following submental intubation.

Conclusion: Submental intubation is a very useful technique in the management of maxillofacial trauma patients, with a low complication rate.

Keywords: Intubation; Jaw fracture; Submental.

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Figures

Fig1
Fig1
Schematic pictures of submental intubation. The tube illustrated is inserted in the midline submental region (skin is not shown). Note the myelohyoid muscle is penetrated but the anterior belly of the digaster is retracted. 1. Submental–submandibular intubation in anterior submandibular triangle; 2. Posterior submandibular intubation; 3. Myelohyoid muscle; 4. Anterior belly of digaster
Fig 2
Fig 2
Schematic picture of submental intubation. Note the myelohyoid muscle is penetrated but the geniohyoid muscle is retracted. 1.Submental–submandibular intubation in anterior submandibular triangle; 2.Posterior submandibular intubation; 3. Myelohyoid muscle; 4. Geniohyoid muscle; 5. Submandibular salivary gland; 6. Lingual nerve; 7. Sublingual salivary gland; 8. Mandibular lingual perforation vessels
Fig3
Fig3
A and B. Orotracheal armored tube disconnected from ventilator, detachable connector removed, tube cuff first introduced C. completed submental tube
Fig4
Fig4
Original subperiosteal midline submental intubation described by Altemir. This system has increased risk of bleeding and hematoma due to possible mandibular lingual perforation vessel damage during subperiosteal dissection in midline, medial mandibular border
See this image and copyright information in PMC

References

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