Novel alternative for submental intubation - A case report

Abstract

Background: Submental intubation is commonly used during general anesthesia for maxillofacial surgeries as it provides a safe unrestricted surgical access compared to tracheostomy. During submental intubation, soft tissues and blood clots can become lodged in the endotracheal tube. To overcome this problem, we used a laparoscopic trocar.

Case: A 52-year-old male with maxillofacial injury was scheduled to undergo an open reduction and internal fixation. We performed submental intubation using laparoscopic trocar, which created sufficient space for the insertion of the endotracheal tube. Unlike conventional methods, our method did not require any blunt dissection and caused significantly less soft tissue damage and required significantly less time.

Conclusions: Submental intubation with laparoscopic trocar is a one-step method and is quick and easy-to-perform technique with less complications.

Keywords: Airway management; Intratracheal; Intubation; Maxillofacial injuries; Trocar.

Fig. 1.

(A) Removal of the armored tube connector. (B) The armored endotracheal tube (internal diameter, 7.5 mm) passes through the 12-mm diameter lumen of the laparoscopic trocar.

Fig. 2.

(A) The 12-mm laparoscopic trocar is inserted in the skin-to-oral direction. (B) The tube is pulled through the passage of the trocar’s lumen.