[Submental intubation for airway management in patients with middle third facial skeleton fractures]

Airway management in patients with middle third facial skeleton fractures is a challenge for anesthesiologists and surgeons, given that the natural routes for intubation--the nose and mouth--are both compromised by trauma. In this setting, the airway can only be accessed by tracheotomy. Tracheotomy, however, is an invasive technique that should be reserved for cases in which it is absolutely necessary.

To establish the utility of submental intubation as an alternative to tracheotomy in patients with middle third facial skeletal fractures.

We reviewed the cases of the 15 patients intubated with the aforementioned technique between 1996 and 2002 in Hospital Universitario La Paz in Madrid, Spain. We describe the surgical technique and postoperative course recorded for those patients.

The courses of surgery and postoperative recovery were without complications. All extubations were uneventful and no patient required a tracheotomy.

Submental intubation is a simple, useful technique for managing the airway of patients with middle third facial skeletal fractures. The technique has few complications.