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Endotracheal Intubation via Tracheotomy and Subsequent Thoracotomy in Rats for Non-Survival Applications

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Submandibular approach for tracheal intubation - a case report.

G Uma¹, P N Viswanathan, P S Nagaraja

¹Lecturer, Department of Anaesthesiology, JSS Medical College & Hospital, Mysore - 570004.

Indian Journal of Anaesthesia

|July 20, 2010

Summary

Managing airway in patients with panfacial fractures presents challenges. This case study details a successful modified submandibular approach for endotracheal intubation in severe facial trauma, ensuring an adequate surgical field.

Keywords:

Le Fort's fracture Maxillofacial surgeries Panfacial fractures Submandibular intubation

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Area of Science:

Anesthesiology
Oral and Maxillofacial Surgery
Trauma Management

Background:

Panfacial fractures, including Le Fort III, nasal bone, and symphysis menti fractures, pose significant airway management difficulties for anesthesiologists.
Securing a patent airway while maintaining surgical access is critical in patients with extensive facial trauma.

Purpose of the Study:

To describe a modified submandibular approach for endotracheal intubation in a patient with complex panfacial fractures.
To demonstrate a technique that facilitates both airway management and surgical access in severe facial trauma.

Main Methods:

Initial oral endotracheal intubation was performed in a patient with panfacial fractures.
A modification involved creating a submandibular incision to exteriorize the endotracheal tube.
The endotracheal tube was maintained via the submandibular approach throughout the surgical procedure.

Main Results:

Successful airway management was achieved using the modified submandibular approach.
The technique provided an adequate surgical field for the duration of the operation.
This method offered a viable alternative for intubation in complex facial trauma cases.

Conclusions:

The modified submandibular approach is a feasible and effective technique for endotracheal intubation in patients with panfacial fractures.
This approach can overcome challenges associated with securing an airway and maintaining surgical access in severe facial trauma.
Anesthesiologists can consider this technique to optimize patient care during complex maxillofacial surgeries.