Submental intubation: an alternative and cost-effective technique for complex maxillofacial surgeries

Area of Science:

• Maxillofacial Surgery
• Trauma Management
• Airway Management

Background:

• Airway management is critical in complex maxillofacial trauma, particularly with panfacial or nasoethmoidal injuries.
• Nasotracheal intubation is often contraindicated or problematic in such cases, leaving tracheostomy as the primary alternative.
• Tracheostomy can lead to significant post-operative complications and extended hospital stays.

Purpose of the Study:

• To evaluate submental intubation as a viable alternative to tracheostomy in maxillofacial trauma.
• To highlight the advantages of submental intubation regarding complications and cost-effectiveness.

Main Methods:

• Submental intubation involves orally intubating the patient with a reinforced tube.
• A submental incision creates a tunnel for the tube's proximal end, allowing intraoperative occlusion checks.
• The tube is repositioned orally for extubation after surgery.

Main Results:

• Submental intubation provides an alternative airway management strategy.
• The technique allows for intraoperative assessment of the patient's occlusion.
• It avoids the complications associated with tracheostomy.

Conclusions:

• Submental intubation is a useful alternative to tracheostomy, especially where cost is a concern.
• While not universally applicable, it offers significant benefits in specific maxillofacial trauma scenarios.
• Maxillofacial surgeons should consider submental intubation before resorting to tracheostomy to mitigate associated risks.