Retrotuberosity versus submentosubmandibular and median submental intubation: patients with maxillofacial surgery

In certain maxillofacial trauma cases, nasotracheal intubation is contraindicated and the standard method of orotracheal intubation interferes with maxillomandibular fixation. In such cases alternative techniques, such as submental, submentosubmandibular, and retromolar intubation have been used.

We reviewed 8 patients who underwent median submental intubation, 7 patients who underwent submentosubmandibular intubation, and 10 patients who underwent a retromolar intubation with an armored endotracheal tube secured in place with a circumdental wire. The tube was positioned in the retromolar region behind the most posterior maxillary tooth.

In the group of patients who underwent median submental intubation, 1 presented difficulty in performing a median submental intubation. No complications were recorded in the rest of the patients.

Submental and submentosubmandibular intubation are useful methods with low morbidity. However, both are invasive techniques compared with retrotuberosity intubation secured in place with a circumdental wire placed around the most posterior maxillary tooth.