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[Submental intubation in maxillofacial traumatology]
M El Bouihi1, A Bouaichi, S Lahmiti
1Service de chirurgie maxillofaciale et esthétique, centre hospitalier universitaire Mohammed VI, faculté de médecine et de pharmacie de Marrakech, Marrakech, Morocco. melbouihi@hotmail.com
Introduction:
Free access to the upper respiratory tract may be a challenge for the management of severe facial trauma. Tracheotomy is routinely used in this case. Submental intubation is little used, but it is an alternative to tracheotomy.
Material And Method:
A retrospective study was made over 1 year. Sixteen patients with facial smash were included. Patients who had undergone an immediate tracheotomy or a long-term intubation were excluded. Submental intubation was used in all patients with the same protocol. The studied data was: operative time, duration of ventilator disconnection, postoperative complications, and scar assessment.
Results:
The average operative time was seven minutes. No speech disorder, hematoma, or postoperative infection was observed. The scar was barely visible in 13 cases out of 16.
Discussion:
Submental intubation seems to be a reliable, simple and easy to learn technique. A perfect knowledge of the local anatomy allows opening the airway without any risk of hematoma. Incision packing reduces the bacterial inoculum and infectious risk. The residual scarring is minimal.
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