Submental Intubations in Panfacial Fractures

Area of Science:

• Oral and Maxillofacial Surgery
• Anesthesiology
• Trauma Surgery

Background:

• Airway management in panfacial fractures presents significant challenges.
• Submental intubation offers a less invasive alternative to tracheostomy for intraoperative airway control.
• This technique facilitates oronasal airway access and occlusion.

Purpose of the Study:

• To evaluate the outcomes of submental intubation in patients with panfacial, complex maxillary/mandible, or naso-orbito-ethmoid fractures.
• To assess the safety and efficacy of submental intubation in managing complex craniofacial trauma.

Main Methods:

• A retrospective study reviewed 23 patients undergoing submental endotracheal intubation.
• Data collected included trauma mode, intubation time, complications, hospital stay, and scar healing.
• Evaluated outcomes for panfacial, complex maxillary/mandible, and naso-orbito-ethmoid fractures.

Main Results:

• Successful submental intubation in all patients with minimal complications.
• Road traffic accidents were the primary cause of injury (69.56%).
• Mean intubation time was 8.43 minutes; no accidental extubations occurred. One pilot balloon perforation managed successfully. Mean hospital stay was 7.95 days. Scar healing was uneventful.

Conclusions:

• Submental intubation is a safe and effective airway management strategy for panfacial and craniofacial fractures.
• It avoids the complications associated with tracheostomy.
• The procedure does not impede intraoperative intermaxillary fixation (IMF).