Submental intubation in complex maxillofacial trauma: Pilot balloon protection

Area of Science:

• Anesthesiology
• Oral and Maxillofacial Surgery

Background:

• Submental intubation is a valuable technique for complex maxillofacial trauma.
• Intraoperative complications, including pilot balloon rupture and tube damage, can occur during this procedure.
• A novel technique for pilot balloon protection is needed to improve safety.

Purpose of the Study:

• To describe a refined submental intubation technique.
• To evaluate the efficacy of a new pilot balloon protection method.
• To reduce intraoperative complications associated with submental intubation.

Main Methods:

• Retrospective case series of 21 patients with complex maxillofacial trauma.
• January 2019 to January 2023.
• A modified submental intubation technique involving pilot balloon protection without deflation, with the tube passed extraorally and the pilot balloon wire secured extraorally.

Main Results:

• No intraoperative complications related to the procedure were reported.
• Only 2 patients (9.5%) experienced post-procedural complications: one with oral floor infection (4.8%) and one with an unesthetic scar (4.8%).

Conclusions:

• The proposed pilot balloon protection technique is effective in minimizing intraoperative risks.
• This refined method reduces complications such as pilot balloon rupture, damage, or early extubation.
• The technique enhances safety during submental intubation for maxillofacial trauma patients.