In Situ Submental Tunneling Using Traumatic Tracts for Airway Management in Maxillofacial Gunshot Injury: A Two-Case...

Area of Science:

• Anesthesiology
• Trauma Surgery
• Otolaryngology

Background:

• Submental intubation is an alternative to tracheostomy for airway management in maxillofacial surgery when standard intubation is not feasible.
• Tracheostomy and submental intubation involve additional surgical procedures and incisions.

Purpose of the Study:

• To describe a novel approach using pre-existing traumatic tracts for airway management in patients with severe facial trauma.
• To evaluate the safety and efficacy of externalizing endotracheal tubes through existing facial wounds as an alternative to tracheostomy.

Main Methods:

• Reported two cases of self-inflicted facial gunshot injuries requiring airway intervention.
• Utilized pre-existing traumatic tracts to externalize reinforced endotracheal tubes.
• Emphasized multidisciplinary coordination between anesthesia and surgical teams.

Main Results:

• Successful airway management was achieved by externalizing endotracheal tubes through existing traumatic tracts.
• Tracheostomy and additional incisions were avoided.
• Patients had uncomplicated postoperative recovery with airway protection via the endotracheal tube.

Conclusions:

• Existing traumatic tracts can serve as a safe and efficient alternative to traditional submental intubation in selected maxillofacial trauma patients.
• This technique facilitates unobstructed surgical access and avoids the morbidity associated with tracheostomy.