Submandibular intubation; our experience in Qatar and a short review of literature

Faraj, Jafar H.; Alkhalil, Moustafa; Darwish, A.; Faraj, Ismail; El-Zenati, Hesham; Altraifi, Yasir; Nassir, F

doi:10.1016/j.ejenta.2013.01.001

Cited by 6 publications

(2 citation statements)

References 20 publications

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“…During exteriorization of the tube, we followed the recommendations of Faraj et al 31 The pilot bulb was first removed followed by ETT. Pilot bulb of the tube is carefully grasped at the tip of the spring-loaded valve and was carefully manipulated through the preformed tunnel to the external environment to prevent damage to the cuff.…”

Section: Discussionmentioning

confidence: 99%

Anterior Submandibular Approach for Transmylohyoid Endotracheal Intubation: A Reappraisal with Prospective Study in 206 Cases of Craniomaxillofacial Fractures

Bhola

Jadhav

Kala

et al. 2017

Craniomaxillofacial Trauma & Reconstruction

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Despite a paradigm shift in anesthesia and trauma airway management, the craniomaxillofacial fracture (CMF) patients continue to pose a challenge. A prospective study was planned between April 2007 and March 2015 to investigate the safety, efficacy, utility, and complications of anterior submandibular approach for transmylohyoid intubation (TMI) in CMFs using an armored endotracheal tube (ETT). Out of 1,207 maxillofacial trauma cases reported, this study recruited 206 patients (152 males and 54 females) aged between 21 and 60 years. No episode of oxygen desaturation was noted intraoperatively. Mean time to perform TMI was 6 ± 2 minutes. The mean transmylohyoid ETT withdrawal time/disconnection time from ventilator was approximately 1.5 minutes. Accidental partial extubation of ETT was noted in two patients (0.97%), and three patients (1.45%) developed abscess formations at anterior submandibular site which were managed by incision and drainage. The anterior submandibular approach for TMI was successfully used and provided stable airway in all elective CMF surgery cases, where oral or nasal intubations were not indicated/feasible and long-term ventilation support was not required. It permitted simultaneous dental occlusion-guided reduction and fixation of all the facial fractures without interference from the tube during the surgery with unhindered maintenance of the anesthesia and airway. The advantages include easy, swift, efficient, and reliable approach with a small learning curve.

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Section: Discussionmentioning

confidence: 99%

Anterior Submandibular Approach for Transmylohyoid Endotracheal Intubation: A Reappraisal with Prospective Study in 206 Cases of Craniomaxillofacial Fractures

Bhola

Jadhav

Kala

et al. 2017

Craniomaxillofacial Trauma & Reconstruction

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“…In our case, the minimum time was 6 min and the maximum time was 14 min, similar to the figures reported in the literature. [14][15][16] It is noteworthy and worth mentioning that: 1. The incision and blunt dis-section are made in the paramedian area, in order to avoid the separation or injury of geniohyoid and genioglossus muscles, which are moved towards the middle area.…”

Section: Discussionmentioning

confidence: 99%

Transmylohyoid Submental Intubation in complex maxillofacial trauma: The easiest method is also the safest method

Singh¹,

Dulal²,

Yadav³

et al. 2016

J Coll Med Sci-Nepal

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Background & Objectives:Complex maxillofacial tr auma is a common occurrence with high velocity road traffic accidents. Multiple facial bone fracture with loss of reference point for bony reduction requires use of intra-operative intermaxillary fixation to obtain good occlusion which precludes oral intubation. Fractures of nasal bones and ethmoid bones with complex distorted anatomy lead to inability to perform a nasal intubation. In such cases sub-mental intubation can be a safe and easy method of securing the intra-operative airway thus avoiding tracheotomy and its complications. Materials & Methods: Retrospective clinical analytical study was planned in which 25 patients were included. Patient's age, sex, type of trauma, time taken for procedure and complications were taken as study variables. Results: Average time taken for the procedure was nine minutes and only four out of 25 cases had complications. Conclusion: Sub-mental intubation requires simple skills, less time and is relatively complication free compared to tracheotomy in securing intra-operative airway during surgeries for complex maxillofacial trauma. Key words: Air way management; Panfacial fr actur e; Sub-mental intubation Citation: Singh AK, Dulal S, Yadav R, Thapa AS. Tr ansmylohyoid Submental Intubation in complex maxillofacial trauma: The easiest method is also the safest method. JCMS Nepal. 2016;12(2):55-9.

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Stoll's submandibular intubation: A safety alternative to Altemir's submental technique and traditional tracheostomy

Beeram

Seelam

Prasad

2016

Journal of Oral and Maxillofacial Surgery, Medicine, and Pathol

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Submandibular intubation; our experience in Qatar and a short review of literature

Cited by 6 publications

References 20 publications

Anterior Submandibular Approach for Transmylohyoid Endotracheal Intubation: A Reappraisal with Prospective Study in 206 Cases of Craniomaxillofacial Fractures

Anterior Submandibular Approach for Transmylohyoid Endotracheal Intubation: A Reappraisal with Prospective Study in 206 Cases of Craniomaxillofacial Fractures

Transmylohyoid Submental Intubation in complex maxillofacial trauma: The easiest method is also the safest method

Stoll's submandibular intubation: A safety alternative to Altemir's submental technique and traditional tracheostomy

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