Submental Intubation: An Alternative and Cost-Effective Technique for Complex Maxillofacial Surgeries

Kar, Chiradip; Mukherjee, Siddhartha

doi:10.1007/s12663-010-0084-x

Cited by 16 publications

(8 citation statements)

References 11 publications

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“… 14,15 This procedure was recently evaluated and has been found to be a simple technique and one of choice that is favoured by maxillofacial surgeons, superseding tracheostomy, due to the fewer complications. 16,17 …”

Section: Case Presentationmentioning

confidence: 99%

Submandibular intubation

Faraj

Khalil

Darwish

et al. 2012

Qatar Medical Journal

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Section: Case Presentationmentioning

confidence: 99%

Submandibular intubation

Faraj

Khalil

Darwish

et al. 2012

Qatar Medical Journal

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“…[ 19 20 ] These procedures were recently evaluated and were been found to be simple technically and favoured by maxillofacial surgeons due to fewer complications related to these techniques. [ 17 21 ] Overall, the technique used in this study proved to be optimal both for surgeon and anaesthesiologist with respect to surgical access and patient's airway safety, respectively. It also avoided the poor aesthetic appeal and stigma associated with tracheostomy.…”

Section: Discussionmentioning

confidence: 90%

Submandibular intubation as an alternative for intra-operative airway management in maxillofacial fractures - our institutional experience

2016

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Background and Aims:Airway management in anaesthesia for maxillofacial surgical procedures is tricky at times when the nasal/oral routes are contraindicated or are impossible. Tracheostomy as an alternative inherits its own complications. We present a case series of the submandibular route for tracheal intubation as an alternative.Methods:The procedure was performed in ten selected adult patients with maxillofacial/mandibular fractures associated with a fracture of skull base or nasal bone. All of them were medically stable with no need of intensive care or mechanical ventilation in post-operative period.Results:Submandibular intubation in all ten patients of panfacial fractures allowed uninterrupted surgical techniques with a secured airway. All patients were reverted to oro-tracheal tube at the end of surgery as immediate maxillomandibular fixation was not necessary. The patients were extubated after recovery from anaesthesia before they left the operating theatre. One patient in the post-operative period had a superficial infection of incision site that responded well to local treatment. No other complications were encountered in the intra-operative or post-operative period.Conclusion:In complex maxillofacial injuries, when oral or nasal intubation hampers surgeon's field of view, submandibular intubation offers an effective alternative to short-term tracheostomy along with small risk potential. There is a need to emphasise its regular application in such cases so that technique can be mastered by both surgeons and anaesthesiologist.

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“…Most of the studies have either not mentioned the status of the patients at the time of SMI or conversion has been done subsequent to full induction and relaxation of the patient, later to the awake oral intubation. [ 18 19 20 21 22 ]…”

Section: Introductionmentioning

confidence: 99%

A randomized control trial of awake oral to submental conversion versus asleep technique in maxillofacial trauma

Ali

Athar

Siddiqi

et al. 2017

Ann Maxillofac Surg

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Aim:This study was designed to evaluate the efficacy of awake oral to submental conversion over asleep technique.Materials and Methods:This randomized clinical study was conducted in maxillofacial department of a tertiary care hospital in patients who had panfacial or mandibular fractures requiring elective surgical correction. The patients were randomly divided into two groups of 12 patients each, asleep fiberoptic-assisted submental intubation (SMI) (Group G; n = 12) and awake fiberoptic-assisted SMI (Group A; n = 12). The primary predictor was mean conversion time of oral to SMI while other predictors were overall success rate, ease of conversion, and complications. Data are presented as mean (±standard deviation) and frequencies (%) as appropriate. Statistical analysis done using unpaired t-test or Chi-square test was performed and P < 0.05 was considered statistically significant.Results:Twenty-four patients (19:5;Male:Female) aged 18–55 years (Group G = 35.96; Group A = 32.43 years) were included in the study. SMI was successful in all except two patients in group G. Overall success rate was similar in both groups. Time to convert orotracheal intubation to SMI was significantly less in group A (Group G = 9.55 ± 1.42, Group A = 5.67 ± 1.73; P < 0.001). Ease of SMI was found Grade I in 30% and 83% of the patients of group G and A, respectively. No serious complications were observed except 2 cases of bleeding, and 1 case of tube damage.Conclusion:Awake oral to submental conversion requires lesser time in comparison to asleep technique besides improving the ease (Δ = 53%) of the procedure.

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Submental Intubation: An Alternative and Cost-Effective Technique for Complex Maxillofacial Surgeries

Cited by 16 publications

References 11 publications

Submandibular intubation

Submandibular intubation

Submandibular intubation as an alternative for intra-operative airway management in maxillofacial fractures - our institutional experience

A randomized control trial of awake oral to submental conversion versus asleep technique in maxillofacial trauma

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