Submental intubation: our experience

Navaneetham, Anuradha; Thangaswamy, S Vinod; Rao, Naveen

doi:10.1007/s12663-010-0018-7

Cited by 18 publications

(13 citation statements)

References 17 publications

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“…30 Navaneetham A et al noted the mean time of 7 min for the procedure. 31 Tidke AS et al evidenced mean time of 15.51±1.85min for whole procedure of submental intubation and apnea time of 49.7±24.8 sec. 32 None of the studies evidenced hypoxia during disconnection of the tube from the circuit.…”

Section: Discussionmentioning

confidence: 95%

A study of submental intubation for anaesthesia in patients with faciomaxillary injuries

et al. 2016

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Background: Surgical repair of faciomaxillary trauma requires intraoperative occlusion of teeth that precludes orotracheal intubation. Airway management options in these patients are either nasotracheal intubation or tracheostomy. However nasal intubation is contraindicated in nasal bone fractures, skull base fractures. Tracheostomy, being a morbid procedure is not always a good option. Submental intubation allows a safe alternative in such patients.Methods: 25 Patients were studied with faciomaxillary trauma where submental intubation was indicated. After standard anesthesia induction patients were intubated with reinforced endotracheal tube (ETT), which is converted to submental route by a paramedian incision. At the end of the procedure, all patients had inter-maxillary wiring, were shifted to recovery room. Once they are recovered from the neuromuscular blockade ETT was removed through the submental tunnel.Results: This was a prospective observational study in 25 adult patients undergoing faciomaxillary surgeries requiring submental intubation. The mean apnoea time was 1.28±0.38 minutes and induction to submental intubation time was 9.68±1.82 minutes. In one case there was damage to the pilot balloon while pulling the tube through the submental tunnel. Two patients had right endobronchial migration of the ETT. On postoperative follow up, one patient had infection at the submental incision site. Conclusions: Submental intubation is a safe, effective, alternative for short term tracheostomy in faciomaxillary sugeries. Careful handling of the ETT is must to avoid damage while passing through the submental tunnel. Avoid extra length of the tube introrally to prevent endobronchial migration of the ETT.

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Section: Discussionmentioning

confidence: 95%

A study of submental intubation for anaesthesia in patients with faciomaxillary injuries

et al. 2016

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“…The most common indication for submental intubation was trauma (N = 721) in 86% of the reported cases followed by elective facial osteotomy (N = 100) in 12% of patients 1,2,4,6,[9][10][11]13,15,17,[19][20][21][22][25][26][27][28][31][32][33][34][35][36][37][39][40][41][42][43][44][45][49][50][51][52]54 . Transmaxillary cranial base tumour access (N = 18) comprised 2% of patients 13 .…”

Section: Indicationsmentioning

confidence: 99%

“…Devices utilized in performing the submental intubation consisted of reinforced spiral embedded endotracheal tubes (N = 775), non-reinforced endotracheal tubes (N = 22), reinforced laryngeal mask airway (LMA) (N = 6), Combitube (N = 1) and not reported (N = 38). Fibre or metal reinforced tubing is preferred due to the ability to maintain lumen patency at the acute tube angles common in submental intubation 1,9,[13][14][15]19,21,22,[25][26][27][31][32][33]35,36,38,[40][41][42][43][49][50][51]54 . No correlations were found between the type of tube utilized and damage to the tube during the procedure.…”

Section: Original Technique and Sequential Modificationsmentioning

confidence: 99%

“…Additional research is needed to validate various technique modifications aimed at reducing infrequent complications. 9 Retrospective study 3 BIGLIOLI et al 13 Retrospective study 3 CARON et al 15 Retrospective study 3 CAUBI et al 17 Retrospective study 3 CHANDU et al 19 Retrospective study 3 DAVIS 21 Retrospective study 3 GADRE & WAKNIS 25 Retrospective study 3 JÚ NIOR et al 31 Retrospective study 3 NAVANEETHAM et al 41 Retrospective study 3 SCHÜ TZ & HAMED 49 Retrospective study 3 TAGLIALATELA et al 51 Retrospective study 3 BABU et al 11 Case report 4 DROLET et al 22 Case report 4 EIPE et al 23 Case report 4 GORDON & TOLSTUNOV 27 Case report 4 GREEN & MOORE 28 Case report 4 KIM et al 32 Case report 4 KIM et al 33 Case report 4 LANGFORD 34 Case report 4 MACINNIS & BAIG 36 Case report 4 MAK & OOI 38 Case report 4 MANGANELLO-SOUZA et al 39 Case report 4 MEYER et al 40 Case report 4 UMA et al 52 Case report 4 YOON et al 54 Case report 4 CHOI et al 20 Case report 4 NYÁ RÁ DY et al 43 Case report 4 GARG et al 26 Case series 4 SHARMA et al 50 Case series 4 ALTEMIR et al 5 Surgical technique 4 ARYA et al 10 Surgical technique 4 ALTEMIR et al 6 Surgical technique 4 LIM et al 35 Surgical technique 4 MAHMOOD & LELLO 37 Surgical technique 4 NWOKU et al 42 Surgical technique 4 NYÁ RÁ DY et al 44 Surgical technique 4 AHMED & MITCHEL 2 Correspondence 5 BALL et al …”

Section: Original Technique and Sequential Modificationsmentioning

confidence: 99%

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Submental intubation: a literature review

Jundt¹,

Cattano²,

Hagberg³

et al. 2012

International Journal of Oral and Maxillofacial Surgery

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“…The advantages of these modifications are reported in the literature. 1,3,[10][11][12][13][14][15] 3. Though this method is a good option for the securing the airway of patients with multiple fractures in the maxillofacial region, it is not free of complications.…”

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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Submental intubation: our experience

Cited by 18 publications

References 17 publications

A study of submental intubation for anaesthesia in patients with faciomaxillary injuries

A study of submental intubation for anaesthesia in patients with faciomaxillary injuries

Submental intubation: a literature review

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

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