Submental tracheal intubation: A useful alternative during orthognathic surgery in an acromegalic patient with a history of cranial base surgery

Nasotracheal Intubation After Transsphenoidal Surgery: A Case Report

“…However, if these patients omit to undergo maxillofacial surgery that requires interdental occlusion, for the adjustment and fixation of maxillary fractures or orthognathic surgery, the standard orotracheal intubation may be unsuitable. Therefore, in these cases, anesthesiologists might consider two options for airway management during general anesthesia: the surgical approach, including elective tracheostomy and submental intubation [8,10], and fiberoptic nasotracheal intubation [11]. Although tracheostomy is traditionally used and well established for airway management, the surgical procedure is associated with several complications, including hemorrhage, recurrent laryngeal nerve damage, pneumothorax, tracheal stenosis, and undesirable scarring [10,12].…”

“…Therefore, in these cases, anesthesiologists might consider two options for airway management during general anesthesia: the surgical approach, including elective tracheostomy and submental intubation [8,10], and fiberoptic nasotracheal intubation [11]. Although tracheostomy is traditionally used and well established for airway management, the surgical procedure is associated with several complications, including hemorrhage, recurrent laryngeal nerve damage, pneumothorax, tracheal stenosis, and undesirable scarring [10,12]. Submental intubation can also cause hemorrhage, infection, orocutaneous fistula, and injury to the sublingual or lingual nerves [8,12].…”