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

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• 作者：Chiradip Kar (1)
  Srijon Mukherjee (2)
  
• 关键词：Submental intubation ; Maxillofacial surgery ; Tracheostomy ; Nasoethmoidal injury
• 刊名：Journal of Maxillofacial and Oral Surgery
• 出版年：2010
• 出版时间：September 2010
• 年：2010
• 卷：9
• 期：3
• 页码：266-269
• 全文大小：397KB
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• 作者单位：Chiradip Kar (1)
  Srijon Mukherjee (2)
  
  1. Department of Oral and Maxillofacial Surgery, Haldia Institute of Dental Sciences and Research, Banbishnupur, Balughata, Purba Medenipur, Haldia, 721645, West Bengal, India
  2. Calcutta Institute of Maxillofacial Surgery and Research, Kolkata, 700078, West Bengal, India
  

文摘

Introduction Management of airway is a significant issue especially in cases of complex maxillofacial trauma like panfacial fractures or concomitant nasoethmoidal injuries, where the nasotracheal intubation is contraindicated or possess a significant problem. In these cases the only other alternative is tracheostomy. Submental intubation is an alternative to tracheostomy and it can be easily performed with little or lesser post-operative complications. This method involves lesser expenses as it does away with longer post-operative stay in the hospital as required by tracheostomy patients. Technique The patient is orally intubated with a reinforced armoured tube with a detachable plastic gas connector. An incision is made in the submental area of the patient and a tunnel is prepared from this region to the floor of the mouth through which the proximal end of the tube is diverted. Thus the occlusion of the patient can be checked intraoperatively. After completion of the surgery the proximal end in reintroduced onto the oral cavity and the patient is extubated orally. Discussion Originally proposed by Altemir in 1986, this method cannot be used in all cases as it is not without limitations. In spite of these, submental intubation can be a useful alternative to tracheostomy, especially in regions where cost cutting is a major factor in health infrastructure. Conclusion Maxillofacial surgeons addressing major facial trauma surgery may have this procedure in mind before opting for tracheostomy. It avoids a lot of complications associated with tracheostomy.