Journal of The Korean Dental Society of Anesthesiology (대한치과마취과학회지)

The Korean Dental Society of Anesthsiology (대한치과마취과학회)
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Endotracheal Intubation Using Submandibular Approach for Maxillofacial Trauma Patients: Report of 2 Cases

  • Youn, Gap-Hee (Department of Oral and Maxillofacial Surgery, School of Dentistry, Dental Science Research Institute) ;
  • Ryu, Sun-Youl (Department of Oral and Maxillofacial Surgery, School of Dentistry, Dental Science Research Institute) ;
  • Oh, Hee-Kyun (Department of Oral and Maxillofacial Surgery, School of Dentistry, Dental Science Research Institute) ;
  • Park, Hong-Ju (Department of Oral and Maxillofacial Surgery, School of Dentistry, Dental Science Research Institute) ;
  • Jung, Seunggon (Department of Oral and Maxillofacial Surgery, School of Dentistry, Dental Science Research Institute) ;
  • Jeong, Seongtae (Department of Anesthesiology and Pain medicine, Chonnam National University Medical School) ;
  • Kook, Min-Suk (Department of Oral and Maxillofacial Surgery, School of Dentistry, Dental Science Research Institute)
  • Received : 2014.10.28
  • Accepted : 2014.12.23
  • Published : 2014.12.31
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Abstract

The indication for submandibular intubation is the requirement for intraoperative maxillomandibular fixation (MMF) in the presence of injuries that preclude nasotracheal intubation. Thus, We reported 2 cased of endotracheal intubations via submandibular approach that is applicable in patients with skull base fractures for a reliable general anesthesia. Endotracheal intubation via submandibular approach was applied during general anesthetic procedures for open reduction in three patients with Le Fort II, III or nasoorbitoethmoid (NOE) fractures. No complications due to submandibular intubation, such as infection, postoperative scarring, nerve injury, hematoma, bleeding, or orocutaneous fistula, were observed following submandibular intubation. Endotracheal intubation via submandibular approach is effective in patients with skull base fractures. In our method, the tube connector is removed in orotracheal intubation in order to avoiding the tube removal or displacement. The advantages of this method are very simple, safe, and to provide the good operation field.

Keywords

References

  1. Rawicz M: [Indications for endotracheal intubation], Med Wieku Rozwoj 2007; 12: 851-6.
  2. Zmyslowski WP, Maloney PL: Nasotracheal intubation in the presence of facial fractures, JAMA 1989; 262: 1327-8. https://doi.org/10.1001/jama.1989.03430100061014
  3. Benumof J: Conventional (laryngoscopic) orotracheal and nasotracheal intubation (single-lumen tube), Airway Management: Principles and Practice. St. Louis: Mosby 1996; 267.
  4. Gordon NC, Tolstunov L: Submental approach to oroendotracheal intubation in patients with midfacial fractures, Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1995; 79: 269-72. https://doi.org/10.1016/S1079-2104(05)80218-5
  5. Fonseca RJ. Oral and Maxillofacial Surgery: Orthognathic surgery, esthetic surgery, cleft and craniofacial surgery. WB Saunders Co; 2009.
  6. Peterson LJ. Peterson's principles of oral and maxillofacial surgery. PMPH-USA; 2004.
  7. Hall D, PETERSON A. Nasotracheal intubation with facial fractures. In.: AMER MEDICAL ASSOC 515 N STATE ST, CHICAGO, IL 60610; 1989. p. 1198-.
  8. Henderson J: Airway management in the adult, Miller's Anesthesia, 7th ed. Philadelphia: Churchill Livingston Elsevier 2010; 1573.
  9. Fonseca RJ, Barber HD, Powers MP, Frost DE. Oral and maxillofacial trauma. Elsevier Health Sciences; 2013.
  10. Cosgrove JF, Carrie S: Indications for and management of tracheostomies, Surgery (Oxford) 2012; 30: 238-43. https://doi.org/10.1016/j.mpsur.2012.02.002
  11. Cameron JL, Cameron AM. Current Surgical Therapy: Expert Consult. Elsevier Health Sciences; 2010.
  12. Lindholm CE, Grenvik A: Tracheal tube and cuff problems, Int Anesthesiol Clin 1982; 20: 103-52. https://doi.org/10.1097/00004311-198211000-00006
  13. Gaudet PT, Peerless A, Sasaki CT, Kirchner JA: Pediatric tracheostomy and associated complications, Laryngoscope 1978; 88: 1633-41.
  14. Jundt J, Cattano D, Hagberg C, Wilson J: Submental intubation: a literature review, Int J Oral Maxillofac Surg 2012; 41: 46-54. https://doi.org/10.1016/j.ijom.2011.08.002
  15. MacInnis E, Baig M: A modified submental approach for oral endotracheal intubation, Int J Oral Maxillofac Surg 1999; 28: 344-6. https://doi.org/10.1016/S0901-5027(99)80079-4
  16. Amin M, Dill‐Russell P, Manisali M, Lee R, Sinton I: Facial fractures and submental tracheal intubation, Anaesthesia 2002; 57: 1195-9. https://doi.org/10.1046/j.1365-2044.2002.02624_1.x
  17. Anwer H, Zeitoun I, Shehata E: Submandibular approach for tracheal intubation in patients with panfacial fractures, Br J Anaesth 2007; 98: 835-40. https://doi.org/10.1093/bja/aem094