• 대한치과마취과학회지
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• 제1권1호
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• pp.10-15
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• 2001

Background: This prospective study was designed to compare the cardiovascular response to endotracheal insertion of either an orotracheal tube or a nasotracheal tube Methods: 120 ASA physical status I and II surgical patients requiring general anesthesia and tracheal intubation were studied and assigned to two groups: orotracheal intubation group (n = 60) and nasotracheal intubation group (n = 60). Patients were premedicated with midazolam 0.05 mg/kg and glycopyrrolate 0.005 mg/kg intramuscularly and anesthesia was induced with thiopental sodium 5 mg/kg and succinylcholine 0.1 mg/kg intravenously. Systolic blood pressure (SBP), diastolic blood pressure (DBP). mean arterial pressure (MAP) and heart rate (HR) were assessed noninvasively before induction of anesthesia and immediately after intubation, 1 min, 2 min, 3 min, and 5 min after intubation. Results: Cardiovascular responses such as SBP, DBP, MAP and HR were similar for both techniques and no significant differences between two groups were observed until 5 min after intubation. Conclusions: In healthy ASA I and II patients with normal blood pressure, induction doses of thiopental sodium 5 mg/kg and succinylcholine 0.1 mg/kg didn't attenuated the cardiovascular response to laryngoscopy and tracheal intubation. Insertion of an endotracheal tube may be the most invasive stimulus during intubation procedures. (JKDSA 2001; 1: 10-15)

• Journal of Trauma and Injury
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• 제28권2호
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• pp.75-78
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• 2015

Mandible dislocation during endotracheal intubation is an unusual occurrence but easy to be overlooked for its unfamiliarity. We recently had a case of iatrogenic bilateral dislocation of a temporomandibular joint during orotracheal intubation and emphasize the importance of an early awareness of this possible complication.

• Journal of Dental Anesthesia and Pain Medicine
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• 제19권5호
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• pp.245-252
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• 2019

This paper describes the potential oral complications in preterm infants who have undergone orotracheal intubation. Neonatal intubation may have adverse effects on the developing deciduous teeth, oral soft tissues, and even the permanent teeth. However, endotracheal intubation may be essential for the survival of premature infants, owing to incomplete tracheal development. Excessive pressure to the oral tissue must be avoided, in cases where orotracheal intubation is inevitable. Moreover, the potential oral complications must be considered when neonatal intubation is performed for the patient's survival, and subsequent reevaluation and proper oral health care are needed.

• Journal of Dental Anesthesia and Pain Medicine
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• 제18권2호
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• pp.115-117
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• 2018

Lingual nerve injury is a rare complication of general anesthesia. The causes of lingual nerve injury following general anesthesia are multifactorial; possible mechanisms may include difficult laryngoscopy, prolonged anterior mandibular displacement, improper placement of the oropharyngeal airway, macroglossia and tongue compression. In this report, we have described a case of bilateral lingual nerve injury that was associated with orotracheal intubation for open reduction and internal fixation of the left distal radius fracture in a 61-year-old woman. In this case, early treatment with dexamethasone effectively aided the recovery of the injured lingual nerve.

• Journal of Dental Anesthesia and Pain Medicine
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• 제18권2호
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• pp.125-128
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• 2018

In cases of a difficult intubation where numerous intubation methods, including laryngoscopy, have failed, yet oral intubation is still necessary, the method of tube exchange after fiberoptic nasal intubation may be attempted. Fiberoptic nasal intubation allows intubation to be performed relatively easily when the laryngeal view grade is poor. We report a case in which our attempt at oral intubation for total maxillectomy with laryngoscopy and fiberoptic oral intubation had failed due to an unexpected difficult airway; subsequently, we successfully completed the surgery by performing fiberoptic nasal intubation to secure the airway, followed by using a tube exchanger to exchange to an oral endotracheal tube.

• Archives of Plastic Surgery
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• 제38권1호
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• pp.127-129
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• 2011

Purpose: Nasotracheal or oral intubation procedure is widely used for facial bone fractures. However, during the operation intubated tube can interfere or obstruct the view of the operator. We authors used a modified submental intubation method in panfacial bone fracture patients for intact airway and the operation view. Methods: After intravenous induction of anaesthesia, traditional orotracheal tubation was done. A horizontal incision was made 2 cm from the midline, 2 cm medial to and parallel with the mandible in the submental region. 1 In order to approach to the floor of the oral cavity, a haemostat was pushed through the soft tissues. A chest tube front cover was applied to the intubation tube and the tube was inserted through the submental tunnel. Orotracheal tube was disconnected and pulled back through the soft tissue and secured with a suture. Results: The procedure took about 30 minutes and there were no problems during the intubation. Intraoral manipulation and occlusal checks were free without any interference. Extubation was also easily done without any complications such as lung aspiration, infection, hematoma, or fistula. Conclusion: Submental endotracheal intubation is fast, safe, easy to use and free from the concern about the tube being pull back again. Conventional submental intubations are being held without any coverage of the tip. We authors applied the modified method to the trauma patients and obtained satisfactory results. From the above advantages, modified submental intubation can be widely available not only in fractured patients, but also in aesthetic or orthognathic surgeries.

• 대한치과마취과학회지
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• 제14권4호
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• pp.227-232
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• 2014

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.

• Journal of Dental Anesthesia and Pain Medicine
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• 제24권3호
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• pp.213-217
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• 2024

Numerous neoplastic lesions can arise in the orofacial region in the pediatric populations. Odontogenic tumors typically affect the mandible more than the maxilla. Airway management can be challenging in pediatric oral tumors because of the distorted anatomy and physiological variations. Conventional awake fiberoptic intubation is not always possible owing to limited cooperation from the pediatric populations. Herein, we report the case of a 1-year-old child with odontogenic myxoma of the mandible and an anticipated difficult airway. Given the expected difficulties in the airway, video laryngoscope-assisted orotracheal intubation under general anesthesia with maintenance of spontaneous breathing was scheduled. Proper planning and thorough examinations are vital for successful airway management in pediatric patients.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제42권2호
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• pp.99-104
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• 2016

Objectives: Submental intubation has been advocated as an alternative to classical tracheostomy for certain indicated panfacial trauma surgeries. Surgeons should have various options for airway management in maxillofacial trauma patients. Most maxillofacial injuries involve occlusal derangements, which might require intraoperative occlusal corrections; hence, orotracheal intubation is not ideal. Maxillofacial surgeons generally prefer nasotracheal intubation; however, in cases with concomitant skull base fracture or nasal bone fracture, nasotracheal intubation might not be suitable; in these situations, tracheostomy is typically performed. However, the possible complications of tracheostomy are well known. Due to trauma situations and to avoid the complications of tracheostomy, submental intubation would be an ideal alternative procedure in selected maxillofacial trauma surgery patients. This study aimed to evaluate the safety and usefulness of a submental intubation technique for panfacial trauma surgery. Moreover, we intended to share our experience of submental intubation and to recommend this simple, safe procedure for certain panfacial trauma surgeries. Materials and Methods: In five panfacial trauma patients, we performed submental intubation for airway management; the mean time required for the procedure was only eight minutes. Results: We were able to execute this procedure safely in a short time without any intraoperative or postoperative complications. Conclusion: Submental intubation is a safe and simple technique for airway management in indicated panfacial trauma surgery patients.

• Clinics in Shoulder and Elbow
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• 제7권1호
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• pp.51-55
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• 2004

Arthroscopic surgery of the shoulder is regarded as a convenient and safe approach, but there is a possibility of complication during procedure. We report an isolated unilateral hypoglossal neurapraxia following combined arthroscopic and open Bankart reconstruction performed in beach-chair position under general anesthesia with orotracheal intubation.