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Troise S, Committeri U, Barone S, Palumbo D, D'Auria D, Arena A, Romano A, Salzano G, Abbate V, Raccampo L, Sembronio S, Vaira LA, Dell'Aversana Orabona G, Califano L, Piombino P. Submental intubation in complex maxillofacial trauma: Pilot balloon protection. J Craniomaxillofac Surg 2024; 52:212-221. [PMID: 38143159 DOI: 10.1016/j.jcms.2023.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 10/02/2023] [Accepted: 12/11/2023] [Indexed: 12/26/2023] Open
Abstract
AIMS This study aims to describe our refined technique of submental intubation to avoid the recorded intraoperative complications related to tube passage and pilot balloon rupture. CASE SERIES This is a retrospective case series of 21 patients with complex maxillofacial trauma who underwent submental intubation from January 2019 to January 2023. All the patients underwent to the same procedure with a new technique of pilot balloon protection: the pilot balloon was not deflated because, once the connector was removed, only the tube was curved and passed through the incision extraorally while the cuff remained inflated. The wire of the pilot balloon was passed behind the last tooth so as not to interfere with the maxillary-mandibular fixation, remaining extraorally under the anesthetist's view. DISCUSSION Only 2 patients (9.5%) reported complications related to submental intubation: in particular a patient (4.8%) reported oral floor infection, and in another patient (4.8%) an unesthetic skin scar was observed. No patients reported intraoperative complications related to the procedure. CONCLUSION The technique of pilot balloon protection that we have proposed seems to be effective in reducing the intraoperative complications related to the passage of the pilot balloon, such as rupture, damage or early extubation.
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Affiliation(s)
- Stefania Troise
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Via Sergio Pansini 5, 80131, Naples, Italy
| | - Umberto Committeri
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Via Sergio Pansini 5, 80131, Naples, Italy
| | - Simona Barone
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Via Sergio Pansini 5, 80131, Naples, Italy.
| | - Daniela Palumbo
- Department of Surgical, Anesthesiological Intensive Care and Emergency Sciences, Federico II University of Naples, Naples, Italy
| | - David D'Auria
- Department of Surgical, Anesthesiological Intensive Care and Emergency Sciences, Federico II University of Naples, Naples, Italy
| | - Antonio Arena
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Via Sergio Pansini 5, 80131, Naples, Italy
| | - Antonio Romano
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Via Sergio Pansini 5, 80131, Naples, Italy
| | - Giovanni Salzano
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Via Sergio Pansini 5, 80131, Naples, Italy
| | - Vincenzo Abbate
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Via Sergio Pansini 5, 80131, Naples, Italy
| | - Luca Raccampo
- Maxillofacial Surgery Unit, Academic Hospital of Udine, Department of Medicine, University of Udine, 33100, Udine, Italy
| | - Salvatore Sembronio
- Maxillofacial Surgery Unit, Academic Hospital of Udine, Department of Medicine, University of Udine, 33100, Udine, Italy
| | - Luigi Angelo Vaira
- Maxillofacial Surgery Operative Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100, Sassari, Italy
| | - Giovanni Dell'Aversana Orabona
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Via Sergio Pansini 5, 80131, Naples, Italy
| | - Luigi Califano
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Via Sergio Pansini 5, 80131, Naples, Italy
| | - Pasquale Piombino
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Via Sergio Pansini 5, 80131, Naples, Italy
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Rajan S, Suresh AP, Ramakrishnan M, Paul J. Techniques of securing endotracheal tube during cosmetic facial surgeries involving nose, cheeks, and chin. J Anaesthesiol Clin Pharmacol 2023; 39:668-669. [PMID: 38269178 PMCID: PMC10805206 DOI: 10.4103/joacp.joacp_132_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 05/01/2022] [Accepted: 05/30/2022] [Indexed: 01/26/2024] Open
Affiliation(s)
- Sunil Rajan
- Department of Anaesthesiology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, India
| | - Aishwarya P. Suresh
- Department of Anaesthesiology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, India
| | - Madhumita Ramakrishnan
- Department of Anaesthesiology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, India
| | - Jerry Paul
- Department of Anaesthesiology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, India
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Bihani P, Paliwal N, Jaju R, Chattopadhyay C, Chhabra A. Ultrasound-guided seldinger technique-assisted submental intubation for panfacial trauma-walking off the beaten path. Saudi J Anaesth 2023; 17:349-352. [PMID: 37601507 PMCID: PMC10435798 DOI: 10.4103/sja.sja_778_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 11/18/2022] [Accepted: 11/18/2022] [Indexed: 08/22/2023] Open
Abstract
Introduction After introduction of ultrasound, there is paradigm shift towards under vision performance of procedures in anaesthesia. Blind puncture and dissection of submental space may lead to vascular injury and injury to salivary glands. We describe the ultrasound guided Seldinger technique assisted submental intubation for panfacial trauma. Methodology Modified ultrasound guided Seldinger technique for submental intubation in 10 patients, who were posted for open reduction and fixation of panfacial fractures. Total procedural time, peri-procedural complications such as bleeding, dislodgment of tube, desaturation and postoperative complications such as injury to sublingual glands/submandibular glands, hematoma, cheloid or hypertrophic scar formation or skin site infection were noted. Results The mean time to perform submental intubation was 8.9 ± 0.94 minutes (range, 8-11 minutes). Only one patient had minor bleeding during procedure which was stopped after local application of pressure. All patients had a clean scar with no formation of cheloid or hypertrophic scar in the postoperative follow up. Conclusion Ultrasound assisted submental intubation increases safety of the procedure in patients presenting with maxilla-facial trauma.
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Affiliation(s)
- Pooja Bihani
- Department of Anaesthesiology, S.N. Medical College, Jodhpur, Rajasthan, India
| | - Naveen Paliwal
- Department of Anaesthesiology, S.N. Medical College, Jodhpur, Rajasthan, India
| | - Rishabh Jaju
- Department of Anaesthesiology, AIIMS, Deoghar, Jharkhand, India
| | | | - Abhas Chhabra
- Department of Anaesthesiology, S.N. Medical College, Jodhpur, Rajasthan, India
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de Souza AAB, Araújo SCS, Martins GH, de Jesus AO, Amaral MBF, Silveira RL. New Device for Submental Endotracheal Intubation: A Prospective Cohort Study. J Oral Maxillofac Surg 2022; 80:1927-1942. [PMID: 36137556 DOI: 10.1016/j.joms.2022.08.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 08/18/2022] [Accepted: 08/18/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE Silveira et al (2020) described a new device that aims to facilitate submental intubation. This study aimed to verify the clinical complications from using this new device for submental endotracheal compared to the conventional technique. MATERIAL AND METHODS Patients who underwent submental intubation with the orotracheal tube transposition device were compared to those who underwent the conventional technique in a prospective cohort study. The primary predictor variable was intubation technique: conventional versus device-assisted. The primary outcome was total complications (all complications trans and postoperative, were recorded). Secondary variables were 1) age, 2) sex, 3) etiology, 4) race/ethnicity, 5) fracture types, and 6) intubation procedure time. The data were analyzed using descriptive and inferential statistics. Differences were considered statistically significant at P < .05. RESULTS Forty-two cases are described, including 24 cases with the device and 18 cases using the conventional technique. The mean age was 30.5 ± 11.228 years. The majority of patients were of male sex (88%), non-white (64%), and victims of motorcycle accidents (33%). The mean time to perform submental intubation was 9.9 minutes (±2.1293). Nine complications were recorded, including 2 intraoperative (2 tube dislocations) and 7 postoperative (5 unesthetic scars, one localized hematoma, and one skin infection). The technique used did not affect the time to submental intubation (P = .610). There was no association between technique and occurrence of intraoperative (P = .679; RR = 0.75; confidence interval [CI], 0.05-11.2), postoperative (P = .656; RR = 1.000; CI, 0.255-3.922), or total complications (P = .602; RR = 0.938; CI, 0.293-3.003). CONCLUSION The new device proposed seems to be a good option with similar complication rates as compared to conventional submental intubation.
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Affiliation(s)
| | | | - Gustavo Henrique Martins
- Resident, Resident of Oral and Maxillofacial Surgery, Hospital João XXIII/FHEMIG, Belo Horizonte, MG, Brazil
| | | | | | - Roger Lanes Silveira
- Residency Program Director of Oral and Maxillofacial Surgery, Hospital João XXIII/FHEMIG, Belo Horizonte, MG, Brazil; Otorhinolaryngology/Head and Neck Surgery Service, Santa Casa, Belo Horizonte, MG, Brazil
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Contemporary management of complex craniofacial trauma: virtual planning, navigation and the novel thermoformed cage splints in a strategic, sequential, computer-guided protocol. J Craniomaxillofac Surg 2022; 50:837-847. [PMID: 36272940 DOI: 10.1016/j.jcms.2022.09.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 09/13/2022] [Accepted: 09/27/2022] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION It was the aim of the study to assess if computerized simulation and the use of thermoformed cage splints are useful to plan cases of complex craniofacial trauma. MATERIALS AND METHODS patients with fractures in any of the thirds of the craniofacial skeleton and occlusion impairment. Virtual surgical planning with digital reduction of fractures, navigated planning, thermoformed cage splints were used in all cases. Surgical outcomes were evaluated by computing the surface deviation and occlusograms between planned and postoperative models. RESULTS 13 patients were enrolled in this study. Accuracy of bone repositioning was evaluated compared with the surgical planning. For the mandible, mean Root Mean Square Error (RMSE) was of 1.67 with a standard deviation (SD) of ±0.75 mm (p < 0.001); for the maxilla, average RMSE was of 0.88 with SD of ±0.52 mm (p < 0.001); and for midfacial and upper third bone segments, average RMSE was of 0.59 with SD of ±0.47 mm (p < 0.001) CONCLUSIONS: Within the limitations of the study it seems that thermoformed cage splints might be a promising alternative to other well-established approaches for accurate occlusal restoration and can be fully integrated within the digital workflow.
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Williams KAD, Tariq M, Acharekar MV, Guerrero Saldivia SE, Unnikrishnan S, Chavarria YY, Akindele AO, Jalkh AP, Eastmond AK, Shetty C, Rizvi SMHA, Sharaf J, Mohammed L. Submental Intubation in Maxillofacial Procedures: A More Desired Approach Than Nasotracheal Intubation and Tracheostomy. Cureus 2022; 14:e27475. [PMID: 36060344 PMCID: PMC9421558 DOI: 10.7759/cureus.27475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Accepted: 07/29/2022] [Indexed: 11/20/2022] Open
Abstract
To achieve adequate airway management in maxillofacial procedures, the right intubation technique should be employed. This is because the surgeons and the anesthesiologists will need to work in the same surgical field to ensure a successful procedure. The type of intubation method used can either complicate either's role or pose some difficulties in the surgery itself. Nasotracheal intubation and orotracheal intubation may often be contraindicated in different types of maxillofacial surgeries and due to the complications associated with a tracheostomy, this method is often utilized as a last resort. Submental intubation has become very popular and favored alternative and has been associated with fewer complications. This literature review was conducted to explore the indications, complications, and contraindications of the different intubation methods. Sources were gathered from PubMed Central, PubMed, and Google scholar and included articles published between 2012 and 2022. A mix of literature reviews, case base studies, retrospective studies, prospective studies, and a few systematic reviews were examined. It was found that the use of submental intubation was preferred due to its less invasive nature, minimal intraoperatively and postoperatively complications, and greater patient compliance compared to tracheostomy. In addition, it is the best method when Nasotracheal intubation is contraindicated.
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Abstract
Panfacial trauma refers to high-energy mechanism injuries involving two or more areas of the craniofacial skeleton, the frontal bone, the midface, and the occlusal unit. These can be distracting injuries in an unstable patient and, as in any trauma, Advanced Trauma Life Support (ATLS) protocols should be followed. The airway should be secured, bleeding controlled, and sequential examinations should take place to avoid overlooking injuries. When indicated, neurosurgery and ophthalmology should be consulted as preservation of brain, vision, and hearing function should be prioritized. Once the patient is stabilized, reconstruction aims to reduce panfacial fractures, restore the horizontal and vertical facial buttresses, and resuspend the soft tissue to avoid the appearance of premature aging. Lost or comminuted bone can be replaced with bone grafts, although adequate reduction should be ensured prior to any grafting. Operative sequencing can be performed from top-down and outside-in or from bottom-up and inside-out depending on patient presentation. All protocols can successfully manage panfacial injuries, and the emphasis should be placed on a systematic approach that works from known areas to unknown areas.
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Affiliation(s)
- Benjamin B Massenburg
- Division of Plastic Surgery, Department of Surgery, University of Washington, Seattle, Washington
| | - Melanie S Lang
- Department of Oral and Maxillofacial Surgery, University of Washington, Seattle, Washington
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Nseir S, Abu Shqara F, Krasovsky A, Rachmiel A. Surgical Dilemmas in Multiple Facial Fractures - Coronal Flap Versus Minimally Invasive: Case Report and Literature Review. Ann Maxillofac Surg 2021; 11:191-194. [PMID: 34522683 PMCID: PMC8407624 DOI: 10.4103/ams.ams_452_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 03/21/2021] [Accepted: 03/30/2021] [Indexed: 11/28/2022] Open
Abstract
The Rationale: Pan-facial fracture is a complex trauma that involves the upper, middle, and lower third of the facial bones. The surgical management of such complex cases is either by the posterior approach (coronal flap) or anterior approach through local incisions. Patient Concerns: This report describes the case of severe pan-facial trauma in a 52-year-old male who sustained a severe pan-facial trauma. Diagnosis: He suffered from multiple facial fractures that included: Frontal bone, skull base, Naso-orbitoethmoid (NOE), zygomatic and sub-condylar fractures. Treatment: He was managed by minimally local periorbital and lynch incisions. Outcomes: Fractures were properly reduced with resultant symmetrical facial dimensions. No postoperative complications were demonstrated including facial nerve function. Take-away Lessons: We should consider minimally invasive local incisions in pan-facial fractures when there is no need to restore the frontal sinus and the anterior-posterior dimensions of the zygomatic arch.
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Affiliation(s)
- Saleh Nseir
- Department of Oral and Maxillofacial Surgery, Rambam Health Care Campus, Haifa, Israel
| | - Fadi Abu Shqara
- Department of Oral and Maxillofacial Surgery, Rambam Health Care Campus, Haifa, Israel
| | - Andrei Krasovsky
- Department of Oral and Maxillofacial Surgery, Rambam Health Care Campus, Haifa, Israel
| | - Adi Rachmiel
- Department of Oral and Maxillofacial Surgery, Rambam Health Care Campus, Haifa, Israel.,The Ruth and Bruce Rappaport Faculty of Medicine, Institution of Technion, Haifa, Israel
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Daniels JS, Albakry I, Braimah RO, Samara MI, Albalasi RA, Begum F, Al-Kalib MAM. Experience with Airway Management and Sequencing of Repair of Panfacial Fractures: A Single Tertiary Healthcare Appraisal in Najran, Kingdom of Saudi Arabia - A Retrospective Study. Ann Maxillofac Surg 2020; 10:402-408. [PMID: 33708586 PMCID: PMC7943977 DOI: 10.4103/ams.ams_202_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 06/27/2020] [Accepted: 07/17/2020] [Indexed: 11/25/2022] Open
Abstract
Introduction: Special cooperation is required among surgeons and anesthetists in airway management during repair of panfacial fractures, due to problems of shared airway and occlusion. Several methods have been proposed for airway management and sequencing of repair of panfacial fractures. The main objective of the current study was to share our experience in the airway management and sequencing of repair of panfacial fractures. Methods: This was a retrospective study of panfacial fractures in the Kingdom of Saudi Arabia from January 2008 to December 2018. Data collected included demographics, type of airway management, sequence of repair (as primary variables), and outcome of surgery (secondary variable), while surgeon and anesthetic expertise are confounders. Data were analyzed using IBM SPSS Statistics for Windows Version 25 (Armonk, NY, USA: IBM Corp). Results were presented as simple frequencies and descriptive statistics. Pearson Chi-square was used to compare categorical variables such as airway management and sequencing of repair with the panfacial fractures. Statistical significance was set at P ≤ 0.05. Results: Overall, 1057 patients sustained different categories of maxillofacial bone fractures with 23 females and 1034 males (M:F of 46:1). A total of 43 male patients out of 1057 patients had panfacial fractures during the study period, giving a prevalence rate of 4.1%. Only the 43 male patients with panfacial fractures were analyzed. All cases were as a result of motor vehicular accident. Six (13.9%) patients had tracheostomy while 37 (86.1%) patients had submental intubation. “Bottom-up” and “outside-in” approach was used in 33 (76.7%) patients, while “top-bottom” and “inside-out” approach was used in 10 (23.3%) patients. Discussion: Submental intubation was the major airway management of panfacial fracture, and “bottom-up” and “outside-in” approach was the main sequence of repair in our series. These approaches have been mentioned in the literature. Conclusion: From our study, victims of pan-facial fractures were found to be exclusively male with MVA as the sole etiological factor. Barring severe head injuries, which may necessitate the use of tracheostomy to sustain breathing over a longer period, submental intubation is extremely reliable as a mode of airway management during surgical treatment of panfacial fractures. The sequencing of repair of panfacial fractures can only be determined according to the case presentation rather than a predetermined one.
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Affiliation(s)
- John Spencer Daniels
- Department of Oral and Maxillofacial Surgery, King Khalid Hospital, Najran, Kingdom of Saudi Arabia
| | - Ibrahim Albakry
- Department of Oral and Maxillofacial Surgery, King Khalid Hospital, Najran, Kingdom of Saudi Arabia
| | - Ramat Oyebunmi Braimah
- Department of Oral and Maxillofacial Surgery, Specialty Regional Dental Center, Najran, Kingdom of Saudi Arabia
| | - Mohammed Ismail Samara
- Department of Oral and Maxillofacial Surgery, King Khalid Hospital, Najran, Kingdom of Saudi Arabia
| | - Rabea Arafa Albalasi
- Department Oral and Maxillofacial Surgery, Sharourah General Hospital, Sharourah, Kingdom of Saudi Arabia
| | - Farzana Begum
- Department of Oral and Maxillofacial Surgery, King Khalid Hospital, Najran, Kingdom of Saudi Arabia
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Mishra R, Yadav D, Tripathi S, Kandel L, Baral PP, Shubham S, Karn A, Dutta K. Submental Intubations in Panfacial Fractures. Clin Cosmet Investig Dent 2020; 12:41-48. [PMID: 32110114 PMCID: PMC7036666 DOI: 10.2147/ccide.s228326] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 01/31/2020] [Indexed: 11/23/2022] Open
Abstract
Introduction Airway management in patients with panfacial fracture remains a challenge to anesthesiologists and surgeons. Submental intubation is an effective and less invasive alternative to tracheostomy during intraoperative airway management where orotracheal and nasotracheal intubation are not appropriate options. In addition, submental intubation allows proper access to oronasal airways and occlusion during intraoperative management. Methods The descriptive retrospective study was carried out and evaluated the outcomes of submental intubation in the management of panfacial fracture, complex maxillary or mandible fracture associated with nasal bone fracture and naso-orbito-ethmoid (NOE) fracture. The medical records of 23 patients who received submental endotracheal intubation were reviewed at UCMS College of Dental Surgery, Bhairahawa, Rupandehi, Nepal from March 2014 to December 2018. The following parameters were evaluated: mode of trauma, time required for intubation, accidental extubation, accidental perforation of the pilot balloon during its insertion, period of hospital stay, post-operative complications, such as the healing of submental scars both intraorally and extraorally. Results The submental intubation was successfully done in all patients with minimal obvious post-operative complications. The mode of trauma for majority of cases of panfacial fracture who underwent submental intubation was road traffic accident (69.56%). The mean time required for intubation was 8.43 (±0.84) minutes. No accidental extubations occurred. Accidental perforation of the pilot balloon was seen in one patient (4.35%) during tube manipulation which was managed successfully by changing the tube. The healing of submental scars was uneventful intraorally and extraorally in almost every case. The mean period of hospital stay in patients with submental intubation was 7.95 (±1.49) days. Discussion Submental intubation is an effective and safe method as it is not associated with complications of tracheostomy during management of panfacial fracture, NOE fracture and craniofacial fracture. In addition, it does not interfere with IMF during intraoperative period.
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Affiliation(s)
- Ravish Mishra
- Department of Oral and Maxillofacial Surgery, UCMS College of Dental Surgery, Bhairahawa, Rupandehi, Nepal
| | - Deepak Yadav
- Department of Oral and Maxillofacial Surgery, UCMS College of Dental Surgery, Bhairahawa, Rupandehi, Nepal
| | - Shashank Tripathi
- Department of Oral and Maxillofacial Surgery, UCMS College of Dental Surgery, Bhairahawa, Rupandehi, Nepal
| | - Laxmi Kandel
- Department of Oral and Maxillofacial Surgery, UCMS College of Dental Surgery, Bhairahawa, Rupandehi, Nepal
| | - Pawan Puspa Baral
- Department of Anaesthesiology and Critical Care, Universal College of Medical Sciences, Bhairahawa, Rupandehi, Nepal
| | - Snigdha Shubham
- Department of Conservative Dentistry and Endodontics, UCMS College of Dental Surgery, Bhairahawa, Rupandehi, Nepal
| | - Abhishek Karn
- Department of Forensic Medicine and Toxicology, Universal College of Medical Sciences, Bhairahawa, Rupandehi, Nepal
| | - Kishor Dutta
- Department of Orthodontics and Dentofacial Orthopaedics, UCMS College of Dental Surgery, Bhairahawa, Rupandehi, Nepal
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Submental intubation in oral and maxillofacial surgery: a systematic review 1986–2018. Br J Oral Maxillofac Surg 2020; 58:43-50. [DOI: 10.1016/j.bjoms.2019.10.314] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 10/25/2019] [Indexed: 01/04/2023]
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Submental Intubation: an Underutilized Technique for Airway Management in Patients With Panfacial Trauma. J Craniofac Surg 2018; 29:1349-1351. [PMID: 29561488 DOI: 10.1097/scs.0000000000004496] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
PURPOSE To evaluate submental intubation compared with secure airways of patients who have sustained significant maxillofacial trauma. PATIENTS AND METHODS Patient series of 3 patients who underwent submental intubation prior to open reduction internal fixation of fractures associated with the mid and lower face. All of these patients were initially orally intubated, and then converted to submental intubation prior to the reparative procedure. Detailed description of the procedure is discussed in each patient. RESULTS All the patients received appropriate reduction of facial fractures following submental intubation with no intraoperative complications. Two of the 3 patients were extubated immediately postoperatively and 1 was extubated on the second postoperative day. None of the patients had any complications associated with submental intubation. CONCLUSIONS Submental intubation is a safe and expedient technique to divert the airway in patients who require operative repair of panfacial injuries. This procedure is preferable over tracheostomy in selected patients of maxillofacial trauma without indication for prolonged ventilation support.
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