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Submental intubation

Yuseon Cheong, Seong Sik Kang, Minsoo Kim, Hee Jeong Son, Jaewoo Park, Jeong-Mo Kim
Airway management in patients with complex maxillofacial injuries is a challenge to anesthesiologists. Submental intubation is a useful technique that is less invasive than tracheostomy in securing the airways where orotracheal and nasotracheal intubation cannot be performed. This procedure avoids the use of tracheostomy and bypasses its associated morbidities. A flexible and kink-resistant reinforced endotracheal tube with detachable universal connector is commonly used for submental intubation. Herein, we report cases involving submental intubation using a reinforced endotracheal tube with a non-detachable universal connector in patients with complex maxillofacial injuries...
September 2016: Journal of Lifestyle Medicine
Hooshang Akbari, Mohammad Ali Heidari-Gorji, Rostam Poormousa, Mitra Ayyasi
It can be challenging to create a safe airway in maxilla facial fracture and some skull surgeries. In this case study, the patient experienced jaw fractures that disturbed the dental occlusion and associated fracture of the base of the skull. Neither nasal nor oral intubation was possible based on the side effects of tracheotomy; therefore, submental intubation was applied successfully. The procedure and results are presented in the text.
June 2016: Journal of the Korean Association of Oral and Maxillofacial Surgeons
Ravi Raja Kumar, Suresh Vyloppilli, Shermil Sayd, Annamala Thangavelu, Benny Joseph, Auswaf Ahsan
OBJECTIVES: To assess submental route intubation as an alternative technique to a tracheostomy in the management of the airway in cranio-maxillofacial trauma, along with an assessment of its morbidity and complications. MATERIALS AND METHODS: Submental intubation was performed in 17 patients who had maxillofacial panfacial trauma and management was done under general anesthesia during a period of one year from 2013 to 2014 at Departments of Oral and Maxillofacial Surgery and Dentistry, the Malankara Orthodox Syrian Church Medical College, Kochi, India...
June 2016: Journal of the Korean Association of Oral and Maxillofacial Surgeons
Ashwant Kumar Vadepally, Brig Ramen Sinha, A V S S Subramanya, Anmol Agarwal
PURPOSE: The optimal route of intubation that may be planned for different oral and maxillofacial surgical manoeuvres. MATERIALS AND METHODS: A study was performed on patients who underwent nasal, oral or submental route of intubation for elective oral and maxillofacial surgery under general anaesthesia. The study variables were the anaesthetic and surgeon factors that should be taken into consideration before intubation and during surgery, and also algorithms for uneventful surgical procedures...
June 2016: Journal of Maxillofacial and Oral Surgery
Mohanavalli Singaram, Ilango Ganesan, Radhika Kannan, Rajesh Kumar
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...
April 2016: Journal of the Korean Association of Oral and Maxillofacial Surgeons
A Ujam, M Perry
PURPOSE: Submental intubation is widely accepted as a safe and effective alternative to nasal intubation or tracheostomy in head and neck surgery patients. Forceful or careless technique can cause significant bleeding and trauma to the soft tissues at this point, increasing the likelihood of troublesome sublingual haematoma. METHODS: We describe the use of a percutaneous tracheostomy horn (Cook Medical Blue Rhino(®)) to allow minimally traumatic submental intubation without the need for serial dilations...
April 30, 2016: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Ryosuke Kita, Toshihiro Kikuta, Masahiro Takahashi, Taishi Ootani, Masao Takaoka, Michitaka Matsuda, Hiroki Tsurushima, Izumi Yoshioka
Submental tracheal intubation is a technique for use in patients with maxillofacial trauma. The purpose of this retrospective study was to evaluate the efficacy and complications of this technique compared with tracheostomy. Twenty-five patients underwent submental tracheal intubation since 2001. Submental tracheal intubation was performed in cases needing intermaxillary fixation complicated by a nasal pyramid or anterior skull base fracture. No severe perioperative or long-term complications were noted. Intra- and postoperative complications were observed in three patients...
2016: Journal of Oral Science
Keelara Shivalingaiah Savitha, Abha Rani Kujur, M S Vikram, Shirley Joseph
In patients with concomitant occurrence of maxillofacial and basilar skull fractures, open reduction and internal fixation is the treatment. It requires intermittent intra operative dental occlusion which precludes oral or nasal intubation. In such cases submental intubation (SMI) is a recognized technique in practice. We describe a modified technique for smooth exteriorization of the endotracheal tube (ETT) during SMI. As the SMI technique is unusual for the performer, emphasis is laid on the applied aspects to minimize probable complications during the procedure...
January 2016: Anesthesia, Essays and Researches
K A Jeevan Kumar, B Pavan Kumar, A P Mohan, Aruna Kishore Masram, David Tyro, Divya Gandla
No abstract text is available yet for this article.
March 2016: Journal of Maxillofacial and Oral Surgery
Benjamin D Bradford, Jared C Inman, Farhad Ardeshirpour
No abstract text is available yet for this article.
May 1, 2016: JAMA Facial Plastic Surgery
Olanrewaju Abdurrazaq Taiwo, Adebayo Aremu Ibikunle, Ramat Oyebunmi Braimah, Musa Kallamu Suleiman
Several oral and maxillofacial surgery procedures require the simultaneous use of the oropharyngeal space by both the surgeons and the anaesthetists. This poses a lot of challenges especially in optimally securing the airway. Nasotracheal intubation or tracheostomy with their significant morbidity might even be contraindicated in these scenarios owing to several factors elucidated in the literature. Submental endotracheal intubation might be the last resort in adequately protecting the airway without interfering with the surgery...
October 2015: African Journal of Paediatric Surgery: AJPS
Tristan C Dumbarton, Orlando R Hung, Blaine Kent
In this report, we describe the case of a young female with Down syndrome who presented to the anesthesia service after pulseless electrical activity arrest with a King LT(S)-D extraglottic airway device in situ. She had multiple predictors of difficult intubation, including what appeared to be a submental mass consistent with Ludwig's angina. She went on to receive an urgent tracheotomy because of those predictors but had full resolution of the submental mass on removal of the extraglottic airway device, which had been overinflated at the time of insertion...
February 15, 2016: A & A Case Reports
Xinpei Zhang, Xing Wang, Qianping Gu, Jie Zhang, Ruihan Wu, Qianwei Zhuang, Li Na, Jian Meng
BACKGROUND: Severe cranio-maxillofacial trauma requires the utilization of alternative airway management techniques when oral and nasal routes of tracheal intubation are either not possible or contraindicated. METHODS: This retrospective study evaluated the techniques of submental intubation, retromolar intubation and tracheostomy in terms of their frequency of use, time required, costs involved and associated complications in a total of 200 patients. RESULTS: Frequency of utilization of alternative airway management techniques was 3...
December 2016: Minerva Chirurgica
M-Irfan Suleman, Anita N AkbarAli, M Saif Siddiqui, William F Alfonso
Submental intubation is an alternative to tracheostomy in patients requiring surgical access to both oral and nasal cavities. It is relatively safe, simple, and low morbidity procedure and requires only basic surgical equipment to perform. We successfully performed a submental intubation in a young patient with maxillofacial hypoplasia undergoing Le Fort I maxillary advancement without any intra- and post-operative complications.
June 2015: Middle East Journal of Anesthesiology
K A Jeevan Kumar, B Pavan Kumar, A P Mohan, Aruna Kishore Masram, David Tyro, Divya Gandla
INTRODUCTION: Securing an airway in maxillofacial injuries remains a challenge and is an important objective on the part of a maxillofacial surgeon to thoroughly understand its management. PURPOSE: The aim of this study was to evaluate the efficacy and complications of submental intubation in the management of midfacial/panfacial trauma patients where oro-endotracheal or naso-endotracheal intubation is contraindicated and tracheostomy can be avoided. PATIENTS AND METHODS: Twenty patients with maxillofacial injuries were selected for submental intubation who were admitted in Kamineni Hospital, Narketpally, Nalgonda during a 2 year period (2010-2012)...
September 2015: Journal of Maxillofacial and Oral Surgery
Mehul R Jaisani, Leeza Pradhan, Balkrishna Bhattarai, Alok Sagtani
OBJECTIVE: To evaluate the clinical outcomes of alternative techniques of intubation in patients sustaining maxillofacial injuries, where nasotracheal intubation (NTI) is best avoided. MATERIAL AND METHODS: Alternative techniques to standard naso-tracheal intubation like submental intubation, orotracheal intubation-retrotuberosity/retromolar and missing dentition were used and variables of clinical outcome recorded. RESULTS: Submental intubation provides an unobstructed intraoral surgical field, avoids intraoperative and postoperative complications of tracheostomy, and overcomes the disadvantages of NTI...
June 2015: Journal of Maxillofacial and Oral Surgery
Imran Khan, Deborah Sybil, Anurag Singh, Tarun Aggarwal, Rizwan Khan
Successful management of airway in complex maxillofacial injuries is quite challenging. The complications and the post-operative care associated with tracheotomy makes it an unpopular choice for airway management meant solely for surgery in these patients. A retrospective analysis of 12 patients from June 2008 to December 2011, seeking treatment for pan facial fractures who underwent transmylohyoid oroendotracheal (submental) intubation is discussed here. The stepwise procedure is explained along with problems of intubation in pan facial fractures...
July 2014: National Journal of Maxillofacial Surgery
Aruloli Mohambourame, Mohamed Sameer, V R Hemanth Kumar, Muthukumaran Ramamirtham
The main anesthetic concern with oral submucous fibrosis is progressive restriction of mouth opening due to fibrosis producing difficult airway. Securing airway by nasotracheal intubation and tracheostomy are associated with potential complications. Flexible fiberoscope is not available in all the institutes. Submental intubation using intubating laryngeal mask airway is an acceptable alternative technique in such situations. It also provides an unobstructed surgical field.
January 2015: Anesthesia, Essays and Researches
Babita Gupta, Arunima Prasad, Sarita Ramchandani, Maneesh Singhal, Purva Mathur
BACKGROUND: Maxillofacial trauma is an apt example of a difficult airway. The anesthesiologist faces challenges in their management at every step from airway access to maintenance of anesthesia and extubation and postoperative care. METHODS: A retrospective study was done of 288 patients undergoing surgery for maxillofacial trauma over a period of five years. Demographic data, detailed airway assessment and the method of airway access were noted. Trauma scores, mechanism of injury, duration of hospital stay, requirement of ventilator support were also recorded...
January 2015: Anesthesia, Essays and Researches
Madhu Rao, Deviprasad Shetty, Kush A Goyal, Kanika P Nanda
No abstract text is available yet for this article.
April 2015: Saudi Journal of Anaesthesia
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