Yonsei Med J.  2005 Aug;46(4):571-574. 10.3349/ymj.2005.46.4.571.

Submental Intubation with Reinforced Tube for Intubating Laryngeal Mask Airway

Affiliations
  • 1Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, Korea.
  • 2Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Korea. hanesth@yumc.yonsei.ac.kr
  • 3Department of Oral & Maxillofacial Surgery, Yonsei University College of Medicine, Seoul, Korea.

Abstract

Submental endotracheal intubation is a simple and secure alternative to either nasoendotracheal intubation or a tracheostomy in the airway management of maxillofacial trauma. However, a submental endotracheal intubation is quite difficult to manage if adverse events such as a tube obstruction, accidental extubation, or a leaking cuff with the endotracheal tube in the submental route occur, which could endanger the patient. This paper describes the use of a LMA-Fastrach (TM) ETT in the submental endotracheal intubation of patients suffering from maxillofacial trauma. One of the patients was a 16-year-old male, and the other was a 19-year-old male. They were scheduled for an open reduction and internal fixation of the maxillofacial fracture including naso-orbital-ethmoidal (NOE) complex, and a zygomaticomaxillary complex fracture. A submental intubation with a LMA-Fastrach (TM) ETT was performed in both cases, and the operation proceeded without any difficulties. These cases show that the use of the LMA- Fastrach (TM) ETT can improve the safety and efficacy of submental endotracheal intubation. This is because the LMA- Fastrach (TM) ETT has a freely detachable connector, and is flexible enough to keep the patency despite the acute angle of airway.

Keyword

LMA-Fastrach (TM) ETT; maxillofacial trauma; submental intubation

MeSH Terms

Adolescent
Adult
Humans
Intubation, Intratracheal/*instrumentation
*Laryngeal Masks
Male

Figure

  • Fig. 1 Reinforced tube (LMA-Fastrach™ETT) for intubating laryngeal mask airway and tube connector (detached).

  • Fig. 2 Intraoperative photograph. (A) Intra-oral view of placing the LMA-Fastrach™ETT. (B) Extra-oral view of LMA-Fastrach™ETT fixed through submental incision.


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