J Korean Assoc Maxillofac Plast Reconstr Surg.  2003 Jan;25(1):74-78.

Modified submental approach to oroendotracheal intubation in patients with panfacial bone fractures

• Kwon KH

Abstract

The use of nasoendotracheal intubation has become feasible in a wide variety of patients who were previously considered for tracheostomy in oral and maxillofacial surgery. But, according to the development of surgical technique, we need another method of intubation. It is possible that orthognathic surgery can be accomplished with other supplemental surgeries. However, rhinoplasty is impossible using the nasoendotracheal intubation. During the operation, it is uncomfortable and dangerous for intubation position to be changed. In addition, Le Fort II and III facial fractures, which involve the cribriform plates, pose the greatest potential for untoward effects from nasoendotracheal intubation. The purpose of this article is to present another technique of airway management, first described by Altermir in 1986. With the intention of avoiding tracheostomies and making our surgery easier in given cases, the submental approach has been developed for endotracheal intubation. In our method, the incision sites are lo ated in different positions between skin and muscle in order to avoiding the direct connection from extraoral to intraoral sites. The advantages of this method are very simple, non-complicated, secured the good operation field and avoiding the tracheostomy.

Keyword

Submental approach; Oroendotracheal intubation; Panfacial bone fractures

MeSH Terms

Airway Management
Ethmoid Bone
Fractures, Bone*
Humans
Intention
Intubation*
Intubation, Intratracheal
Orthognathic Surgery
Rhinoplasty
Skin
Surgery, Oral
Tracheostomy