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Korean J Anesthesiol > Volume 43(3); 2002 > Article
Korean Journal of Anesthesiology 2002;43(3):375-378.
DOI: https://doi.org/10.4097/kjae.2002.43.3.375   
Submental Orotracheal Intubation for Maxillofacial Surgery: A case report.
Hyun Kyung Lim, Tae Jung Kim, Choon Soo Lee, Hong Sik Lee, Hae Jin Park, Chong Kweon Chung
Department of Anesthesiology, Inha University College of Medicine, Incheon, Korea. cck1264@unitel.co.kr
Abstract
Airway management for patients who have suffered multiple facial fractures and skull base fractures is complicated. Nasal intubation can interfere with centralization and stabilization of nasal fractures and may lead to cranial intubation. Restoring the dental occlusion by means of intraoperative maxillo- mandibular fixation is a prerequisite to the corrrect anatomical reduction of multiple facial fractures. This fixation precludes oral endotracheal intubation. In the past, it has been overcome by a tracheostomy. Complications of a tracheostomy include infection, hemorrhage, subcutaneous emphysema, pneumothorax, pneumomediastinum, recurrent laryngeal nerve damage, tracheal stenosis, and tracheoesophageal fistula. The technique of submental intubation was originally described by Altemir. This technique provide secure airway, an unobstructed intraoral airway field. and allows maxillomandibular fixation while avoiding the drawbacks and complications of naso-endotracheal intubation or tracheostomy. With this technique, the multiple facial fractures were corrected successfully.
Key Words: Airway; maxcillofacial surgery; submental intubation
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