Basic and patient-oriented researchSubmental Intubation Versus Tracheostomy in Maxillofacial Trauma Patients
Section snippets
Surgical Procedure
After the induction of general anesthesia, the patient's trachea is intubated orally by standard direct laryngoscopy with a reinforced, spiral embedded, tracheal tube (Fig 1). It is important to release the sealed connector from the proximal end of the tube before intubation so that it can be easily disconnected during the procedure. Patients already intubated by other types of tubes must have their tubes replaced.
The oral route of intubation is converted into the transcutaneous
Discussion
An often-stated reason for avoidance of NTI in maxillofacial trauma patients is the danger of accidental passage of the tracheal tube into the cranial cavity during nasal intubation.2, 3 However, this is a rare incident and thinner gastric tubes are incomparably more prone to such a complication, as has been reported multiple times in the literature.16 A much more frequent obstacle to NTI is an associated nasal bone fracture, which cannot be properly managed in the presence of a nasal tube.
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Cited by (51)
Submental intubation in oral and maxillofacial surgery: a systematic review 1986–2018
2020, British Journal of Oral and Maxillofacial SurgeryCitation Excerpt :Two of them did not report sample size.24,25 Three studies on tracheostomy (n = 27) and submental intubation (n = 38) reported data on tracheostomy complications.26–28 No data were reported for 166 cases (7%).
The Characteristics and Cost of Le Fort Fractures: A Review of 519 Cases From a Nationwide Sample
2019, Journal of Oral and Maxillofacial SurgeryThirty years of submental intubation: a review
2018, International Journal of Oral and Maxillofacial SurgeryCan Submandibular Tracheal Intubation Be an Alternative to Tracheotomy During Surgery for Major Maxillofacial Fractures?
2017, Journal of Oral and Maxillofacial SurgeryCitation Excerpt :If not performed properly, damage to the Wharton duct openings may occur. Moreover, close positioning of the tube in the paralingual sulcus may be compromised.2 Toledo et al12 found that the main morbidities reported in the literature were skin infection (42%), salivary fistula (22%), tube-related accidents (16%), unaccepted scars (12%), bleeding (4%), and abscesses in the floor of the mouth.
Stoll's submandibular intubation: A safety alternative to Altemir's submental technique and traditional tracheostomy
2016, Journal of Oral and Maxillofacial Surgery, Medicine, and PathologyOtorhinolaryngology trainees and the alternatives to surgical tracheostomy: A survey study
2015, Journal of Taibah University Medical Sciences