nach oben

22.03.2024

Pathways to Airways: Review and Considerations of Different Intubation Techniques in Oral and Maxillofacial Surgery

verfasst von: Kalyani Bhate, Sayali A Awate, Dharmesh C Gandhi, Uday Londhe, Sunnypriyatham Tirupathi, Bhushan Bhagat

Erschienen in: Current Oral Health Reports

Einloggen, um Zugang zu erhalten

Abstract

Purpose of Review

The aim of this work is to review and enlist the variations of intubations required in complex maxillofacial surgeries where temporary maxillomandibular fixation is essential.

Recent Findings

Most of the major maxillofacial trauma cases are operated under general anaesthesia. In these cases, both the anaesthetist and maxillofacial surgeon compete for the same area that is oral cavity. Routinely oral intubation is used in anaesthesia, but in maxillofacial surgical cases, there is a possibility of oro-endotracheal tube interfering with the sterile field of surgery as well as it causes inconvenience while working in the oral cavity. Modifications in intubation techniques for anaesthesia are important in complex maxillofacial surgeries.

Summary

In complex maxillofacial surgeries fibreoptic, submental, transmylohyoid and retromolar intubation are available techniques where interim maxillomandibular fixation is essential for the reduction of fracture. Of all these techniques, the fibreoptic technique is preferred as it is the most reliable of all techniques. In the case of pan-facial trauma, maxillomandibular fixation is required and interference of tube cannot afford trans mylohyoid and submental can be used as a potential alternative.

Asai T. Are videolaryngoscopes useful for nasotracheal intubation? J Anesth. 2014;28(5):647–9.CrossRefPubMed

Magill IW. Technique in endotracheal anaesthesia. Br Med J. 1930;2(3645):817–9. https://doi.org/10.1136/bmj.2.3645.817.CrossRefPubMedPubMedCentral

Hall CE, Shutt LE. Nasotracheal intubation for head and neck surgery. Anaesthesia. 2003;58:249–56.CrossRefPubMed

Shah JP. Head and neck surgery. 2nd ed. London: Mosby- Wolfe; 1996. p. 186–226.

Lee J-H, Kim C-H, Bahk J-H, Park K-S. The influence of endotracheal tube tip design on nasal trauma during nasotracheal intubation: Magill-tip versus murphy-tip. Anesth Analg. 2005;101:1226–9. https://doi.org/10.1213/01.ane.0000169293.59514.28.CrossRefPubMed

Berry FA, Blankenbaker W, Ball CG. A comparison of bacteremia occurring with nasotracheal and orotracheal intubation. Anesth Analg. 1973;5:873–6.

7.••

Prasanna D, Bhat S. Nasotracheal intubation: An overview. J Maxillofac Oral Surg. 2014;13(4):366–72. Review article that describes about nasotracheal intubation.CrossRefPubMed

Wong J, Lee JSE, Wong TGL, Iqbal R, Wong P. Fibreoptic intubation in airway management: A review article. Singapore Med J. 2019;60(3):110–8.CrossRefPubMedPubMedCentral

Stella JP, Kageler WV, Epker BN. Fiberoptic endotracheal intubation in oral and maxillofacial surgery. J Oral Maxillofac Surg. 1986;44(11):923–5. https://doi.org/10.1016/0278-2391(86)90235-1.CrossRefPubMed

10.

Gadre KS, Kushte D. Transmylohyoid oroendotracheal intubation: A novel method. J Craniofac Surg. 1992;3(1):39–40.CrossRefPubMed

11.

Das S, Das TP, Ghosh PS. Submental intubation: A journey over the last 25 years. J Anaesthesiol Clin Pharmacol. 2012;28(3):291.CrossRefPubMedPubMedCentral

12.

Adamo AK. Intraoperative airway management with panfacial fractures, Alternative approach. J Craniomaxillofac Surg. 1996;2(3):30–5.

13.

Jacob DD, Tuncer FB, Kashan DL, Gurunluoglu R. Clinical anatomy of submental intubation: A review of the indications, technique, and a modified approach. Ann Plast Surg. 2020;84(2):232–7.CrossRefPubMed

14.

Davis C. Submental intubation in complex craniomaxillofacial trauma. ANZ J Surg. 2004;74(5):379–81.CrossRefPubMed

15.

Luce EA, Alvarez SM. Submental intubation. Plast Reconstr Surg Glob Open. 2018;6(9):e1896.CrossRefPubMedPubMedCentral

16.

Altemir FH. The submental route for endotracheal intubation. J Maxillofac Surg. 1986;14(1):64–5.CrossRef

17.••

Gadre KS, Waknis PP. Transmylohyoid/Submental intubation: review, analysis, and refinements. J Craniofac Surg. 2010;21(2):516–9. https://doi.org/10.1097/SCS.0b013e3181d023d3. Review article that describes about submental intubation.

18.

Soukup JW, Snyder CJ. Transmylohyoid orotracheal intubation in surgical management of canine maxillofacial fractures: An alternative to pharyngotomy endotracheal intubation. Vet Surg. 2015;44(4):432–6.CrossRefPubMed

19.

Badjate SJ, Cariappa KM, Shenoi SR, Nakhate S. Ramsay-Hunt syndrome complicating osteonecrosis of edentulous maxilla and mandible: Report of a rare case. J Maxillofac Oral Surg. 2009;8(2):188–91. https://doi.org/10.1007/s12663-009-0046-3.CrossRefPubMedPubMedCentral

20.

Malhotra N. Submentotrachael intubation: An alternative to tracheostomy. J Anaesthesiol Clin Pharmacol. 2012;28(3):287–90.CrossRefPubMedPubMedCentral

21.

Piepho T, Thierbach A, Werner C. Nasotracheal intubation: Look before you leap. Br J Anaesth. 2005;94(6):859–60.CrossRefPubMed

22.

Rao M, Shetty D, Goyal KA, Nanda KP. Retromolar intubation: A better alternative to submental intubation or tracheostomy for dental occlusion by intermaxillary fixation. Saudi J Anaesth. 2015;9(2):222–4. https://doi.org/10.4103/1658-354X.152896.CrossRefPubMedPubMedCentral

23.

Chen YY, Lin JC, Tsai MJ, Cheng KY. Retromolar intubation with video intubating stylet in difficult airway: A randomized crossover manikin study. Am J Emerg Med. 2022;54:212–20.CrossRefPubMed

24.

Truong AT, Ahmad B, Cata JP, Martin JW, Truong DT, Rahlfs TF. Measurement of retromolar space dimensions using dental pantomograms for intubation feasibility. Head Neck. 2016;38:E638–42.CrossRefPubMed

25.

Jaisani MR, Pradhan L, Bhattarai B, Sagtani A. Intubation techniques: Preferences of maxillofacial trauma surgeons. J Maxillofac Oral Surg. 2015;14(2):501–5.CrossRefPubMed

26.

Myers EN, Stool SE, Johnson JT. Tracheostomy. New York: Churchill Livingstone; 1985. p. 1–11. 1895; 40: 150-162

27.

Emara TA, El-Anwar MW, Omara TA, Anany A, Elawa IA, Rabea MM. Submental intubation versus tracheostomy in maxillofacial fractures. Oral Maxillofac Surg. 2019;23(3):337–41.CrossRefPubMed

28.

Demas PN, Sotereanos GC. The use of tracheotomy in oral and maxillofacial surgery. J Maxillofac Surg. 1988;46(6):483–6.CrossRef

29.

Apfelbaum JL, Hagberg CA, Caplan RA, et al. Practice guidelines for management of the difficult airway: An updated report by the American Society of Anesthesiologists Task Force on Management of the Difficult Airway. Anesthesiology. 2013;118(2):251–70.CrossRefPubMed

30.

Kearney PA, Griffen M, Ochoa JB, Boulanger BR, Tseui BJ, Mentzer RM. A single-center 8-year experience with percutaneous dilational tracheostomy. Ann Surg. 2000;231(5):701–9.CrossRefPubMedPubMedCentral

31.

Yuen HW, Loy AH-C, Johari S. Urgent awake tracheotomy for impending airway obstruction. Otolaryngol Head Neck Surg. 2007;136(5):838–42.CrossRefPubMed

32.

Meier J, Wunschel M, Angermann A, Ettl T, Metterlein T, Klingelhöffer C, Reichert TE, Ritzka M. Influence of early elective tracheostomy on the incidence of postoperative complications in patients undergoing head and neck surgery. BMC Anesthesiol. 2019;19(1):43. https://doi.org/10.1186/s12871-019-0715-9.CrossRefPubMedPubMedCentral

33.

Myatra SN, Gupta S, D'Cruz AK, Rajanala V, Dhar H, Sharma S, Divatia JV. Identification of patients for a delayed extubation strategy versus elective tracheostomy for postoperative airway management in major oral cancer surgery: A prospective observational study in seven hundred and twenty patients. Oral Oncol. 2021;121:105502. https://doi.org/10.1016/j.oraloncology.2021.105502.CrossRefPubMed

34.••

Barak M, Bahouth H, Leiser Y, Abu E-NI. Airway management of the patient with maxillofacial trauma: Review of the literature and suggested clinical approach. Biomed Res Int. 2015;2015:724032. https://doi.org/10.1155/2015/724032. Review article that describes about intubation of various techniques.CrossRefPubMedPubMedCentral

35.

Cai TY, Zhang WB, Yu Y, Wang Y, Mao C, Guo CB, Yu GY, Peng X. Scoring system for selective tracheostomy in head and neck surgery with free flap reconstruction. Head Neck. 2020;42(3):476–84. https://doi.org/10.1002/hed.26028. Epub 2019 Dec 4CrossRefPubMed

36.

Freeman BD. Tracheostomy update: When and how. Crit Care Clin. 2017;2:311–22. https://doi.org/10.1016/j.ccc.2016.12.007.CrossRef

37.

Harbour PW, Charipova K, Dang D, Moores L, Baker SB. Novel use of a custom fixation plate in pediatric fibrous dysplasia. Plast Reconstr Surg Glob Open. 2020;8(11):e3262. https://doi.org/10.1097/GOX.0000000000003262.CrossRefPubMedPubMedCentral

38.

Arora S, Rattan V, Bhardwaj N. An evaluation of the retromolar space for oral tracheal tube placement for maxillofacial surgery in children. Anesth Analg. 2006;103(5):1122–5. https://doi.org/10.1213/01.ane.0000247852.09732.ec.CrossRefPubMed

Titel: Pathways to Airways: Review and Considerations of Different Intubation Techniques in Oral and Maxillofacial Surgery
verfasst von: Kalyani Bhate
Sayali A Awate
Dharmesh C Gandhi
Uday Londhe
Sunnypriyatham Tirupathi
Bhushan Bhagat
Publikationsdatum: 22.03.2024
Verlag: Springer International Publishing
Erschienen in: Current Oral Health Reports
Elektronische ISSN: 2196-3002
DOI: https://doi.org/10.1007/s40496-024-00373-4

Neu im Fachgebiet Zahnmedizin

Parodontalbehandlung verbessert Prognose bei Katheterablation

19.04.2024 Vorhofflimmern Nachrichten

Werden Personen mit Vorhofflimmern in der Blanking-Periode nach einer Katheterablation gegen eine bestehende Parodontitis behandelt, verbessert dies die Erfolgsaussichten. Dafür sprechen die Resultate einer prospektiven Untersuchung.

Invasive Zahnbehandlung: Wann eine Antibiotikaprophylaxe vor infektiöser Endokarditis schützt

11.04.2024 Endokarditis Nachrichten

Bei welchen Personen eine Antibiotikaprophylaxe zur Prävention einer infektiösen Endokarditis nach invasiven zahnärztlichen Eingriffen sinnvoll ist, wird diskutiert. Neue Daten stehen im Einklang mit den europäischen Leitlinienempfehlungen.

Zell-Organisatoren unter Druck: Mechanismen des embryonalen Zahnwachstums aufgedeckt

08.04.2024 Zahnmedizin Nachrichten

Der Aufbau von Geweben und Organen während der Embryonalentwicklung wird von den Zellen bemerkenswert choreografiert. Für diesen Prozess braucht es spezielle sogenannte „Organisatoren“. In einer aktuellen Veröffentlichung im Fachjournal Nature Cell Biology berichten Forschende durch welchen Vorgang diese Organisatoren im Gewebe entstehen und wie sie dann die Bildung von Zähnen orchestrieren.

Die Oralprophylaxe & Kinderzahnheilkunde umbenannt

11.03.2024 Kinderzahnmedizin Nachrichten

Infolge der Umbenennung der Deutschen Gesellschaft für Kinderzahnheilkunde in Deutsche Gesellschaft für Kinderzahnmedizin (DGKiZ) wird deren Mitgliederzeitschrift Oralprophylaxe & Kinderzahnheilkunde in Oralprophylaxe & Kinderzahnmedizin umbenannt. Aus diesem Grunde trägt die erste Ausgabe in 2024 erstmalig den neuen Titel.

Bestellen Sie unseren kostenlosen Newsletter Update Zahnmedizin und bleiben Sie gut informiert – ganz bequem per eMail.

Newsletter bestellen