Submental Intubation Versus Tracheostomy in Maxillofacial Trauma Patients
Purpose
To evaluate the indications and outcomes of airway management by submental intubation or tracheostomy in patients with maxillofacial trauma, and to describe the technique of submental intubation in detail and discuss its latest refinements.
Patients and Methods
Of 356 patients admitted from January 2004 through September 2007 with maxillofacial trauma, 222 were operated on under general anesthesia. Eight patients underwent urgent or elective tracheostomy; 8 patients underwent submental intubation.
Results
Seven patients with submental intubation were extubated at the end of the procedure. One patient received elective tracheostomy 3 days later. We did not encounter any complications in the tracheostomy group, while 1 case of slight damage to the endotracheal tube occurred in the submental intubation group.
Conclusions
Submental endotracheal intubation is a simple technique with very low morbidity and can replace tracheostomy in selected cases of maxillofacial trauma without indication for prolonged ventilation support.
⁎Consultant, Head of Oral and Maxillofacial Surgery Unit, Al-Adan Dental Center and the Oral and Maxillofacial Surgery Department; Ministry of Health, State of Kuwait.
†Senior Registrar, Oral and Maxillofacial Surgery Unit, Al-Adan Dental Center and the Oral and Maxillofacial Surgery Department; Ministry of Health, State of Kuwait.
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ABSTRACT