Abstract
The submento-submandibular intubation technique has been used in facial trauma cases where there is a requirement of addressing the facial fracture requiring intraoperative verification of occlusal relationship and also addressing the nasal fractures. However the utility of this technique in orthognathic surgery cases has not been reported as much. The case report presents and discusses the effective use of this technique in the surgical management of a case of bimaxillary protrusion with lip deficiency.
Highlights
Contemporary Oral and Maxillofacial Surgery (OMFS) is aggressive and exacting
One of the areas critical to OMFS is the route of administration of General Anesthesia
Since the patient had an upturned nose with small nares and a sharp antero-posterior decline of the anterior nasal floor (Figure 1) close to the osteotomy site coupled with a prominent anterior nasal spine, decision was taken to use the submento-submandibular route for placement of the endotreacheal tube for administration of general anesthesia
Summary
Contemporary Oral and Maxillofacial Surgery (OMFS) is aggressive and exacting. As the specialty expands its focus and looks more closely at orthognathic surgery, cleft lip and palate surgery etc, adjunctive procedures become increasingly important in the quest to achieve superlative goals. OMFS has relied on oral and nasal routes for endotreacheal intubation [1]. The literature is replete and primarily projects the use of submento-submandibular intubation technique in the management of complex facial trauma cases [7]. Since the patient had an upturned nose with small nares and a sharp antero-posterior decline of the anterior nasal floor (Figure 1) close to the osteotomy site coupled with a prominent anterior nasal spine, decision was taken to use the submento-submandibular route for placement of the endotreacheal tube for administration of general anesthesia. We present a case report of the use of submento-submandibular intubation in the surgical management of bimaxillary protrusion using anterior maxillary osteotomy and mandibular subapical osteotomy and set back. There was no complaint of sore throat/throat discomfort in the postoperative phase and the submandibular and floor of the mouth incisions healed uneventfully
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