Two Cases of Submental Endotracheal Intubation in Patients Having Multiple Facial Fractures

Abstract

Submental endotracheal intubation is a method introduced by Hernandez Altemir in 1986 for maintaining the airway. In the treatment of multiple facial fractures, the appropriate airway maintenance is a challenge for both anesthesiologists and surgeons. Oral endotracheal intubation precludes achieving adequate access to the fracture and maxillomandibular fixation for proper occlusion. Nasotracheal intubation is contraindicated in cases accompanying fractures of skull base or nasal bones. Tracheostomy is the standard method for airway management in these traumas. It does not interfere with surgical access and occlusion, and can be used for prolonging ventilation treatment. However, it has a significant risk of iatrogenic complications. On the other hand, submental endotracheal intubation is an alternative method of airway maintenance in facial traumas. It does not compromise the surgical fields but enables maxilloman dibular fixation and can avoid complications of tracheostomy. In this case report, we present our experience of submental endotracheal intubation in two cases with multiple facial traumas. � Korean J Otorhinolaryngol-Head Neck Surg 2012;55:315-8 Key WordsZZIntubation ㆍSubmental ㆍAirway management ㆍMaxillofacial injuries.