Submental Intubation in Maxillofacial Trauma: Case Report

Complex midfacial or panfacial injuries often require tracheostomy to ensure a free operative field. Oral intubation can interfere with the assessment of occlusion and nasotracheal intubation may lead to complications (brain damage, leakage of cerebrospinal fluid, and meningitis) when there are associated fractures of the base of the skull. Tracheostomy is associated with complications such as haemorrhage, pneumomediastinum or pneumothorax, injury to the recurrent laryngeal nerve and tracheal stenosis and should be reserved for severely injured patients who need protracted assistance with ventilation or further operations. A useful alternative method of managing the airway intraoperatively is submental endotracheal intubation, where, the tube is passed through a submental skin incision into the mouth. This paper reports a case of maxillofacial injury, operated using submental intubation technique.