Airway management by submental intubation in maxillofacial fractures

Abstract

Submental intubation is useful in surgical procedures where nasotracheal intubation is contraindicated and orotracheal intubation is not ideal, due to intermaxillary fixation. The maxillofacial surgeon Hernández Altemir (Spain) proposed an SI technique that involved passing the endotracheal tube through an extraoral incision in the submental region of the floor of the mouth, to perform open reduction of facial fractures. This report describes two male patients who presented to the Rosales National Hospital, in the Maxillofacial Surgery service of El Salvador with a history of suffering a traffic accident. In the first case, the radiological examination revealed a mandibular symphysis fracture, a simple fracture of the nasal bones, and a deviation of the nasal septum. The second case is a patient with a symphysis fracture and a double mandibular condyle. SI is an alternative to tracheostomy, since it is performed in less time, less morbidity and mortality, minimal postoperative care, and with an aesthetic scar.