Limits...
Submental intubation in maxillofacial fracture: a case report.

Akbari H, Heidari-Gorji MA, Poormousa R, Ayyasi M - J Korean Assoc Oral Maxillofac Surg (2016)

Bottom Line: It can be challenging to create a safe airway in maxilla facial fracture and some skull surgeries.Neither nasal nor oral intubation was possible based on the side effects of tracheotomy; therefore, submental intubation was applied successfully.The procedure and results are presented in the text.

View Article: PubMed Central - PubMed

Affiliation: Department of Nursing, Mazandaran University of Medical Sciences, Sari, Iran.

ABSTRACT
It can be challenging to create a safe airway in maxilla facial fracture and some skull surgeries. In this case study, the patient experienced jaw fractures that disturbed the dental occlusion and associated fracture of the base of the skull. Neither nasal nor oral intubation was possible based on the side effects of tracheotomy; therefore, submental intubation was applied successfully. The procedure and results are presented in the text.

No MeSH data available.


Related in: MedlinePlus

Schematic of submental intubation. The tube is inserted in the midline submental region (skin is not shown). Note that the mylohyoid muscle is penetrated, but the anterior belly of the digastric is retracted. 1, submental-submandibular intubation in the anterior submandibular triangle; 2, posterior submandibular intubation; 3, mylohyoid muscle; 4, anterior belly of the digastric muscle.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4940203&req=5

Figure 1: Schematic of submental intubation. The tube is inserted in the midline submental region (skin is not shown). Note that the mylohyoid muscle is penetrated, but the anterior belly of the digastric is retracted. 1, submental-submandibular intubation in the anterior submandibular triangle; 2, posterior submandibular intubation; 3, mylohyoid muscle; 4, anterior belly of the digastric muscle.

Mentions: After sterile painting and draping of the chin and mouth, lignocaine 2% with 1:80,000 adrenaline was infiltrated into the incision site. A midline incision 1.5 cm in length was made anterior to the inferior border of the mandible at the chin level. A curved hemostat was passed from the submental incision through the subcutaneous layer, platysma, mylohyoid muscle, submucosal layer, and mucosa. After entering the oral cavity at the junction of the attached lingual alveolar mucosa and the free mucosa of the floor of the mouth, an incision 1.5 cm in length was made parallel to the gingival margin. Then, based on bilateral symmetric lungs sounds, the patient was connected to a ventilator through a manual ambo bag. A 1.5 cm incision was made in the right submental region parallel and medial to the inferior border of the mandible. The endotracheal tube was briefly disconnected from the breathing circuit, and the tube connector was removed from the tube. A pilot balloon connected to the endotracheal tube was gently removed through the incision.(Fig. 1)


Submental intubation in maxillofacial fracture: a case report.

Akbari H, Heidari-Gorji MA, Poormousa R, Ayyasi M - J Korean Assoc Oral Maxillofac Surg (2016)

Schematic of submental intubation. The tube is inserted in the midline submental region (skin is not shown). Note that the mylohyoid muscle is penetrated, but the anterior belly of the digastric is retracted. 1, submental-submandibular intubation in the anterior submandibular triangle; 2, posterior submandibular intubation; 3, mylohyoid muscle; 4, anterior belly of the digastric muscle.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4940203&req=5

Figure 1: Schematic of submental intubation. The tube is inserted in the midline submental region (skin is not shown). Note that the mylohyoid muscle is penetrated, but the anterior belly of the digastric is retracted. 1, submental-submandibular intubation in the anterior submandibular triangle; 2, posterior submandibular intubation; 3, mylohyoid muscle; 4, anterior belly of the digastric muscle.
Mentions: After sterile painting and draping of the chin and mouth, lignocaine 2% with 1:80,000 adrenaline was infiltrated into the incision site. A midline incision 1.5 cm in length was made anterior to the inferior border of the mandible at the chin level. A curved hemostat was passed from the submental incision through the subcutaneous layer, platysma, mylohyoid muscle, submucosal layer, and mucosa. After entering the oral cavity at the junction of the attached lingual alveolar mucosa and the free mucosa of the floor of the mouth, an incision 1.5 cm in length was made parallel to the gingival margin. Then, based on bilateral symmetric lungs sounds, the patient was connected to a ventilator through a manual ambo bag. A 1.5 cm incision was made in the right submental region parallel and medial to the inferior border of the mandible. The endotracheal tube was briefly disconnected from the breathing circuit, and the tube connector was removed from the tube. A pilot balloon connected to the endotracheal tube was gently removed through the incision.(Fig. 1)

Bottom Line: It can be challenging to create a safe airway in maxilla facial fracture and some skull surgeries.Neither nasal nor oral intubation was possible based on the side effects of tracheotomy; therefore, submental intubation was applied successfully.The procedure and results are presented in the text.

View Article: PubMed Central - PubMed

Affiliation: Department of Nursing, Mazandaran University of Medical Sciences, Sari, Iran.

ABSTRACT
It can be challenging to create a safe airway in maxilla facial fracture and some skull surgeries. In this case study, the patient experienced jaw fractures that disturbed the dental occlusion and associated fracture of the base of the skull. Neither nasal nor oral intubation was possible based on the side effects of tracheotomy; therefore, submental intubation was applied successfully. The procedure and results are presented in the text.

No MeSH data available.


Related in: MedlinePlus