Title: Modified Submental Intubation –RD Technique

Authors: Dr Isha Singhal, Dr R.D. Patel, Dr Aarti Kulkarni

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i2.166

Abstract

Patients with panfacial fracture pose a unique set of problems to the anaesthesiologist and surgeon and both are competing for the same space. In such cases submental intubation can be done. Here we discuss a modified approach to submental intubation which reduces apnoea time and damage to pilot balloon of tube.

References

  1. Adamo AK, Katsnelson T, Rodriquez ED, Karasik E. Intraoperative airway management with panfacial fractures: alternative approach. J Craniomaxillofac Trauma 1996 Fall;2(3):30-5.
  2. Markowitz BL, Manson PN. Panfacial fractures: Organization of treatment. Clin Plast Surg 1989 Jan;16(1):105-14.
  3. Shumrick KA, Kersten RC, Kulwin DR, Sinha PK, Smith TL. Extented access internal approaches for the management of facial trauma. Arch Otolaryngol Head Neck Surg 1992 Oct;118(10):1105-12
  4. Phero JC, Weaver JM, Peskin RM. Anesthesia for maxillofacial/mandibular trauma. In: Benumof JL, editor. Anesthesiology clinics of North America. Anesthesia of otolaryngologic and head and neck surgery. Philadelphia: Saunders; 1993. pp. 509–23
  5. Shetty PM, Yadav SK, Upadya M. Submental intubation in patients with panfacial fractures: a prospective study. Indian J Anaesth. 2011;55:299–304.
  6. Kishoria N, Upadhyaya RM, Shah DM, Mahajan A. Submental intubation an alternative to tracheostomy in patients with panfacial fractures. OA Case Reports 2014 Jan 18;3(1):8.
  7. Hernández Altemir F. The submental route for endotracheal intubation. A new technique. J Maxillofac Surg 1986;14:64-5
  8. Haug RH,Indresano AT : Management of maxillary fractures.In: Peterson LJ.ed. Principles of oral and maxillofacial surgery.Philadelphia:JB Lippincott,1992:469-48
  9. Caron G, Paquin R,Lessard  MR, et al.Submental endotracheal intubation :an                                                            alternative to tracheaostomy in midfacial and panfacial fractures. J Trauma 2002:48:218 -20. [ISI] [Medline]
  10. Waldron J, Padgham ND,Hurley SE.Complications of emergency and elective tracheastomy; a retrospective study of 150 consecutive cases.Ann R Coll Surg Engl 1990:72;218-20.[Medline].
  11. Callahan V, O Connor AFF. Adult ana paediatric tracheostomy-technique, complications and alternatives. Curr Pract Surg 1994;6:219-22.
  12. Ahmed FB,Mitchel V.Hazards of submental tracheal intubation. Anaesthesia 2004:59(4):410-11.

Corresponding Author

Dr Isha Singhal