Submandibular intubation as an alternative for intra-operative airway management in maxillofacial fractures - our institutional experience
Background and Aims: Airway management in anaesthesia for maxillofacial surgical procedures is tricky at times when the nasal/oral routes are contraindicated or are impossible. Tracheostomy as an alternative inherits its own complications. We present a case series of the submandibular route for trac...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2016-01-01
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| Series: | Indian Journal of Anaesthesia |
| Subjects: | |
| Online Access: | http://www.ijaweb.org/article.asp?issn=0019-5049;year=2016;volume=60;issue=8;spage=573;epage=577;aulast=Banerjee |
| _version_ | 1830306924186304512 |
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| author | Praveer K Banerjee Abhineet Jain Bikram Behera |
| author_facet | Praveer K Banerjee Abhineet Jain Bikram Behera |
| author_sort | Praveer K Banerjee |
| collection | DOAJ |
| description | Background and Aims: Airway management in anaesthesia for maxillofacial surgical procedures is tricky at times when the nasal/oral routes are contraindicated or are impossible. Tracheostomy as an alternative inherits its own complications. We present a case series of the submandibular route for tracheal intubation as an alternative. Methods: The procedure was performed in ten selected adult patients with maxillofacial/mandibular fractures associated with a fracture of skull base or nasal bone. All of them were medically stable with no need of intensive care or mechanical ventilation in post-operative period. Results: Submandibular intubation in all ten patients of panfacial fractures allowed uninterrupted surgical techniques with a secured airway. All patients were reverted to oro-tracheal tube at the end of surgery as immediate maxillomandibular fixation was not necessary. The patients were extubated after recovery from anaesthesia before they left the operating theatre. One patient in the post-operative period had a superficial infection of incision site that responded well to local treatment. No other complications were encountered in the intra-operative or post-operative period. Conclusion: In complex maxillofacial injuries, when oral or nasal intubation hampers surgeon′s field of view, submandibular intubation offers an effective alternative to short-term tracheostomy along with small risk potential. There is a need to emphasise its regular application in such cases so that technique can be mastered by both surgeons and anaesthesiologist. |
| first_indexed | 2024-12-19T10:22:24Z |
| format | Article |
| id | doaj.art-ef50d249e06c47879c62240155fdedd4 |
| institution | Directory Open Access Journal |
| issn | 0019-5049 |
| language | English |
| last_indexed | 2024-12-19T10:22:24Z |
| publishDate | 2016-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Indian Journal of Anaesthesia |
| spelling | doaj.art-ef50d249e06c47879c62240155fdedd42022-12-21T20:26:01ZengWolters Kluwer Medknow PublicationsIndian Journal of Anaesthesia0019-50492016-01-0160857357710.4103/0019-5049.187789Submandibular intubation as an alternative for intra-operative airway management in maxillofacial fractures - our institutional experiencePraveer K BanerjeeAbhineet JainBikram BeheraBackground and Aims: Airway management in anaesthesia for maxillofacial surgical procedures is tricky at times when the nasal/oral routes are contraindicated or are impossible. Tracheostomy as an alternative inherits its own complications. We present a case series of the submandibular route for tracheal intubation as an alternative. Methods: The procedure was performed in ten selected adult patients with maxillofacial/mandibular fractures associated with a fracture of skull base or nasal bone. All of them were medically stable with no need of intensive care or mechanical ventilation in post-operative period. Results: Submandibular intubation in all ten patients of panfacial fractures allowed uninterrupted surgical techniques with a secured airway. All patients were reverted to oro-tracheal tube at the end of surgery as immediate maxillomandibular fixation was not necessary. The patients were extubated after recovery from anaesthesia before they left the operating theatre. One patient in the post-operative period had a superficial infection of incision site that responded well to local treatment. No other complications were encountered in the intra-operative or post-operative period. Conclusion: In complex maxillofacial injuries, when oral or nasal intubation hampers surgeon′s field of view, submandibular intubation offers an effective alternative to short-term tracheostomy along with small risk potential. There is a need to emphasise its regular application in such cases so that technique can be mastered by both surgeons and anaesthesiologist.http://www.ijaweb.org/article.asp?issn=0019-5049;year=2016;volume=60;issue=8;spage=573;epage=577;aulast=BanerjeeAnaesthesiamaxillofacial surgerypanfacial fracturessubmandibular intubation |
| spellingShingle | Praveer K Banerjee Abhineet Jain Bikram Behera Submandibular intubation as an alternative for intra-operative airway management in maxillofacial fractures - our institutional experience Indian Journal of Anaesthesia Anaesthesia maxillofacial surgery panfacial fractures submandibular intubation |
| title | Submandibular intubation as an alternative for intra-operative airway management in maxillofacial fractures - our institutional experience |
| title_full | Submandibular intubation as an alternative for intra-operative airway management in maxillofacial fractures - our institutional experience |
| title_fullStr | Submandibular intubation as an alternative for intra-operative airway management in maxillofacial fractures - our institutional experience |
| title_full_unstemmed | Submandibular intubation as an alternative for intra-operative airway management in maxillofacial fractures - our institutional experience |
| title_short | Submandibular intubation as an alternative for intra-operative airway management in maxillofacial fractures - our institutional experience |
| title_sort | submandibular intubation as an alternative for intra operative airway management in maxillofacial fractures our institutional experience |
| topic | Anaesthesia maxillofacial surgery panfacial fractures submandibular intubation |
| url | http://www.ijaweb.org/article.asp?issn=0019-5049;year=2016;volume=60;issue=8;spage=573;epage=577;aulast=Banerjee |
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