Submental Intubation: an Underutilized Technique for Airway Management in Patients With Panfacial Trauma

Purpose: To evaluate submental intubation compared with secure airways of patients who have sustained significant maxillofacial trauma. Patients and Methods: Patient series of 3 patients who underwent submental intubation prior to open reduction internal fixation of fractures associated with the mid and lower face. All of these patients were initially orally intubated, and then converted to submental intubation prior to the reparative procedure. Detailed description of the procedure is discussed in each patient. Results: All the patients received appropriate reduction of facial fractures following submental intubation with no intraoperative complications. Two of the 3 patients were extubated immediately postoperatively and 1 was extubated on the second postoperative day. None of the patients had any complications associated with submental intubation. Conclusions: Submental intubation is a safe and expedient technique to divert the airway in patients who require operative repair of panfacial injuries. This procedure is preferable over tracheostomy in selected patients of maxillofacial trauma without indication for prolonged ventilation support. Address correspondence and reprint requests to Jody C. Digiacomo, MD, Department of Surgery, Nassau University Medical Center, 2201 Hempstead Turnpike, East Meadow, NY 11554; E-mail: jdigiac1@numc.edu Received 30 October, 2017 Accepted 27 January, 2018 The authors report no conflicts of interest. © 2018 by Mutaz B. Habal, MD.

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