Background: Submental intubation has emerged as a crucial alternative airway management technique within the realm of oral maxillofacial surgery, addressing scenarios where conventional intraoral or nasal intubation proves infeasible or hazardous. The landscape of oral maxillofacial surgeries is characterized by intricate fractures, extensive soft tissue damage, and anatomical deviations that render traditional intubation methods untenable. This innovative technique involves the insertion of a modified oral endotracheal tube through a submental incision, subsequently threading it into the oropharynx. This procedure ensures secure airway access while safeguarding the integrity of oral and nasal passages. This modality reaps manifold benefits, spanning augmented surgical field visibility, diminished oral trauma risk, superior postoperative pain management, and amplified patient comfort during the recuperative phase.
However, the implementation of submental intubation does not come devoid of potential complications. These encompass plausible surgical site infections, subcutaneous emphysema occurrence, hematoma formation, infliction upon sublingual and lingual arteries, compromise to the recurrent laryngeal nerve, and challenges associated with tube manipulation. Prudent familiarity with anatomical landmarks coupled with meticulous execution is imperative to curtail these risks, thus optimizing patient outcomes.
Case Presentation: The focal point of this case study is a 45-year-old female patient with a medical history encompassing diabetes mellitus, hypertension, and hyperlipidemia. The patient was transferred to a level 1 trauma center following a motor vehicle collision that rendered her with severe neurological impairment. The trauma inflicted multiple complex facial fractures necessitating oral maxillofacial surgery, during which the decision to proceed with submental intubation was made due to the complexity of her injuries. The intervention led to significant improvement in the patient's respiratory status, prompting the discontinuation of respiratory support measures.
Conclusions: This case report sheds light on the indispensability of submental intubation in the realm of oral maxillofacial surgery, specifically in scenarios where conventional methods are unviable. Through a comprehensive exploration of indications, technique, and potential complications, a holistic understanding of this innovative approach is cultivated. By amalgamating this clinical illustration with the corpus of existing literature, a more nuanced grasp of submental intubation's intricacies is nurtured, thereby equipping clinicians to make informed decisions and optimize patient care within the dynamic landscape of oral maxillofacial surgery.
Alvarado, Ed W.; Inofomoh, Jennifer; Lavering, Mark; and Aleman, Diego, "Submental Intubation in Oral Maxillofacial Surgery: A Case Report and Review of Indications and Complications" (2023). MEDI 9331 Scholarly Activities Clinical Years. 74.