Abstract

ABSTRACT Background: In some maxillofacial surgical procedures, orotracheal intubation obstruct the surgical field and nasotracheal intubations are contraindicated or interfere with surgical procedure. In these patients, tracheostomy is the only way for protection of airways. However, it carries high incidence of complications, demands high quality of postoperative care and longer hospital stay. We performed submento-submandibular intubation in selected patients as an alternative to tracheostomy in such situations. Aims &
Objective: The aim of the study is to evaluate the problems encountered during submento-submandibular intubation. This study also investigates the long term complications of this route.
Materials and Methods: This study was conducted on 20 adult ASA – I and ASA – II grade patients of either sex, scheduled for faciomaxillary surgery under general anaesthesia where oral intubation was not suitable for the procedure or nasal intubation was contraindicated or impossible. Extra time needed for submento-submandibular route, problems encountered during procedure and long term complications were recorded.
Results: Extra time needed for this intubation was less than 10 mins; mild hypoxia was encountered in one patient while negotiating the tube through submento-submandibular incision. No other complications were occurred during intraoperative period. Follow up examinations revealed no injury to adjacent structures. The small cutaneous scar was found which left no aesthetic damage. Conclusion: Submento-submandibular intubation is better alternative to tracheotomy in selected patients in whom postoperative airway protection not required. It shortens hospital stay and less postoperative care is required as compared to tracheostomy.