Submental intubation in oral and maxillofacial surgery: a systematic review 1986-2018.

Autor: Goh EZ; University of Queensland, Faculty of Medicine and School of Dentistry, 288 Herston Road, Herston 4006, Queensland, Australia. Electronic address: elizabeth.goh@uq.net.au., Loh NHW; Department of Anaesthesia, National University Hospital, 5 Lower Kent Ridge Rd, Singapore 119074. Electronic address: will.loh@nus.edu.sg., Loh JSP; Discipline of Oral & Maxillofacial Surgery, National University Hospital, 5 Lower Kent Ridge Rd, Singapore 119074. Electronic address: johnloh@nus.edu.sg.
Jazyk: angličtina
Zdroj: The British journal of oral & maxillofacial surgery [Br J Oral Maxillofac Surg] 2020 Jan; Vol. 58 (1), pp. 43-50. Date of Electronic Publication: 2019 Nov 11.
DOI: 10.1016/j.bjoms.2019.10.314
Abstrakt: Submental intubation is a low-risk alternative to tracheostomy when nasotracheal or orotracheal intubation is not appropriate. To improve the selection of patients and clinical outcomes we have explored published papers on submental intubation in oral and maxillofacial surgery, and included a proposal for a decision pathway. Systematic searches of PubMed, Scopus, and Cochrane databases for papers published between 1986 and 2018 yielded 116 eligible articles (one randomised controlled trial, 61 case series, 40 case reports, six surgical techniques, and eight letters) that included 2 229 patients. Measured outcomes were the indications, techniques, devices used, time taken to complete the procedure, and complications. Indications were trauma (81%), orthognathic surgery (15%), disease (2%), and cosmetic surgery (1%). Technical preferences were for a one-tube (84%) over a two-tube technique (6%), and a paramedian (52%) over a median incision (33%). The preferred device was a reinforced endotracheal tube (85%). The mean (range) intubation time was 10 (2-37) minutes. The complication rate was 7% (n=152), the most common being superficial skin infection (n=54), hypertrophic scarring (n=18), and damage to the tube apparatus (n=15). Submental intubation has minimal complications, takes a short time to do, and it is a useful alternative to tracheostomy in some oral and maxillofacial operations. More robust evidence regarding the selection of patients, modifications to the technique, and a comparison of risk with that of tracheostomy, are needed for further evaluation of its feasibility.
(Copyright © 2019 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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