| Autor: |
Tümer, Murat, Doğan, Alper Tunga, Yükselen, Mehmet Ali, Özmen, Selahattin, Erçelen, Ömür |
| Předmět: |
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| Zdroj: |
Journal of Anesthesia / Anestezi Dergisi (JARSS); 2023 Special Issue, Vol. 31, p270-270, 1p |
| Abstrakt: |
Background: Submental intubation is an alternative to nasal intubation and tracheostomy in maxillofacial trauma. In this case report, we present our middle submental intubation experience in a maxillofacial trauma patient. Case: A 29-year-old ASA-1 female patient who had an in-vehicle traffic accident was admitted to the operating room with internal fixation and close reduction plan of the zymotic bone, multiple nasal bones, and LeForte fractures. She had bilateral femur fractures and a right elbow fracture. Her mouth opening was limited to 2 cm due to temporomandibular joint pain. After standard monitoring and anesthesia induction, orotracheal intubation with a 7.5 mm spiral endotracheal tube was performed by video laryngoscope. After intubation, a 1.5 cm midline submental incision was made and a foley catheter was inserted into the oropharynx through this incision by the help of the surgeon. Intubation tube was attached to foley catheter and pulled out from incision (Figure). At the end of surgery, the endotracheal tube was pushed back into the oropharynx and incision was sutured. Extubation was performed after reversing muscle relaxation with sugammadex. After a 4-day follow-up, patient was discharged. Incision was healed with a cosmetic minimal scarring and without any infection. Discussion: Nasal intubation is contraindicated during maxillofacial injuries that involves Leforte fracture and nasal area when occlusion should be supplied during fracture reduction and fixation. Although tracheotomy is an alternative in this patient group, submental intubation is a better way to supply the airway with minimal trauma and scarring. Submental intubation, described by Altemir in 1986, is a fast and simple technique with minimal morbidity and complication rate that can be used as an alternative to nasal intubation and tracheostomy. There are limited numbers of case series and reviews about submental intubation in the literature. We chose midline incision because it is anatomically safer and less scarring than lateral. Furthermore, we used a Foley catheter as a guide to endotracheal tube to reduce tissue damage. Conclusion: Submental intubation is a good, safe, less invasive and easy alternative in maxillofacial surgeries when oral or nasal intubation is not possible or tracheotomy is required. [ABSTRACT FROM AUTHOR] |
| Databáze: |
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