Indication for and technical refinements of submental intubation in oral and maxillofacial surgery

Introduction: In maxillofacial injuries, a choice has often to be made between different ways of intubation when surgical access to both the nasal and the oral cavities is necessary. Submental intubation is an interesting alternative to tracheotomy, especially when short-term postoperative control of the airway is foreseeable, and as control of the dental occlusion is complete, and access to the nose and mouth is undisturbed. Material: This kind of intubation has been used in our department in 25 cases since 1997. All patients had fractures disturbing the dental occlusion plus either an associated fracture of the skull base, or a displaced nasal fracture. Results: There was no intra-operative complication, average intubation duration was 1.5 days. Postoperative complications consisted of one case with hypertrophic scarring and two cases of abscess formation in the floor of the mouth. All these completely healed following local conservative treatment. Conclusion: Submental intubation demands certain technical skills but it is simple, rapid and may avoid tracheotomy in selected patients.,c 2003 European Association for Cranio-Maxillofacial Surgery.