Submental intubation as an alternative to tracheostomy in severe craniofacial trauma: A case report

Abstract

The present study outlines airway management through a submental approach in a patient with severe craniofacial trauma diagnosed with LeFort III fracture. The case was discussed in a multidisciplinary session to determine intraoperative airway management, ultimately opting for submental intubation over tracheostomy to prevent complications associated with the latter. Following asleep orotracheal intubation using a fiberoptic bronchoscope, a paramedial submental approach was employed. Once intermaxillary fixation was established, fractures were subjected to osteosynthesis. Post-surgery, submental intubation was converted back to orotracheal. Given the extensive inflammation at the base of the mouth, it was decided to maintain intubation for the next 12 hours, followed by uncomplicated extubation. Submental intubation emerges as a secure and effective option in managing patients with complex maxillofacial fractures, thereby obviating the need for tracheostomy and its associated risks.