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Official Journal of the Italian Society of Maxillofacial Surgery
Frequency: 3 issues
Online ISSN 1827-1901
Valsecchi S. 1, Ardito E. 1,2, Merlini M. 1,2, Gervasoni C. 1, Spotti S. 1, Di Francesco A. 1, Colombo L. 1
1 Department of Maxillofacial Surgery Sant’Anna Hospital Como, Italy
2 Department of Maxillofacial Surgery S. Gerardo Hospital, Faculty of Medicine, Bicocca University of Milan, Monza e Brianza, Italy
Aim. Surgical management of tumours of upper jaw often requires free or local flaps reconstruction. In these situations the intubation technique is not of minor importance as well as the safety for the patients and the suitability of the operative field. When we choose the temporal muscle flap, nasotracheal intubation could limit the flap harvesting with a coronal access, so as to preserve a sterile operative field; otherwise, the orotracheal intubation, having the tube in the field of surgery, interfere strongly surgeon’s work and surgical plan especially during the reconstructive stage. When nasotracheal or orotracheal way are contraindicated or not accessible, cricotiroidotomy or tracheostomy could be an alternative procedure; unfortunately the literature reports on a significant complication rate and its use must be therefore considered with caution. In these circumstances the submental endotracheal intubation could be an attractive alternative.
Methods. The authors carried on a retrospective analysis of the surgical treatment of the tumours of the upper jaw from October 2007 to October 2009, focusing on 7 patients affected by neoplasm of the upper jaw submitted to a submandibular intubation, in order to evaluate the time of intubation, early and late compliances.
Results. The submental route intubation is a fast, safe, reliable procedure widely accepted for the craniofacial trauma, with fewer complications than nasotracheal intubation or tracheotomy.
Conclusion. In our experience the procedure could be recommended not only for trauma but also for treatment of the tumours of the upper jaw when no long term control of the airway is needed.