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Rivista di Chirurgia

Indexed/Abstracted in: EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 0,877

Periodicità: Bimestrale

ISSN 0026-4733

Online ISSN 1827-1626


Minerva Chirurgica 2015 Oct 22

Evaluation of alternative airway management strategies in surgical repair of severe craniomaxillofacial trauma

Zhang X., Xing W., Ping G. Q., Jie Z., Ruihan W., Qianwei Z, Li N., Meng J.

Department of Stomatology, Central Hospital of Xuzhou City, Affiliated to Southeast University, Xuzhou Stomatology Clinical School of Weifang Medical, University, Xuzhou Jiangsu Province, China

INTRODUCTION: Severe craniomaxillofacial trauma requires the utilization of alternative airway management techniques when oral and nasal routes of tracheal intubation are either not possible or contraindicated.
MATERIALS AND METHODS: This retrospective study evaluated the techniques of submental intubation, retromolar intubation and tracheostomy in terms of their frequency of use, time taken, cost involved and associated complications in a total of 200 patients.
RESULTS: Frequency of utilization of alternative airway management techniques was 3.63%. Tracheostomy was associated with the most severe complications, took the most time to establish and was the most expensive technique. Although retromolar intubation was not associated with any complications, it was not suitable in adults with erupted third molars and interfered with the surgical field. Submental intubation was associated with minor complications, was suitable in all cases and did not interfere with surgical access.
CONCLUSION: Retromolar intubation must be considered as a first choice alternative in patients with unerupted third molars provided the surgeon is adept at working in the presence of an oral tube. Submental intubation is a good second choice when retromolar intubation is not possible or is not acceptable to the surgeon. Tracheostomy is only indicated in patients who require long term control of the airway.

lingua: Inglese


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