SUBMENTAL INTUBATION - AN AIRWAY OPTION FOR ORAL SUBMUCOUS FIBROSIS RELEASE

Abstract : Securing the airway in oral and facio-maxillary surgeries is a challenging task and is the major component of intra-op management. Nasotracheal intubation is not always possible in patients with intra-oral lesions. Trauma and bleeding are common complications associated with nasotracheal intubation. Tracheostomy is invasive and is unnecessary for patients who are not the candidates for elective post-op ventilation. Many patients hesitate to give consent for tracheostomy due to the fear of complications like haemorrhage, tracheal stenosis, loss of speech etc. Submental intubation is a newer technique that helps in avoiding potential complications associated with nasotracheal intubation and tracheostomy and also provides an unobstructed surgical field. Oral Submucous Fibrosis (OSF) is a chronic, irreversible, pre-cancerous condition associated with betel nut chewing which leads to progressive fibrosis of submucosal tissues. The main anaesthetic concern with this condition is progressive restriction of mouth opening due to fibrosis. We present this case management of a patient with oral submucous fibrosis with restricted mouth opening posted for fibrosis release and reconstruction.