SUBMENTAL ENDOTRACHEAL INTUBATION IN THE MANAGEMENT OF PANFACIAL SURGERIES

Airway management is a challenge to anaesthesiologist particularly in complex maxillofacial surgeries, where oral cavity is the main field of surgery and dental occlusion is a prerequisite. Comminutedpanfacial fracture causes physical obstruction to the passage of Nasoendotracheal tube and its presence can interfere with surgical reconstruction of fracture of the Naso-orbital complex. Surgical reconstruction often involves Maxillo-mandibular fixation in the intraoperative period to restore patient dental occlusion. This precludes the use of oral endotracheal intubation in such cases and Nasoendotracheal is often contraindicated in the presence of fracture of base of skull. Tracheostomy is now sole answer to these problem, here submental approach for tracheal intubation can be an apt alternative to avoid the complication of tracheostomy. Submental technique should be considered by both the anaesthesiologist and Maxillo-facial surgeon.