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颏下气管插管:颌面骨折治疗的宝贵资源。

Submental endotracheal intubation: a valuable resource for the management of panfacial fractures.

作者信息

de Melo Willian Morais, Brêda Marcus Antônio, Pereira-Santos Darklilson, Pereira Cassiano Costa Silva, Sonoda Celso Koogi, Araújo Marcelo Marotta

机构信息

Surgery & Integrated Clinic Department, Araçatuba Dental School, São Paulo State University , São Paulo, Brazil.

出版信息

J Craniofac Surg. 2012 Nov;23(6):1851-3. doi: 10.1097/SCS.0b013e31826b8345.

Abstract

Modern techniques for surgical treatment of midfacial and panfacial fractures in maxillofacial trauma lead to special problems for airway management. Usually, in perioperative management of panfacial fractures, the surgeon needs to control the dental occlusion and nasal pyramid assessment. For these reasons, oral and nasal endotracheal intubations are contraindicated for the management of panfacial fractures. Tracheotomy is considered by many as the preferred route for airway management in patients with severe maxillofacial fractures, but there are often perioperative and postoperative complications concerning this technique. The submental route for endotracheal intubation has been proposed as an alternative to tracheotomy in the surgical management of patients with panfacial fractures, besides it is accompanied by low morbidity. Thus, this paper aimed to describe the submental endotracheal intubation technique in a patient experiencing panfacial fracture. The subject was well treated using the submental endotracheal intubation to get good reconstruction of the fractures because the authors obtained free access of all facial fractures.

摘要

现代颌面创伤中面中部和全颜面骨折的外科治疗技术给气道管理带来了特殊问题。通常,在全颜面骨折的围手术期管理中,外科医生需要控制牙合关系并评估鼻骨。出于这些原因,经口和经鼻气管插管不适用于全颜面骨折的管理。许多人认为气管切开术是严重颌面骨折患者气道管理的首选途径,但该技术往往存在围手术期和术后并发症。在全颜面骨折患者的外科治疗中,经颏下途径气管插管已被提议作为气管切开术的替代方法,此外其发病率较低。因此,本文旨在描述一名全颜面骨折患者的经颏下气管插管技术。该患者采用经颏下气管插管得到了良好治疗,骨折得以良好重建,因为作者能够自由处理所有面部骨折。

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