SUBMENTAL INTUBATION: A CASE REPORT WITH LITERATURE REVIEW

Managing the airway in patients with faciomaxillary injuries poses challenges due to upper airway disruption. Anesthesiologists must navigate shared airways with surgeons, making oral and nasal intubation often impractical. Nasal fractures commonly accompany these injuries, ruling out nasal intubation. Additionally, intraoperative dental occlusion for fracture alignment prohibits orotracheal intubation. While tracheostomy is conventional, it carries risks, requires specialized postoperative care, prolongs hospitalization, and increases costs. Retromolar intubation is an option, but space limitations in adults may pose problems. Submental intubation offers airway control, bypasses oral and nasal routes, and allows dental occlusion. It's a viable option, especially when prolonged postoperative ventilation isn't needed, with minimal complications and high acceptance by patients and surgeons. Though requiring longer preparation and lacking familiarity, it's an acceptable alternative to tracheostomy for optimal per-operative airway management. We report a case of submental orotracheal intubation for the management of perioperative upper airway in a 35-year-old patient with extensive midfacial fractures requiring jaw immobilization. No complications occurred during the procedure.