Treatment of maxillofacial fracture using submental intubation: Report of two cases

Intraoperative intermaxillary fixation (IMF) is essential for the open reduction and internal fixation (ORIF) of maxillofacial fractures, including mandibular fractures. Nasotracheal intubation is generallyperformed to manage airways.When nasotracheal intubation cannot be performed because of a midface fracture, such as a naso-orbitoethmoid fracture, intraoperative IMF may be performed via a tracheostomy.However, tracheostomy is associated with higher surgical invasiveness, increasing the risk of complications.This study reports two cases of submental intubation during ORIF.During the procedure, the tracheal tube was moved from orotracheal intubation to the submental region to allow occlusion, after which the procedure was performed.Afterward, the tube was returned to orotracheal intubation.The time required in case 1 and case 2 from incision to tracheal tube replacement was 5 min 49 s and 7 min 25 s, respectively.No postoperative complications were observed, suggesting that submental intubation is an option for airway management when nasal intubation can not be performed.