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Submental Intubation in Cases of Panfacial Fractures: A Retrospective Study
Willian Caetano RodriguesDDS, MSc,
Willian Morais de MeloDDS, MSc, PhD,
Rafael Santiago de AlmeidaDDS, MSc,
Shajadi Carlos Pardo-KabaDDS, PhD,
Celso Koogi SonodaDDS, MSc, PhD, and
Elio Hitoshi ShinoharaDDS, PhD
Article Category: Research Article
Volume/Issue: Volume 64: Issue 3
Online Publication Date: Jan 01, 2017
DOI: 10.2344/anpr-64-04-07
Page Range: 153 – 161

retromolar intubation, 17 , 18 use of an indexed splint allowing for IMF around an orotracheal tube, 19 placing the tube through an edentulous area, 20 or, lastly, performing the surgical treatment in 2 or more stages. 3 All of these alternatives present limitations and drawbacks such as technical difficulties, greater morbidity, or higher costs. Given this scenario, Hernandez Altemir 21 proposed in 1986 a new technique called submental endotracheal intubation (SEI), which consisted of passing the tube through a submental skin incision into the anterior floor

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Figure 1 ; A curved hemostat is inserted through a skin incision in the anterior submental area and a passage is created through the mylohyoid muscle by blunt dissection.
Willian Caetano Rodrigues,
Willian Morais de Melo,
Rafael Santiago de Almeida,
Shajadi Carlos Pardo-Kaba,
Celso Koogi Sonoda, and
Elio Hitoshi Shinohara
<bold>Figure 1</bold>
Figure 1

A curved hemostat is inserted through a skin incision in the anterior submental area and a passage is created through the mylohyoid muscle by blunt dissection.

Intraoperative Endobronchial Intubation After Successful Submental Intubation
Shivika NathMD and
Priya SikkaMD
Article Category: Case Report
Volume/Issue: Volume 71: Issue 3
Online Publication Date: Sep 09, 2024
DOI: 10.2344/973799
Page Range: 136 – 139

nasal septum, hypertrophic turbinates, nasal polyps, and other intranasal pathologies. 2 , 3 While elective tracheostomy to establish a surgical airway is a relatively common and effective approach in these types of situations, submental intubation (SMI) is another option that may be considered. Hernández Altemir first introduced SMI for airway management in patients admitted with maxillofacial trauma in 1986. SMI uses a completely different anatomical approach than a traditional tracheostomy and involves percutaneous passage of a flexible endotracheal tube (ETT

Figure.; Patient After Submental Intubation (A) Submental intubation with the lateral approach modification. The ETT is externally positioned in the right submental area and is ready for suturing to secure its position and avoid displacement during surgery. (B) Intraoral surgery after successful submental intubation. The ETT is passed percutaneously through the submental incision and the floor of the mouth to permit the use of maxillomandibular fixation to maintain dental occlusion during the surgical procedure.
Shivika Nath and
Priya Sikka
Figure.
Figure.

Patient After Submental Intubation

(A) Submental intubation with the lateral approach modification. The ETT is externally positioned in the right submental area and is ready for suturing to secure its position and avoid displacement during surgery. (B) Intraoral surgery after successful submental intubation. The ETT is passed percutaneously through the submental incision and the floor of the mouth to permit the use of maxillomandibular fixation to maintain dental occlusion during the surgical procedure.

Figure 2 ; The reinforced tracheal tube is pulled extraorally.
Willian Caetano Rodrigues,
Willian Morais de Melo,
Rafael Santiago de Almeida,
Shajadi Carlos Pardo-Kaba,
Celso Koogi Sonoda, and
Elio Hitoshi Shinohara
<bold>Figure 2</bold>
Figure 2

The reinforced tracheal tube is pulled extraorally.

Subject Index
Article Category: Research Article
Volume/Issue: Volume 64: Issue 4
Online Publication Date: Jan 01, 2017
DOI: 10.2344/0003-3006-64.4.267
Page Range: 267 – 267

, 253 SNRI, 253 Somatosensory evoked potential, 73 Spiral tube, 171 SSRI, 253 St John's Wort, 253 Subcutaneous emphysema, 85 Submental, 153 Superior mesenteric artery syndrome, 244 TCA, 253 Temperament, 17 Tension pneumothorax, 85 Third molars, 8, 80, 127, 136 Tooth extraction, 127 Tricyclic antidepressants, 253 Trismus, 97 Trisomy 9 mosaic, 29 Trisomy 13, 162 Tube-related trouble, 171 Type 2

Ludwig's Angina: Anesthetic Management
Regina A. E. DowdyDDS,
Hany A. Emam BDS, MS,, and
Bryant W. CorneliusDDS, MBA, MPH
Article Category: Research Article
Volume/Issue: Volume 66: Issue 2
Online Publication Date: Jan 01, 2019
DOI: 10.2344/anpr-66-01-13
Page Range: 103 – 110

First described in 1836 by the German surgeon, Friedrich Wilhelm von Ludwig, Ludwig's angina (LA) was discovered to be a gangrenous cellulitis in the soft tissues of the neck. 1 , 2 Angina comes from the Latin word angere , which means “to strangle.” 1 The classical description includes (a) the infection is bilateral, (b) both the submandibular and sublingual spaces are involved as well as the submental space, (c) the infection is a rapidly spreading indurated cellulitis without abscess formation or lymphatic involvement, and (d) the

Alternative Methods for Nasotracheal Intubation and Extubation in a Patient With Apert Syndrome
Masanori TsukamotoDDS, PhD and
Takeshi YokoyamaDDS, PhD
Article Category: Research Article
Volume/Issue: Volume 62: Issue 3
Online Publication Date: Jan 01, 2015
DOI: 10.2344/0003-3006-62.3.122
Page Range: 122 – 124

nasotracheal intubation for surgical access and a secure airway. Of critical concern is the possibility of difficult airway due to facial abnormal abnormalities and the patency of postoperative upper airway secondary to postoperative edema. We performed nasotracheal intubation for this procedure although alternative airway management options such as submental intubation with use of a flexible or wire-reinforced endotracheal tube or tracheotomy could have been considered. Both were felt to be more invasive than the traditional nasotracheal approach. In the

Author Index
Article Category: Research Article
Volume/Issue: Volume 64: Issue 4
Online Publication Date: Jan 01, 2017
DOI: 10.2344/0003-3006-64.4.265
Page Range: 265 – 266

Surgeries With and Without a Dentist Anesthesiologist (scientific report), 8 Reebye U, Letter in Response (reply), 124 Riley CJ, Cardiac Failure in a Trisomy 9 Patient Undergoing Anesthesia: A Case Report (case report), 29 Rodrigues WC, Submental Intubation in Cases of Panfacial Fractures: A Retrospective Study (scientific report), 153 Russell NA, see Young A, 88 Sanders BJ, see Spera AL, 144 Sanuki T, Nitrous Oxide Inhalation Sedation Through a Nasal High-Flow System: The Possibility of a New Technique in Dental

Modified Retrograde Nasal Intubation: A New Airway Technique and Devices
Vernon H. VivianMBChB,
Dip Anaes(SA),
Tyson L. PardonMD, and
Andre A. J. Van ZundertMD, PhD, EDRA
Article Category: Research Article
Volume/Issue: Volume 68: Issue 2
Online Publication Date: Jun 29, 2021
DOI: 10.2344/anpr-68-02-03
Page Range: 107 – 113

NTI include invasive surgical methods such as a tracheostomy and submental or submandibular intubation, which may be useful options for patients with severe facial trauma. The idea of a nasal laryngeal mask airway (NLMA) was first introduced in 1997. After placing an FLMA, Marchionni et al 10 performed a modified retrograde nasal intubation (MRNI) with a Foley catheter, successfully converting the FLMA into an improvised NLMA. In 2007, Arisaka et al 11 used a nasogastric tube instead of a Foley catheter for the MRNI. An article published in 2000 by Agrò