Intraoperative Endobronchial Intubation After Successful Submental Intubation
In complex maxillofacial fractures in which orotracheal and nasotracheal intubation are otherwise contraindicated, alternatives for airway management include tracheostomy and submental intubation (SMI). In this case, SMI was used successfully, although it did result in accidental endobronchial intubation intraoperatively that was quickly recognized and managed appropriately. SMI can be a useful method for securing a patient’s airway, but like all surgical approaches, it does carry the potential for complications. We report a case involving the use of SMI during which an unintended endobronchial intubation occurred.
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.
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