title: Submental endotracheal intubation:  a valuable resource for the management of panfacial fractures.
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.
authors.affiliation: Surgery & Integrated Clinic Department, Araçatuba Dental School, São Paulo State University , São Paulo, Brazil. wmoraismelo@yahoo.com.br
authors.forename: Willian Morais
authors.initials: WM
authors.lastname: de Melo
authors.forename: Marcus Antônio
authors.initials: MA
authors.lastname: Brêda
authors.forename: Darklilson
authors.initials: D
authors.lastname: Pereira-Santos
authors.forename: Cassiano Costa Silva
authors.initials: CC
authors.lastname: Pereira
authors.forename: Celso Koogi
authors.initials: CK
authors.lastname: Sonoda
authors.forename: Marcelo Marotta
authors.initials: MM
authors.lastname: Araújo
mesh_terms: D005147:Facial Bones / Q000293:injuries* / Q000601:surgery*; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal / Q000379:methods*; D012887:Skull Fractures / Q000601:surgery*; D014140:Tracheotomy; D016896:Treatment Outcome