title: Submental intubation: An option of airway management for rhinoplasty and rhytidectomy.
abstract: BACKGROUND
  For rhinoplasty, full control of facial symmetry will improve the aesthetic results. During rhinoplasty, the nasal intubation is contraindicated while oral intubation may interfere with surgical procedure. Hence an alternative airway option of the submental intubation was planned to study the efficacy of the procedure.
  
  
  OBJECTIVE
  The submental intubation may improve the aesthetic results of rhinoplasty and facial symmetry.
  
  
  METHODS
  This is a prospective cohort observational study.
  
  
  METHODS
  Fifteen adult consented patients of ASA grade I and II of either gender aged 20 to 38 years who met the inclusion criteria were enrolled. After induction, orotracheal intubation was done with flexometallic tube, followed by a 1.5-cm skin incision in the submental region, adjacent to lower border of mandible;then endotracheal tube was taken out through this incision. At the end of surgery, the procedure was reversed and submental wound was stitched. Patients were extubated after proper suctioning of oral cavity. No intraoperative and postoperative complications have occurred.
  
  
  RESULTS
  The submental intubation was performed in 15 patients by medial approach without any difficulty. The average time taken to perform the procedure was 7.27±0.63 min. No anesthetic and surgical complications were encountered in any patients. The submental scar was almost invisible after 2 months.
  
  
  CONCLUSIONS
  Submental intubation offers a secure airway, efficient ventilation, and uninterrupted operating field to the plastic surgeon. Lack of anesthesia and surgical complications encouraged us to present the advantages of submental intubation on the basis of our own experience.
authors.affiliation: Department of Anaesthesiology & Critical care, N.S.C.B. Subharti Medical College, Subhartipuram, NH-58, Meerut, Uttar Pradesh, India.
authors.forename: Kumkum
authors.initials: K
authors.lastname: Gupta
authors.affiliation: Department of Anaesthesiology & Critical care, N.S.C.B. Subharti Medical College, Subhartipuram, NH-58, Meerut, Uttar Pradesh, India.
authors.forename: Deepak
authors.initials: D
authors.lastname: Sharma
authors.affiliation: Department of Radio-diagnosis, Imaging & Interventional Radiology, N.S.C.B. Subharti Medical College, Subhartipuram, NH-58, Meerut, Uttar Pradesh, India.
authors.forename: Prashant K
authors.initials: PK
authors.lastname: Gupta
authors.affiliation: Department of Surgery, N.S.C.B. Subharti Medical College, Subhartipuram, NH-58, Meerut, Uttar Pradesh, India.
authors.forename: Amit
authors.initials: A
authors.lastname: Bhatnagar
keywords: Aesthetic scar; flexometallic endotracheal tube; rhinoplasty; submental intubation