title: Submental intubation for airway management of patients with complex caniomaxillofacial injuries: Our experience.
abstract: BACKGROUND
  There is paucity of data regarding the role of submental intubation (SI) in the airway management of patients with craniomaxillofacial trauma from India.
  
  
  OBJECTIVE
  To study the characteristics of patients presenting with craniomaxillofacial injuries requiring submental intubation, the duration of SI procedure and complications of this technique.
  
  
  METHODS
  Tertiary level, teaching institute, retrospective, observational study.
  
  
  METHODS
  Forty patients requiring submental intubation between June, 2007 and December, 2009. The primary outcome measure was the time required for submental intubation defined as starting from the completion of the orotracheal intubation to the fixation of the submental tube. The secondary outcome measures included characteristics of patients with craniomaxillofacial injuries, intraoperative and postoperative complications of the SI technique.
  
  
  METHODS
  Data are presented as mean± standard deviation and frequency and percentages, where relevant.
  
  
  RESULTS
  Most of the patients were young (average age = 35.15 ± 12.02 years), males (75%) and sustained craniomaxillofacial injuries due to road traffic accidents (85%). The 40 patients included in this audit had 56 injuries recorded at the time of admission including, orthopedic injuries in 65% and head injuries in 55% of patients. The mean time required for completion of SI was 8.90 min. The complications observed included, intraoperative tube migration, development of extra oral fistula, and sialocele, in one patient each.
  
  
  CONCLUSIONS
  Submental intubation is a simple, safe, quick, and relatively harmless alternative to tracheostomy for securing the airway in selected patients with craniofacial trauma. Familiarity with the submental intubation technique will help the anesthesiologist to avoid tracheostomy in selected patients with craniofacial trauma who do not require long-term mechanical ventilation.
authors.affiliation: Department of Anaesthesiology and Critical Care, Christian Medical College, Ludhiana, Punjab, India.
authors.forename: Abraham
authors.initials: A
authors.lastname: Valsa
authors.affiliation: Department of Oral and Maxillofacial Surgery, Christian Dental College, Ludhiana, Punjab, India.
authors.forename: Laxman
authors.initials: L
authors.lastname: Kumar
authors.affiliation: Department of Oral and Maxillofacial Surgery, Christian Dental College, Ludhiana, Punjab, India.
authors.forename: Gandhi
authors.initials: G
authors.lastname: Sumir
authors.affiliation: Department of Anaesthesiology and Critical Care, Christian Medical College, Ludhiana, Punjab, India.
authors.forename: Aparna
authors.initials: A
authors.lastname: Williams
authors.affiliation: Department of Anaesthesiology and Critical Care, Christian Medical College, Ludhiana, Punjab, India.
authors.forename: Melchisedek
authors.initials: M
authors.lastname: Singh
authors.affiliation: Department of Anaesthesiology and Critical Care, Christian Medical College, Ludhiana, Punjab, India.
authors.forename: Jyotsana V
authors.initials: JV
authors.lastname: Victor
keywords: Complications; maxillofacial injuries; submental intubation; tracheostomy