title: Assessment of the Efficacy of Submental Intubation in the Management of Midfacial and Panfacial Trauma Patients.
abstract: BACKGROUND
  Securing an airway in maxillofacial injuries remains a challenge and is an important objective on the part of a maxillofacial surgeon to thoroughly understand its management.
  
  
  OBJECTIVE
  The aim of this study was to evaluate the efficacy and complications of submental intubation in the management of midfacial/panfacial trauma patients where oro-endotracheal or naso-endotracheal intubation is contraindicated and tracheostomy can be avoided.
  
  
  METHODS
  Twenty patients with maxillofacial injuries were selected for submental intubation who were admitted in Kamineni Hospital, Narketpally, Nalgonda during a 2 year period (2010-2012). The parameters used to assess the efficacy were; restoration of the occlusion, duration of the surgery, presence of scar, presence of infection, damage to vital structures or any post-operative salivary fistula.
  
  
  RESULTS
  Submental intubation allowed reduction and fixation of all fractures without the interference of the tube during surgical procedure in all of the patients. There were no intra-operative complications and none of the patients required post-operative ventilation. There were no significant post-operative complications. However, in one of the cases (case 4) infection of submental wound was seen and in another case (case 11) salivary fistula was formed. Both the cases were appropriately managed without any difficulty. The submental scar was well accepted by all the patients.
  
  
  CONCLUSIONS
  Submental intubation is a safe and extremely useful procedure in severe maxillofacial injuries. It presents a low incidence of operative and post operative complications. It allows both the surgeon and the anaesthetist to deliver a better quality of patient care.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Kamineni Institute of Dental Sciences, Narketpally, Nalgonda, Andhra Pradesh India.
authors.forename: K A Jeevan
authors.initials: KA
authors.lastname: Kumar
authors.affiliation: Department of Oral and Maxillofacial Surgery, Kamineni Institute of Dental Sciences, Narketpally, Nalgonda, Andhra Pradesh India.
authors.forename: B Pavan
authors.initials: BP
authors.lastname: Kumar
authors.affiliation: Department of Oral and Maxillofacial Surgery, Kamineni Institute of Dental Sciences, Narketpally, Nalgonda, Andhra Pradesh India.
authors.forename: A P
authors.initials: AP
authors.lastname: Mohan
authors.affiliation: Department of Oral and Maxillofacial Surgery, Kamineni Institute of Dental Sciences, Narketpally, Nalgonda, Andhra Pradesh India.
authors.forename: Aruna Kishore
authors.initials: AK
authors.lastname: Masram
authors.affiliation: Department of Oral and Maxillofacial Surgery, Kamineni Institute of Dental Sciences, Narketpally, Nalgonda, Andhra Pradesh India.
authors.forename: David
authors.initials: D
authors.lastname: Tyro
authors.affiliation: Department of Oral and Maxillofacial Surgery, Kamineni Institute of Dental Sciences, Narketpally, Nalgonda, Andhra Pradesh India.
authors.forename: Divya
authors.initials: D
authors.lastname: Gandla
keywords: Maxillofacial trauma; Midfacial fractures; Panfacial trauma; Submental intubation