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Airway management through submental derivation: a safe and easily reproduced alternative for patients with complex facial trauma

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Gonzalez-Magana Fernando, Malagon-Hidalgo Hector Omar, Garcia-Cano Eugenio, Vilchis-Lopez Roberto, Fentanes-Vera Adriana, Ayala-Ugalde Fernan-Alejandra,
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 ( Gonzalez-Magana Fernando ) - Instituto de Seguridad Social del Estado de Mexico y Municipios Department of Plastic and Reconstructive Surgery
 ( Malagon-Hidalgo Hector Omar ) - Instituto de Seguridad Social del Estado de Mexico y Municipios Department of Plastic and Reconstructive Surgery
 ( Garcia-Cano Eugenio ) - Instituto de Seguridad Social del Estado de Mexico y Municipios Department of Plastic and Reconstructive Surgery
 ( Vilchis-Lopez Roberto ) - Instituto de Seguridad Social del Estado de Mexico y Municipios Department of Plastic and Reconstructive Surgery
 ( Fentanes-Vera Adriana ) - Instituto de Seguridad Social del Estado de Mexico y Municipios Department of Plastic and Reconstructive Surgery
 ( Ayala-Ugalde Fernan-Alejandra ) - Instituto de Seguridad Social del Estado de Mexico y Municipios Department of Plastic and Reconstructive Surgery

Abstract


Objectives: Airway management in patients with panfacial trauma is complicated. In addition to involving facial lesions, such trauma compromises the airway, and the use of intermaxillary fixation makes it difficult to secure ventilation by usual approaches (nasotracheal or endotracheal intubation). Submental airway derivation is an alternative to tracheostomy and nasotracheal intubation, allowing a permeable airway with minimal complications in complex patients.

Materials and Methods: This is a descriptive, retrospective study based on a review of medical records of all patients with facial trauma from January 2003 to May 2015. In total, 31 patients with complex factures requiring submental airway derivation were included. No complications such as bleeding, infection, vascular, glandular, or nervous lesions were presented in any of the patients.

Results: The use of submental airway derivation is a simple, safe, and easy method to ensure airway management. Moreover, it allows an easier reconstruction.

Conclusion: Based on these results, we concluded that, if the relevant steps are followed, the use of submental intubation in the treatment of patients with complex facial trauma is a safe and effective option.

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Submental derivation; Complex facial trauma; Safety; Efficacy

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