Submental intubation using laparoscopic trocar in zygomaticomaxillary complex fracture surgery in Korea: a case report

• Published in: Daehan oe'sang haghoeji Vol. 36; no. 2; pp. 128 - 132
• Main Authors: Hyejin Do, Chunui Lee, Hyeon Don Hong, Hyejin Hong, Hyun Kyo Lim, Sujin Kim
• Format: Journal Article
• Language: Korean
• Published: 대한외상학회 30-06-2023
• Subjects: Airway management; Case reports; Intratracheal intubation; Maxillofacial injuries; Surgical instruments; Surgical instruments; Case reports; Airway management; Maxillofacial injuries; Intratracheal intubation
• ISSN: 1738-8767; 2799-4317; 2287-1683

Submental intubation is an effective alternative technique for airway management in patients with maxillofacial trauma. Compared with tracheostomy, it is less invasive, but has risks associated with potential airway compromise such as hypoxia due to tube obstruction, collapse, and kinking. To shorten procedure time and ensure a reinforced tube lumen, we used a laparoscopic trocar as a new device for submental intubation. A 54-year-old male patient sustained a zygomaticomaxillary complex fracture and was scheduled to undergo open reduction and internal fixation. We performed intraoral intubation and made a small 1-cm incision at the submandibular midline. After dissection of the tissue from the incision site, a reinforced tube was passed using a 12-mm laparoscopic trocar. The procedure took about 5 minutes, and apnea time from disconnecting the breathing circuit and passing through the internal lumen of the trocar until it was reconnected to the ventilator was 1 minute 5 seconds. Using a laparoscopic trocar for submental intubation can reduce the time required for dissection, prevent luminal occlusion complications due to soft tissues or blood clots in the endotracheal tube, and decrease soft tissue damage.