Intubação submentoniana para o manejo de vias aéreas em paciente com fratura panfacial: relato de caso

Abstract

Introduction: Panfacial fractures present particularities that require greater attention and interaction from professionals responsible for primary and secondary care of victims. In this context, correct airway management can be highlighted. Submental intubation is a conservative technique, very useful for patients who have associated fractures of the middle and lower third of the face, and who do not require a long-term airway. Also called submental-orotracheal intubation, this consists of passing the tracheal tube through the mouth and then transferring it to the submental region through a submental incision, to perform the maxillomandibular block during surgery. Objective: To present the clinical case of a patient with fractures in the three thirds of the face who opted to use submental intubation for airway management during surgery. Case report: Male patient, 38 years old, victim of a motorcycle accident, requiring a raw approach for fixation of facial fractures with the possibility of a single surgical approach. The identification of all fractures through clinical examination and computed tomography imaging, the patient's clinical condition allowed the planning of a unique approach with the aid of submental intubation. It begins with the orotracheal intubation process, and then the submental access is performed. At the end of the surgery, the tube is reversed into the oral cavity, and the skin must be sutured. Conclusion: Submental intubation proved to be an easy technique to perform when there is in-depth knowledge of the submandibular anatomy, and should therefore be more widespread among multidisciplinary teams.