scholarly journals Intubação Submentoniana: Quando indicar? – Revisão de literatura

2020 ◽  
Author(s):  
Laryssa Dos Santos Pinheiro
Keyword(s):  
Surgical Treatment ◽  
Literature Review ◽  
General Anesthesia ◽  
Surgical Procedures ◽  
Orotracheal Intubation ◽  
Dental Occlusion ◽  
Facial Fractures ◽  
Submental Intubation ◽  
Elective Tracheostomy ◽  
Neurovascular Anatomy

A intubação submentoniana (ISM), é uma derivação da intubação orotraqueal sem que o tubo passe pela oclusão dentária e lábios do paciente, tendo sua maior indicação a possibilidade da realização da ventilação mecânica do paciente durante um procedimento sob anestesia geral, sem que o tubo atrapalhe as manobras cirúrgicas que exijam um bloqueio maxilo-mandibular transoperatório associado à manipulação da região naso-órbito-etmoidal, evitando assim,a necessidade de uma traqueostomia eletiva. O objetivo deste trabalho é realizar uma revisão de literatura sobre a ISM, abordando suas indicações, contraindicações, vantagens e desvantagens na realização desta técnica. Onde apesar de simples, é fundamental que o profissional tenha o domínio da anatomia óssea e neurovascular da região e do exato posicionamento das glândulas sublinguais, submandibulares e seus ductos, a fim de evitar complicações trans e pós-operatórias imediatas ou tardias. Essa técnica é extremamente bem indicada para facilitar o tratamento cirúrgico de pacientes portadores de múltiplas fraturas da face, reduzindo riscos de complicações graves durante o manejo das vias aéreas pelo médico anestesiologista, sendo de realização rápida, segura e de baixa morbidade.Palavras-chave: intubação submentoniana, intubação endotraqueal, trauma de face.AbstractA submental intubation (ISM) is a derivation of orotracheal intubation without a tube or passes through the patient's dental occlusion and lips, with its greatest indication being the possibility of performing the patient's mechanical technique during the procedure under general anesthesia, without a tube disturbing maneuvers surgical procedures that require a maxillomandibular transoperative block associated with manipulation of the naso-abortion-ethmoidal region, thus avoiding the need for an elective tracheostomy. The objective of this work is to carry out a literature review on ISM, addressing its indications, contraindications, advantages and advantages in carrying out this technique. Where, although simple, it is essential that the professional has mastery of the bone and neurovascular anatomy of the region and the exact level of the sublingual, submandibular glands and their ducts, an end to prevent overflow and immediate or late postoperative. This technique is extremely well indicated to facilitate the surgical treatment of patients with multiple facial fractures, risks of serious complications during the management of the airways by the anesthesiologist, being fast and safe and safe and with low morbidity. Keywords: submental intubation, endotracheal intubation, face trauma.

scholarly journals Preoperative Diagnosis and Treatment of Middle Ear Adenoma: A Case Report and Literature Review

2021 ◽  
pp. 014556132110002
Author(s):  
Aleksander Zwierz ◽  
Krystyna Masna ◽  
Paweł Burduk
Keyword(s):  
Case Report ◽  
Surgical Treatment ◽  
Literature Review ◽  
Middle Ear ◽  
Surgical Procedures ◽  
Preoperative Diagnosis ◽  
Proper Treatment ◽  
Second Stage ◽  
Middle Ear Adenoma ◽  
Histopathological Results

Most reported cases of middle ear adenoma (MEA) have focused on histopathology because MEA is usually diagnosed postoperatively, which is considered as a major setback. We focused on the surgical aspect of the disease to facilitate a preoperative diagnosis, resulting in prompt and proper treatment, without requiring a second stage of surgical treatment. In this report, we present the differential diagnoses in a 40-year-old man with MEA requiring surgical treatment. Preoperatively, the patient was suspected to have an MEA. An analysis of the surgical procedures in similar misdiagnosed tumors has enabled us to assess surgical procedures in cases wherein the preoperative diagnosis does not coincide with the postoperative histopathological results.

Comparison among the Intubation Techniques Employed in the Course of Management of Pan-Facial Trauma

2021 ◽  
Author(s):  
Aravindh RJ
Keyword(s):  
General Anesthesia ◽  
Nasotracheal Intubation ◽  
Functional Results ◽  
Orotracheal Intubation ◽  
Facial Trauma ◽  
Minimal Risk ◽  
Intermaxillary Fixation ◽  
Intubation Technique ◽  
Submental Intubation ◽  
Intraoperative Period

Objective: To find the best method of intubation in patients sustaining pan-facial trauma by comparing the pros and cons of each technique. Materials and methods: Three different types of intubation techniques (nasotracheal intubation, orotracheal intubation, and sub-mental intubation) were considered in this study. The study population involves 9 patients who have undergone treatment for pan-facial trauma under general anesthesia (3 patients per technique) and the variables of clinical outcome of each group were recorded. Results: Nasal intubation is the most common and safest method of intubation. However, it can’t be used in some types of pan-facial trauma. In cases like these, oral intubation is not preferred. As it severely compromises maxillofacial repair because of interference with the placement of intermaxillary fixation [3](IMF), which is used to establish the patient s occlusion in the intraoperative period. Submental intubation is an alternative with minimal risk to tracheostomy when orotracheal or nasotracheal intubation is not appropriate. The submental intubation technique gave an uninterrupted surgical field, unobstructed airway, ease of gaining occlusion in general anesthesia, less intraoperative and postoperative complications and it overcomes the disadvantages of both nasotracheal and orotracheal intubation. Conclusion: Preferred techniques of securing an airway are orotracheal, nasotracheal intubation. However these techniques may not always be applicable, thus a trauma surgeon-anesthetist team should always have alternative techniques in their armamentarium which secures the patient's airways without interfering with occlusion, to gain at most postoperative esthetic and functional results.

scholarly journals Submental method for orotracheal intubation in treating facial trauma

1998 ◽  
Vol 116 (5) ◽  
pp. 1829-1832 ◽  
Author(s):  
Luiz Carlos Manganello-Souza ◽  
Nicolas Tenorio-Cabezas ◽  
Luiz Piccinini Filho
Keyword(s):  
Tracheal Intubation ◽  
General Anesthesia ◽  
Surgical Intervention ◽  
Orotracheal Intubation ◽  
Facial Trauma ◽  
Facial Fractures ◽  
Surgical Team ◽  
Visible Scar ◽  
Alternative Method

OBJECTIVE: To demonstrate an alternative method for intubating patients with fractures of maxilla and nose, prior to surgery. DESIGN: Cases Report. PARTICIPANTS: We studied 10 patients with facial fractures that affected maxilla and nose. INTERVENTION: The patients were submitted to surgery under general anesthesia and submental oro-tracheal intubation. RESULTS: This type of intubation allowed the surgical team to work on the whole face of the patient and left no visible scar. CONCLUSION: This procedure is indicated for patients with fractures of maxilla and nose who need surgical intervention under general anesthesia.

scholarly journals The surgical treatment of thoracic metastases in ovarian cancer

2015 ◽  
Vol 10 (2) ◽  
pp. 132-136 ◽  
Author(s):  
Alice SAVESCU ◽  
◽  
Irina BALESCU ◽  
Nicolae BACALBASA ◽  
◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Surgical Treatment ◽  
Literature Review ◽  
Surgical Procedures ◽  
Complete Cytoreduction ◽  
Advanced Stage ◽  
Lymphatic Route

Ovarian cancer still represents one of the most aggressive malignancies affecting women worldwide. Unfortunately many patients are still diagnosed in an advanced stage of the disease when distal metastases are already present. When it comes to thoracic involvement in advanced stage ovarian cancer, this may develop via peritoneal, hematogenous and lymphatic route. This is a literature review of the most commonly seen involvements in ovarian cancer and of the most appropriate surgical procedures which might be performed in order to increase the rate of complete cytoreduction.

scholarly journals Submental intubation in pediatric maxillofacial surgery: report of 2 cases

1969 ◽  
Vol 48 (2) ◽  
pp. 91-95
Author(s):  
Vanessa Alejandri-Gamboa ◽  
Pedro J. Téllez-Rodríguez ◽  
María C.R. López-Fernández ◽  
Abel Sanjuan-Martínez ◽  
Lina Sarmiento
Keyword(s):  
Surgical Procedures ◽  
Current Literature ◽  
Pediatric Patients ◽  
Pediatric Population ◽  
Nasotracheal Intubation ◽  
Maxillofacial Surgery ◽  
Orotracheal Intubation ◽  
Morbidity And Mortality ◽  
Submental Intubation ◽  
Review Current

Submental intubation (SMI) is useful in surgical procedures where nasotracheal intubation is contraindicated and orotracheal intubation is not ideal, making it an alternative to tracheostomy since it is performed in less time, with less morbidity and mortality, minimal postoperatory care, as well as an aesthetically acceptable scar. We present 2 cases of pediatric patients with a successful SMI. In addition, we briefly review current literature regarding pediatric population.

scholarly journals Submental endotracheal intubation in patient with panfacial fracture: a useful alternative to tracheostomy

2014 ◽  
Vol 26 (1) ◽  
pp. 54-57
Author(s):  
Shahadat Hossain ◽  
Hasina Begum ◽  
Ismat Ara Haider ◽  
Selim Sarker
Keyword(s):  
Tracheal Intubation ◽  
Endotracheal Intubation ◽  
Maxillofacial Surgery ◽  
Dental Occlusion ◽  
Facial Fractures ◽  
Optimal Operating ◽  
Operating Field ◽  
Submental Intubation ◽  
Panfacial Fracture

Submental intubation is a simple safe and useful technique for air way management during maxillofacial surgery when both nasal and oral tracheal intubation are deemed unsuitable. This technique offers an optimal operating field and an opportunity to check the dental occlusion. It avoids the need for tracheostomy and its consequent morbidity. We present a case of multiple facial fractures where we avoided tracheostomy by the use of submental endotracheal intubation. DOI: http://dx.doi.org/10.3329/jbsa.v26i1.19818 Journal of Bangladesh Society of Anaesthesiologists 2013; 26(1): 54-57

scholarly journals Submental tracheal intubation in oromaxillofacial surgery

2008 ◽  
Vol 41 (01) ◽  
pp. 15-19
Author(s):  
Ramesh Kumar Sharma ◽  
Puneet Tuli ◽  
Chacko Cyriac ◽  
Atul Parashar ◽  
Surinder Makkar
Keyword(s):  
Skull Base ◽  
Surgical Procedures ◽  
Skull Base Surgery ◽  
Nasotracheal Intubation ◽  
Dental Occlusion ◽  
Emergency Setting ◽  
Le Fort ◽  
Oral Intubation ◽  
Submental Intubation ◽  
Le Fort I

ABSTRACT Background: oromaxillofacial surgical procedures present a unique set of problems both for the surgeon and for the anesthesist. achieving dental occlusion is one of the fundamental aims of most oromaxillofacial procedures. oral intubation precludes this surgical prerequisite of checking dental occlusion. having the tube in the field of surgery is often disturbing for the surgeon too, especially in the patient for whom skull base surgery is planned. nasotracheal intubation is usually contraindicated in the presence of nasal bone fractures seen either in isolation or as a component of le fort fractures. we utilized submental endotracheal intubation in such situations and the experience has been very satisfying.materials and methods: the technique has been used in 20 patients with maxillofacial injuries and those requiring le fort i approach with or without maxillary swing for skull base tumors. initial oral intubation is done with a flexo-metallic tube. a small 1.5 cm incision is given in the submental region and a blunt tunnel is created in the floor of the mouth staying close to the lingual surface of mandible and a small opening is made in the mucosa. the tracheal end of tube is stabilized with magil′s forceps, and the proximal end is brought out through submental incision by using a blunt hemostat taking care not to injure the pilot balloon. at the end of procedure extubation is done through submental location only.results: the technique of submental intubation was used in a series of twenty patients from january 2005 to date. there were fifteen male patients and five female patients with a mean age of twenty seven years (range 10 to 52). seven patients had le fort i osteotomy as part of the approach for skull base surgery. twelve patients had midfacial fractures at the le fort ii level, of which 8 patients in addition had naso-ethomoidal fractures and 10 patients an associated fracture mandible. twelve patients were extubated in the theatre. eight patients had delayed extubation in the post-operative ward between 1 and 3 days postoperatively.conclusion: in conclusion, the submental intubation technique has proved to be a simple solution for many a difficult problem one would encounter during oromaxillofacial surgical procedures. it provides a safe and reliable route for the endotracheal tube during intubation while staying clear of the surgical field and permitting the checking of the dental occlusion, all without causing any significant morbidity for the patient. its usefulness both in the emergency setting and for elective procedures has been proved. the simplicity of the technique with no specialized equipment or technical expertise required makes it especially advantageous. this technique therefore, when used in appropriate cases, allows both the surgeon and the anesthetist deliver a better quality of patient care.

Spinal Cord Stimulation: A Contemporary Series

Neurosurgery ◽  
1991 ◽  
Vol 28 (1) ◽  
pp. 65-71 ◽  
Author(s):  
Roberto Spiegelmann ◽  
William A. Friedman
Keyword(s):  
Spinal Cord ◽  
Chronic Pain ◽  
Pain Relief ◽  
Literature Review ◽  
General Anesthesia ◽  
Detailed Analysis ◽  
Spinal Cord Stimulation ◽  
Significant Pain ◽  
Experience Pain

Abstract Forty-three patients with chronic pain disorders of different causes were selected for spinal cord stimulation. All underwent implantation of a ribbon electrode through a small laminotomy, under general anesthesia. Thirteen patients (30%) failed to obtain significant pain relief during a period of trial stimulation, and their electrodes were removed. The remainder underwent a definitive implant and were followed for a mean of 13 months (range, 3-33 months). Nineteen of them (63%) continued to experience pain relief. A detailed analysis of this series, as well as a literature review, is presented.

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