• Journal of Dental Anesthesia and Pain Medicine
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• 제18권2호
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• pp.125-128
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• 2018

In cases of a difficult intubation where numerous intubation methods, including laryngoscopy, have failed, yet oral intubation is still necessary, the method of tube exchange after fiberoptic nasal intubation may be attempted. Fiberoptic nasal intubation allows intubation to be performed relatively easily when the laryngeal view grade is poor. We report a case in which our attempt at oral intubation for total maxillectomy with laryngoscopy and fiberoptic oral intubation had failed due to an unexpected difficult airway; subsequently, we successfully completed the surgery by performing fiberoptic nasal intubation to secure the airway, followed by using a tube exchanger to exchange to an oral endotracheal tube.

• 대한치과마취과학회지
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• 제12권1호
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• pp.33-37
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• 2012

Dental treatment under general anesthesia is considered a good way for behavioral control in disabled patients. General anesthesia for disabled patients sometimes requires difficult airway management. In this case, intra-oral camera is great helpful to intubation. Originally, the intra-oral camera is designed to facilitate diagnosis dental disease. The intra-oral camera is very efficient on intubation. Laryngeal photo taken by Intra-oral camera can be good guide for difficult intubation. In this report, an 11-year-old boy with chromosomal anomaly received dental care under general anesthesia. And he had a potentially difficult airway. We achieved nasotracheal intubation successfully with intra-oral camera.

• Journal of Dental Anesthesia and Pain Medicine
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• 제19권5호
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• pp.245-252
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• 2019

This paper describes the potential oral complications in preterm infants who have undergone orotracheal intubation. Neonatal intubation may have adverse effects on the developing deciduous teeth, oral soft tissues, and even the permanent teeth. However, endotracheal intubation may be essential for the survival of premature infants, owing to incomplete tracheal development. Excessive pressure to the oral tissue must be avoided, in cases where orotracheal intubation is inevitable. Moreover, the potential oral complications must be considered when neonatal intubation is performed for the patient's survival, and subsequent reevaluation and proper oral health care are needed.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제42권3호
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• pp.151-156
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• 2016

Objectives: To assess submental route intubation as an alternative technique to a tracheostomy in the management of the airway in cranio-maxillofacial trauma, along with an assessment of its morbidity and complications. Materials and Methods: Submental intubation was performed in 17 patients who had maxillofacial panfacial trauma and management was done under general anesthesia during a period of one year from 2013 to 2014 at Departments of Oral and Maxillofacial Surgery and Dentistry, the Malankara Orthodox Syrian Church Medical College, Kochi, India. Results: In all 17 cases, the technique of submental intubation was found to be simple and reliable. Hypertrophic scars were noted in three cases, orocutaneous fistula and mucocele in one case each. All these complications were managed comfortably without significant morbidity to the patient. Conclusion: Submental intubation is a good technique that can be used regularly in the management of the airway in cranio-maxillofacial trauma, but with some manageable complications.

• 대한치과마취과학회지
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• 제14권4호
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• pp.227-232
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• 2014

The indication for submandibular intubation is the requirement for intraoperative maxillomandibular fixation (MMF) in the presence of injuries that preclude nasotracheal intubation. Thus, We reported 2 cased of endotracheal intubations via submandibular approach that is applicable in patients with skull base fractures for a reliable general anesthesia. Endotracheal intubation via submandibular approach was applied during general anesthetic procedures for open reduction in three patients with Le Fort II, III or nasoorbitoethmoid (NOE) fractures. No complications due to submandibular intubation, such as infection, postoperative scarring, nerve injury, hematoma, bleeding, or orocutaneous fistula, were observed following submandibular intubation. Endotracheal intubation via submandibular approach is effective in patients with skull base fractures. In our method, the tube connector is removed in orotracheal intubation in order to avoiding the tube removal or displacement. The advantages of this method are very simple, safe, and to provide the good operation field.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제15권4호
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• pp.322-328
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• 1993

The trauma has been known as a major etiologic factor in temporomadibular joint disorders. The endotracheal intubation is suspected as one of the traumatic factor to temporomandibular disorder. But there are few reports about the amount of mouth opening during endotracheal intubation and temporomandibular joint disorder after endotracheal intubation. The authors studied the effects of endotracheal intubation to temporomandibular joint with 70 patients given surgical operation through general anesthesia. The results were as follows. 1. The mean amount of mouth opening for entire patients during endotracheal intubation was 26.3mm (s, d : 2.6), for oral intubation group 25.9mm(s, d : 3.2), for nasal intubation group 26.6mm(s, d : 1.9). There was no difference between two group stastically. (p<0.05) 2. 1 week later endotracheal intubation, the maximum mouth opening increased 1.5mm for entire patients, 1.5mm for oral intubation group, 1.6mm for nasal intubation group than behare endotracheal intubation. 3. Five patients complained the discomforts around temporomandibular joint after endotracheal intubation. The amount of mouth opening during endotracheal intubation was within physiologic range. It seemed that $45^{\circ}$ upward endoscopic lifting for exposure of glottis gave trauma to temporomandibular joint.

• 대한치과마취과학회지
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• 제14권4호
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• pp.233-236
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• 2014

In order to reduce jaw fracture accompanied by basal skull or nasal fracture, submental intubation could be generally performed. Albeit submental intubation has been widely accepted, it could develop complications such as nerve injury, glandular duct injury, and orocutaneous fistula. Here, we suggest oral intubation for overcoming complications and providing more stable surgical environment in emergency case. Under oral intubation maintaining in retromolar triangle and buccal corridor space, intermaxillary fixation was successfully underwent in 38-years-old female patient with Le Fort I fracture accompanied by pneumocephalus.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제36권3호
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• pp.197-201
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• 2010

Introduction: In a surgery of the oral cavity, nasotracheal intubation is often carried out to secure the surgical field. By passing a tracheal tube through the nasal cavity to the pharynx, the nasotracheal intubation can lead to complications that do not occur with oral intubation, such as nasal bleeding and submucosal aberration etc. The purpose of this study is to examine the method of CT evaluation and pretreatment for a safe nasotracheal intubation. Materials and Methods: Among 30 patients who orthognathic surgery was performed at Chung-Ang University Hospital during the period August 2009 to October 2009, 30 patients were included. The 30 patients were divided into two groups; 15 patients intubated with CT evaluation with pretreatment, and the other 15 patients intubated with no pretreatment. We evaluated nasal bleeding of the two groups during nasotracheal intubation. Results: CT evaluation with pretreatment group had a significantly lower incidence of nasal bleeding than the group with no pretreatment. Conclusion: CT evaluation with pretreatment helps to minimize nasal bleeding during nasotracheal intubation.

• Journal of Dental Anesthesia and Pain Medicine
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• 제20권3호
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• pp.155-160
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• 2020

Submental or submandibular intubation has been reported to cause fewer complications than tracheostomy. However, the risk of infection is always inherent because oral wounds are exposed to microbial flora and bacteria in the oral cavity. A novel technique of submandibular intubation was devised to reduce infection and injury to the soft tissues. We would like to report a novel safe technique that can be performed in patients requiring submental or submandibular intubation. This is the first report of submandibular intubation using a sterile disposable camera cable drape. This novel technique of submandibular intubation is safer, more sterile, easier, and less invasive than conventional submandibular intubation.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제40권5호
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• pp.250-252
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• 2014

Nasotracheal intubation should be performed in patients with jaw fractures because maxillomandibular fixation is required. However, when there are concomitant fractures of the nose and facial bones, an intubation tube positioned at the nose makes it difficult to perform an intricate surgery. In order to overcome these problems, a variety of ways to change the position of the tube have been introduced. We describe a simple technique of switching the tube from a nasal to oral position, which was easily executed in a patient with concomitant nasal and mandibular fractures, accompanied by a literature review.