Intubation techniques: preferences of maxillofacial XXXX surgeons.

@entity1 @entity11253 @entity174 @entity5274 @entity130
OBJECTIVE: To evaluate the clinical outcomes of alternative techniques of intubation in @entity1 sustaining @entity11253 , where nasotracheal intubation (NTI) is best avoided. MATERIAL AND METHODS: Alternative techniques to standard naso-tracheal intubation like submental intubation, orotracheal intubation-retrotuberosity/retromolar and missing dentition were used and variables of clinical outcome recorded. RESULTS: Submental intubation provides an unobstructed intraoral surgical field, avoids intraoperative and postoperative complications of tracheostomy, and overcomes the disadvantages of NTI. In our experience with submental intubation (6 cases), we only had complication related to @entity5274 apparatus like damage to pilot balloon. With retrotuberosity intubation (5 cases) we did not encounter any complications and the only limitations were bulbous maxillary tuberosity. Retromolar intubation (4 cases) a safe noninvasive technique has disadvantages like @entity5274 interference within the surgical field and not feasible in case of limited retromolar space. Orotracheal-missing dentition intubation (4 cases) is of great advantage i.e. it can be used in cases where NTI is contraindicated, no specialized skill required, no added cost, avoids the need for tracheostomy, no extra-oral procedures required and does not interfere with occlusion/MMF; with disadvantage of occasional @entity5274 interference within the surgical field. CONCLUSION: Preferred techniques of securing an airway like orotracheal, nasotracheal may not always be applicable, thus a @entity130 surgeon-anesthesist team should always have alternative techniques in their armamentarium to reduce the morbidity associated with these @entity1 without interference with occlusion, which is prime goal in jaw @entity174 reduction. We have used these techniques in a country with limited resources and found them equally effective and convenient to use.
