H.M.F. Anwer, I.M. Zeitoun, E.A.A. Shehata

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Presentation transcript:

Submandibular approach for tracheal intubation in patients with panfacial fractures H.M.F. Anwer, I.M. Zeitoun, E.A.A. Shehata British Journal of Anaesthesia Volume 98, Issue 6, Pages 835-840 (June 2007) DOI: 10.1093/bja/aem094 Copyright © 2007 British Journal of Anaesthesia Terms and Conditions

Fig 1 Preparation of an armoured tracheal tube by careful removal of its fixed connector to transform it into a removable but fitting connector. British Journal of Anaesthesia 2007 98, 835-840DOI: (10.1093/bja/aem094) Copyright © 2007 British Journal of Anaesthesia Terms and Conditions

Fig 2 A mark representing the site of the skin incision; 1 inch below and 1/2 inch anterior to the angle of the mandible. British Journal of Anaesthesia 2007 98, 835-840DOI: (10.1093/bja/aem094) Copyright © 2007 British Journal of Anaesthesia Terms and Conditions

Fig 3 The tip of an artery forceps seen in the oral cavity after blunt dissection through the skin incision, as close as possible to the inner side of the mandible. British Journal of Anaesthesia 2007 98, 835-840DOI: (10.1093/bja/aem094) Copyright © 2007 British Journal of Anaesthesia Terms and Conditions

Fig 4 The end of the pilot tube grasped with the tip of the artery forceps to be pulled out through the dissected track. British Journal of Anaesthesia 2007 98, 835-840DOI: (10.1093/bja/aem094) Copyright © 2007 British Journal of Anaesthesia Terms and Conditions

Fig 5 The end of the tracheal tube grasped with the tip of the artery forceps to be pulled out through the dissected track in the same way as the pilot tube. British Journal of Anaesthesia 2007 98, 835-840DOI: (10.1093/bja/aem094) Copyright © 2007 British Journal of Anaesthesia Terms and Conditions

Fig 6 The submandibular endotracheal tube reconnected to the anaesthetic ventilator and fixed to the skin of the submandibular region with a strong silk stay suture. British Journal of Anaesthesia 2007 98, 835-840DOI: (10.1093/bja/aem094) Copyright © 2007 British Journal of Anaesthesia Terms and Conditions

Fig 7 The submandibular endotracheal tube left in place during the early postoperative period in the ICU, in an adult patient (a) and in a child (b). British Journal of Anaesthesia 2007 98, 835-840DOI: (10.1093/bja/aem094) Copyright © 2007 British Journal of Anaesthesia Terms and Conditions

Fig 8 The submandibular endotracheal tube in the posterior area of the oral cavity. British Journal of Anaesthesia 2007 98, 835-840DOI: (10.1093/bja/aem094) Copyright © 2007 British Journal of Anaesthesia Terms and Conditions