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Background <p>Panfacial fracture is a maxillofacial injury involving multiple bones of the face. Airway management is difficult in these patients because the&#xa0;normal anatomy of the face is distorted.&#xa0;Oral and nasal endotracheal intubation is not indicated in these patients because the&#xa0;tube interferes with maxillomandibular fixation; an associated nasal bone fracture. Transmylohyoid intubation (TMI) is an easier and safer technique for securing airways in these patients. The study aimed to retrospectively review the data on TMIs in Panfacial Trauma (PT) patients reported to the Department of Oral and Maxillofacial Surgery.</p> Materials and Methods <p>We retrospectively reviewed PT patients who underwent TMIs. The data were collected from the Dept. of Oral and Maxillofacial Surgery at our institute between January 2013 and July 2023. Altemir’s method of TMI had been used. Demographic data of the patients, along with the type of fracture, time for intubation, and complications were recorded.</p> Results <p>Fifty-nine patients with PT were reported for whom TMI was carried out. There were 57 males and two females, with ages ranging from 18 to 65&#xa0;years (mean age 41&#xa0;years). The average time taken for intubation was 10 ± 2&#xa0;min. A few complications such as breakage of the Endotracheal tube (ETT) cuff, slippage of the tube, and extraoral scars were noted in these patients.</p> Conclusion <p>The&#xa0;TMI technique should be mastered by all surgeons in their careers as it is an important procedure in the management of complex maxillofacial trauma.</p>

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Transmylohyoid Intubation in Panfacial Trauma Patients: A 10-Years Retrospective Study

  • 期刊论文

  • 发表日期：

    2025年5月26日

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  • Shilpa S. Bawane,
  • Sushree Mahapatro,
  • Pushkar P. Waknis,
  • Kalyani Bhate,
  • B. M. Rudagi

摘要

Background

Panfacial fracture is a maxillofacial injury involving multiple bones of the face. Airway management is difficult in these patients because the normal anatomy of the face is distorted. Oral and nasal endotracheal intubation is not indicated in these patients because the tube interferes with maxillomandibular fixation; an associated nasal bone fracture. Transmylohyoid intubation (TMI) is an easier and safer technique for securing airways in these patients. The study aimed to retrospectively review the data on TMIs in Panfacial Trauma (PT) patients reported to the Department of Oral and Maxillofacial Surgery.

Materials and Methods

We retrospectively reviewed PT patients who underwent TMIs. The data were collected from the Dept. of Oral and Maxillofacial Surgery at our institute between January 2013 and July 2023. Altemir’s method of TMI had been used. Demographic data of the patients, along with the type of fracture, time for intubation, and complications were recorded.

Results

Fifty-nine patients with PT were reported for whom TMI was carried out. There were 57 males and two females, with ages ranging from 18 to 65 years (mean age 41 years). The average time taken for intubation was 10 ± 2 min. A few complications such as breakage of the Endotracheal tube (ETT) cuff, slippage of the tube, and extraoral scars were noted in these patients.

Conclusion

The TMI technique should be mastered by all surgeons in their careers as it is an important procedure in the management of complex maxillofacial trauma.