Submental intubation: An option of airway management for rhinoplasty and rhytidectomy

CONTEXT: For rhinoplasty, full control of facial symmetry will improve the aesthetic results. During rhinoplasty, the nasal intubation is contraindicated while oral intubation may interfere with surgical procedure. Hence an alternative airway option of the submental intubation was planned to study the efficacy of the procedure. AIMS: The submental intubation may improve the aesthetic results of rhinoplasty and facial symmetry. SETTING AND DESIGN: This is a prospective cohort observational study. MATERIALS AND METHODS: Fifteen adult consented patients of ASA grade I and II of either gender aged 20 to 38 years who met the inclusion criteria were enrolled. After induction, orotracheal intubation was done with flexometallic tube, followed by a 1.5-cm skin incision in the submental region, adjacent to lower border of mandible;then endotracheal tube was taken out through this incision. At the end of surgery, the procedure was reversed and submental wound was stitched. Patients were extubated after proper suctioning of oral cavity. No intraoperative and postoperative complications have occurred. RESULTS: The submental intubation was performed in 15 patients by medial approach without any difficulty. The average time taken to perform the procedure was 7.27±0.63 min. No anesthetic and surgical complications were encountered in any patients. The submental scar was almost invisible after 2 months. CONCLUSION: Submental intubation offers a secure airway, efficient ventilation, and uninterrupted operating field to the plastic surgeon. Lack of anesthesia and surgical complications encouraged us to present the advantages of submental intubation on the basis of our own experience.