Vol. 3, Issue 9 (2017)
Retromolar intubation: An alternative to invasive intubation techniques in multiple facial injuries
Author(s): Dr. Surender Pal Singh, Dr. Soumithran CS, Dr. KS Ravindran Nair, Dr. Manoj Michael, Dr. Ambadas Kulkarni, Dr. Cathrine Diana
Abstract: To evaluate the success and complications of retromolar intubation technique in multiple facial fractures which require maxillo-mandibular fixation (MMF) during the surgical procedure. 11 patients who require treatment for facial fractures which need MMF intra-operatively were included. Routine oro-tracheal intubation was done and the tube was then shifted into the retro-molar space and tied with the last standing tooth. The following parameters were assessed: need for third molar extraction, intraoperative complication, difficulty encountered by operator, difficulty encountered by the anaesthesiologists and accidental extubation. There was a sufficient space for placing the tube in 9 individuals. Mild hindrance by the tube in achieving the occlusion and tube displacement was observed in one case. Neither the anaesthesiologists had difficulty in managing the airway nor was there an accidental extubation during the surgery. Retromolar intubation is simple, quick to perform, low morbidity without need for any extra-oral procedures. Tube patency can be easily monitored and above all optimal intraoperative dental occlusion can be achieved.
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