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- W2023193879 abstract "To the Editor: Existing techniques of submental intubation pose several problems. Current techniques involve blunt dissection in the floor of the mouth (with its potential for injury to the vessels/nerves/glands) to create a submental passage through which a reinforced orotracheal tube is pulled after temporarily disconnecting the connector from the tracheal tube (1,2). Disconnection of the connector may expose the wires of the reinforcing coil, increasing the risk of tissue damage from pulling the endotracheal tube through the submental passage (2,3). Holding the endotracheal tube with a forceps while pulling it through the submental passage may also damage the pilot balloon. To overcome these shortcomings, we used a percutaneous dilational tracheostomy kit (Cook Critical Care, Europe) and modified the technique in two of our patients. We made a small skin incision in the lateral part of the submental area. To create a passage for inserting the endotracheal tube, we enlarged the incision by passing a series of dilators (21F–36F) from the outside, through the incision, into the oral cavity. Then we inserted the endotracheal tube over a smaller diameter dilator into the submental passage. Next, we removed the dilator and passed the endotracheal tube over a tube exchanger inside the trachea. This modification has the following advantages: (a) no need to remove the circuit connector; (b) no need to hold the reinforced endotracheal tube with a forceps during its manipulations; (c) minimal bleeding because of dilators rather than blunt dissection; and (d) minimal scar formation and tissue damage due to reduced tissue dissection. Binay Kumar Biswas, MD Sumati Joshi, MD Prithwis Bhattacharyya, MD Parmod Kumar Gupta, MD Department of Anesthesiology & Critical Care B. P. Koirala Institute of Health Sciences Dharan, Nepal [email protected] Sanjeev Baniwal, MDS Department of Oral & Maxillofacial Surgery B. P. Koirala Institute of Health Sciences Dharan, Nepal" @default.
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- W2023193879 date "2006-10-01" @default.
- W2023193879 modified "2023-10-15" @default.
- W2023193879 title "Percutaneous Dilational Tracheostomy Kit: An Aid to Submental Intubation" @default.
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- W2023193879 doi "https://doi.org/10.1213/01.ane.0000239041.31044.c9" @default.
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