Intubação submental: evitando a traqueostomia em cirurgia bucomaxilofacial

Resumo (EN)

The administration of the aerial roads during the general anesthesia for the treatment of complex facial fractures, is a challenge common to anesthesiologists and surgeons. The nasotracheal intubation in cases of fractures type Fort 1l and ll can contribute for introduction of the tube traqueal into anterior fossa of the skull, causing damages to the brain; already in cases of nasal fractures associated to fracture of the jaw, it disables the correct reduction and contention of the nasal bones. The natural alternative to the nasal intubation would be the orotracheal intubation, but this option impedes the use of the maxilomandibular trans-operative fixation that it is essential to propitiate the correct reduction and fixation of the fractured stumps; this dichotomy between need and opportunity culminated with the compulsory use of the tracheostomy. In 1986 Hernández Altemir* described a methoad of intubation endotracheal submental with the objective of avoiding the tracheostomy for the treatment of facial trauma when the fixation maxilomandibular is necessary.