preprints.org > medicine and pharmacology > dentistry and oral surgery > doi: 10.20944/preprints202310.0996.v1

Preprint Review Version 1 Preserved in Portico This version is not peer-reviewed

Version 1 : Received: 13 October 2023 / Approved: 16 October 2023 / Online: 17 October 2023 (12:03:24 CEST)

Abstract: Panfacial fractures are complex injuries involving multiple regions of the facial skele-ton simultaneously, which may necessitate multiple surgeries over a relatively short period. They are often associated with polytrauma and other injuries including brain trauma, which re-quire either immediate airway management, prolonged intubation, or repeated intubations for staged surgeries. Given the frequent need for intermaxillary fixation and the potential involve-ment of the central nasal complex or skull base, conventional oro-tracheal or nasotracheal intu-bation often presents challenges. Submental intubation is the most reported method of airway management with the aim to avoid tracheostomy and its related complications. A review of the different techniques of airway management in the elective treatment of panfacial fractures was performed focusing on the advantages and disadvantages of each method. Most of the literature consisted of retrospective studies, with only one prospective study comparing submental intu-bation to tracheostomy in panfacial fractures. There is abundant literature that favours the sub-mental intubation for its rapid establishment and low complication rate. Other techniques less reported were retromolar intubation, nasotracheal to orotracheal switch, tracheostomy or crico-thyroidotomy. An algorithm for the management of the airway in panfacial fractures is pre-sented.

airway management; panfacial fractures

Medicine and Pharmacology, Dentistry and Oral Surgery

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