Transmylohyoid Endotracheal Intubation in Pan-facial Trauma: a Paradigm Shift in Airway Management

Conventional methods of airway management includes orotracheal intubation,nasotracheal intubation or tracheostomy. Surgical repair of maxillofacial trauma requires modification of standard anaesthesia techniques because modern techniques for surgical treatment of midfacial $ panfacial fractures pose problems for airway management which needs unobstructed access to operative field. To avoid these complications with classic methods of intubation,alternative technique of submental route for tracheal intubation was first described by Altemir in 1986. The term transmylohyoid intubation was coined by Muzzi in 1991 as endotracheal tube transects mylohyoid muscle. The technique consists of diverting the proximal end of orotracheal tube through floor of mouth allowing free intraoperative access to dental occlusion $ nasal pyramid without endangering patients with skull base trauma and avoids transtracheal dissection for maintenance of airway. Here is presentation of our work on transmylohyoid intubation,its efficacy,utility $ complications in polytrauma patients. Hope this work interests the members associated with primary care of trauma patients $ surgeons operating in facial region.