Airway Management in Complex Maxillofacial Trauma: Evaluating the Role of Submental Intubation as a Viable Alternative to Tracheostomy
Airway management in maxillofacial trauma is a critical and complex challenge, requiring both secure ventilation and optimal surgical access while minimizing risks to vital structures. This study evaluated the efficacy of submental intubation (SMI) as a minimally invasive alternative to tracheostomy...
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| Language: | English |
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MDPI AG
2025-03-01
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| Series: | Craniomaxillofacial Trauma & Reconstruction |
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| Online Access: | https://www.mdpi.com/1943-3883/18/1/21 |
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| author | Giulio Cirignaco Gabriele Monarchi Lisa Catarzi Mariagrazia Paglianiti Enrico Betti Umberto Committeri Alberto Bianchi Paolo Balercia Giuseppe Consorti |
| author_facet | Giulio Cirignaco Gabriele Monarchi Lisa Catarzi Mariagrazia Paglianiti Enrico Betti Umberto Committeri Alberto Bianchi Paolo Balercia Giuseppe Consorti |
| author_sort | Giulio Cirignaco |
| collection | DOAJ |
| description | Airway management in maxillofacial trauma is a critical and complex challenge, requiring both secure ventilation and optimal surgical access while minimizing risks to vital structures. This study evaluated the efficacy of submental intubation (SMI) as a minimally invasive alternative to tracheostomy in patients with complex maxillofacial fractures. A retrospective analysis of 52 patients treated between 2015 and 2023 was conducted by comparing clinical outcomes between those who underwent SMI (n = 26) and those who underwent tracheostomy (n = 26). The duration of hospitalization, infection rates, and perioperative complications were assessed using t-tests, chi-square tests, and multivariate regression. Results indicated that SMI was associated with significantly shorter hospital stays (11.15 ± 3.29 vs. 23.96 ± 6.47 days, <i>p</i> < 0.001) and lower infection rates (3.8% vs. 30.8%, <i>p</i> = 0.028). Additionally, the SMI group demonstrated fewer intraoperative (<i>p</i> = 0.049) and postoperative complications (<i>p</i> = 0.037). Multivariate analysis identified tracheostomy as an independent predictor of prolonged hospitalization and increased complications. These findings support SMI as a safe and effective alternative to tracheostomy for short-term airway management in maxillofacial trauma, providing a shorter recovery period and fewer complications. Therefore, prospective studies with larger cohorts are warranted to confirm these results and establish comprehensive guidelines. |
| format | Article |
| id | doaj-art-7a241edfc2d540b08b25c280b174b69f |
| institution | DOAJ |
| issn | 1943-3883 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Craniomaxillofacial Trauma & Reconstruction |
| spelling | doaj-art-7a241edfc2d540b08b25c280b174b69f2025-08-20T03:11:18ZengMDPI AGCraniomaxillofacial Trauma & Reconstruction1943-38832025-03-011812110.3390/cmtr18010021Airway Management in Complex Maxillofacial Trauma: Evaluating the Role of Submental Intubation as a Viable Alternative to TracheostomyGiulio Cirignaco0Gabriele Monarchi1Lisa Catarzi2Mariagrazia Paglianiti3Enrico Betti4Umberto Committeri5Alberto Bianchi6Paolo Balercia7Giuseppe Consorti8Department of Medicine, Section of Maxillo-Facial Surgery, University of Siena, Viale Bracci, 53100 Siena, ItalyDepartment of Medicine, Section of Maxillo-Facial Surgery, University of Siena, Viale Bracci, 53100 Siena, ItalyDepartment of Medicine, Section of Maxillo-Facial Surgery, University of Siena, Viale Bracci, 53100 Siena, ItalyDepartment of Medicine, Section of Maxillo-Facial Surgery, University of Siena, Viale Bracci, 53100 Siena, ItalyDivision of Maxillofacial Surgery, Department of Neurological Sciences, Marche University Hospitals-Umberto I, 60126 Ancona, ItalyDivision of Maxillofacial Surgery, “Santa Maria” Hospital, V.le Tristano di Joannuccio, 05100 Terni, ItalyDepartment of General Surgery and Medical-Surgical Specialties, University of Catania, 95123 Catania, ItalyDivision of Maxillofacial Surgery, Department of Neurological Sciences, Marche University Hospitals-Umberto I, 60126 Ancona, ItalyDivision of Maxillofacial Surgery, Department of Neurological Sciences, Marche University Hospitals-Umberto I, 60126 Ancona, ItalyAirway management in maxillofacial trauma is a critical and complex challenge, requiring both secure ventilation and optimal surgical access while minimizing risks to vital structures. This study evaluated the efficacy of submental intubation (SMI) as a minimally invasive alternative to tracheostomy in patients with complex maxillofacial fractures. A retrospective analysis of 52 patients treated between 2015 and 2023 was conducted by comparing clinical outcomes between those who underwent SMI (n = 26) and those who underwent tracheostomy (n = 26). The duration of hospitalization, infection rates, and perioperative complications were assessed using t-tests, chi-square tests, and multivariate regression. Results indicated that SMI was associated with significantly shorter hospital stays (11.15 ± 3.29 vs. 23.96 ± 6.47 days, <i>p</i> < 0.001) and lower infection rates (3.8% vs. 30.8%, <i>p</i> = 0.028). Additionally, the SMI group demonstrated fewer intraoperative (<i>p</i> = 0.049) and postoperative complications (<i>p</i> = 0.037). Multivariate analysis identified tracheostomy as an independent predictor of prolonged hospitalization and increased complications. These findings support SMI as a safe and effective alternative to tracheostomy for short-term airway management in maxillofacial trauma, providing a shorter recovery period and fewer complications. Therefore, prospective studies with larger cohorts are warranted to confirm these results and establish comprehensive guidelines.https://www.mdpi.com/1943-3883/18/1/21maxillofacial fracturesubmental intubationtracheostomyairway managementcomplicationshospitalization days |
| spellingShingle | Giulio Cirignaco Gabriele Monarchi Lisa Catarzi Mariagrazia Paglianiti Enrico Betti Umberto Committeri Alberto Bianchi Paolo Balercia Giuseppe Consorti Airway Management in Complex Maxillofacial Trauma: Evaluating the Role of Submental Intubation as a Viable Alternative to Tracheostomy Craniomaxillofacial Trauma & Reconstruction maxillofacial fracture submental intubation tracheostomy airway management complications hospitalization days |
| title | Airway Management in Complex Maxillofacial Trauma: Evaluating the Role of Submental Intubation as a Viable Alternative to Tracheostomy |
| title_full | Airway Management in Complex Maxillofacial Trauma: Evaluating the Role of Submental Intubation as a Viable Alternative to Tracheostomy |
| title_fullStr | Airway Management in Complex Maxillofacial Trauma: Evaluating the Role of Submental Intubation as a Viable Alternative to Tracheostomy |
| title_full_unstemmed | Airway Management in Complex Maxillofacial Trauma: Evaluating the Role of Submental Intubation as a Viable Alternative to Tracheostomy |
| title_short | Airway Management in Complex Maxillofacial Trauma: Evaluating the Role of Submental Intubation as a Viable Alternative to Tracheostomy |
| title_sort | airway management in complex maxillofacial trauma evaluating the role of submental intubation as a viable alternative to tracheostomy |
| topic | maxillofacial fracture submental intubation tracheostomy airway management complications hospitalization days |
| url | https://www.mdpi.com/1943-3883/18/1/21 |
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