Submental intubation for cancrum oris: a case report

Summary Cancrum oris (Noma) is a devastating gangrenous disease that leads to severe tissue destruction in the face. We describe the anesthetic management of a 12‐year‐old girl with cancrum oris sequelae in a Rural Secondary level Hospital in Central India (Padhar Hospital). She presented with a lar...

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Bibliographic Details
Published in:Pediatric anesthesia 2005-11, Vol.15 (11), p.1009-1012
Main Authors: EIPE, NAVEEN, NEUHOEFER, EVA‐SABINE, ROSEE, GABRIELE LA, CHOUDHRIE, RAJIV, SAMMAN, NABIL, KREUSCH, THOMAS
Format: Article
Language:English
Subjects:
airway
Anesthesia
Anesthesia - methods
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Biological and medical sciences
Child
disease: cancrum oris sequelae
Female
Humans
India
Intubation, Intratracheal - methods
Medical sciences
Noma - surgery
Reconstructive Surgical Procedures - methods
submental route
tracheal intubation
Treatment Outcome
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Summary:Summary Cancrum oris (Noma) is a devastating gangrenous disease that leads to severe tissue destruction in the face. We describe the anesthetic management of a 12‐year‐old girl with cancrum oris sequelae in a Rural Secondary level Hospital in Central India (Padhar Hospital). She presented with a large defect in her upper lip on the left side that extended into the columella and the floor of the left nostril. She was scheduled to undergo reconstructive surgery and the surgeons planned to use an Abbé flap based on the lower lip. For this, access to both the mouth and the nose was required. We considered a tracheostomy but decided to attempt the submental route for orotracheal intubation. Following intravenous induction the patient's trachea was intubated with a cuffed oral tracheal tube. This was passed through the submental incision and then reconnected. The surgery proceeded uneventfully and the patient was extubated before transfer. She made a satisfactory recovery and the submental scar healed without complication or scarring. We describe briefly the features of cancrum oris and review the technique of submental intubation (described in adults with midfacial trauma). The use of submental intubation in children and for cancrum oris sequelae has not been previously reported.
ISSN:1155-5645
1460-9592
DOI:10.1111/j.1460-9592.2005.01573.x