Eur J Plast Surg (2009) 32:57–58 DOI 10.1007/s00238-008-0299-y LETTER TO THE EDITOR Can we choose preoperatively between submental orotracheal intubation and tracheostomy in transfacial cranial base surgery? Puneet Tuli & Ramesh Sharma & Vipul Nanada Received: 13 February 2008 /Accepted: 2 October 2008 / Published online: 5 November 2008 Springer-Verlag 2008 Sir, completion of the operative procedure, the submental The ideal approach to skull base tumors is a perplexing orotracheal tube was changed to an orotracheal tube. None problem and invariably involves a multiteam approach. of the patients was extubated in the operating room and all Many complex approaches such as LeFort I osteotomy with extubations were done in the intensive care unit. In three down fracturing of the hard palate, LeFort I osteotomy with patients, postoperative tracheostomy was done; this deci- splitting of the hard palate (maxillary swing), extended sion was jointly taken by the anesthesia and the operating maxillectomy, median mandibulotomy with glossotomy, team. The indications for tracheostomy in these cases were and the mandibular swing transcervical approach have been persistently poor gag reflex, deteriorating neurological described in the literature . However, the management of status and anticipated complications from long-term the airway in these cases is
European Journal of Plastic Surgery – Springer Journals
Published: Feb 1, 2009
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