PDF(Pubmed)
Abstract：
BACKGROUND: Evaluate the possibility of retromolar intubation for general anesthesia in patients with maxillofacial fractures.
METHODS: The medical records of 54 patients with maxillofacial fractures who visited the Oral and Maxillofacial Surgery Department of Nantong First People\'s Hospital from January 2020 to August 2022 were collected. The retromolar areas of each patient were measured from the coronal CT images, and correlated with the patient\'s age, sex, type of fracture (i.e., maxillary fracture, mandibular fracture, or complex fracture of multiple maxillofacial bones), and the presence of the third molar (verified from 3D CT). The dimensions of the retromolar areas were finally compared with the outer diameter (OD) of standard endotracheal tubes (ETTs), most importantly the size 7.5 ETT (OD 10.3 mm) for male and the size 7.0 ETT (OD 9.8 mm) for female.
RESULTS: The survey included 38 male and 16 female patients, with an average age of 44.1 and 54.3 years, respectively. The dimensions of the retromolar area (height × width) were as follows: male, (9.39 ± 1.77) mm × (12.08 ± 0.98) mm on the left and (9.81 ± 2.23) mm × (11.77 ± 1.08) mm on the right; female, (8.82 ± 1.53) mm × (10.51 ± 1.00) mm on the left and (9.73 ± 1.60) mm × (10.63 ± 1.58) mm on the right. The width was always larger than the OD of the routinely used ETT, but the height could be smaller by less than 1 mm. However, the oral mucosa can be compressed to allow the ETT to fit in the retromolar area.
CONCLUSIONS: The retromolar area provided appropriate space to place a reinforced ETT for patients with maxillofacial fractures needing general anesthesia that must not interfere with intermaxillary ligation. Retromolar intubation can help maxillofacial fracture surgeries that focus on occlusal restoration.
METHODS: The medical records of 54 patients with maxillofacial fractures who visited the Oral and Maxillofacial Surgery Department of Nantong First People\'s Hospital from January 2020 to August 2022 were collected. The retromolar areas of each patient were measured from the coronal CT images, and correlated with the patient\'s age, sex, type of fracture (i.e., maxillary fracture, mandibular fracture, or complex fracture of multiple maxillofacial bones), and the presence of the third molar (verified from 3D CT). The dimensions of the retromolar areas were finally compared with the outer diameter (OD) of standard endotracheal tubes (ETTs), most importantly the size 7.5 ETT (OD 10.3 mm) for male and the size 7.0 ETT (OD 9.8 mm) for female.
RESULTS: The survey included 38 male and 16 female patients, with an average age of 44.1 and 54.3 years, respectively. The dimensions of the retromolar area (height × width) were as follows: male, (9.39 ± 1.77) mm × (12.08 ± 0.98) mm on the left and (9.81 ± 2.23) mm × (11.77 ± 1.08) mm on the right; female, (8.82 ± 1.53) mm × (10.51 ± 1.00) mm on the left and (9.73 ± 1.60) mm × (10.63 ± 1.58) mm on the right. The width was always larger than the OD of the routinely used ETT, but the height could be smaller by less than 1 mm. However, the oral mucosa can be compressed to allow the ETT to fit in the retromolar area.
CONCLUSIONS: The retromolar area provided appropriate space to place a reinforced ETT for patients with maxillofacial fractures needing general anesthesia that must not interfere with intermaxillary ligation. Retromolar intubation can help maxillofacial fracture surgeries that focus on occlusal restoration.
摘要：
背景：评估颌面部骨折患者进行全身麻醉的磨牙后插管的可能性。
方法：收集2020年1月至2022年8月在南通市第一人民医院口腔颌面外科就诊的54例颌面骨折患者的病历资料。从冠状CT图像测量每位患者的磨牙后区域，并与患者的年龄相关，性别,骨折类型(即，上颌骨骨折,下颌骨骨折,或多个颌面骨的复杂骨折)，和第三磨牙的存在（从3DCT验证）。最后将磨牙后区域的尺寸与标准气管内导管（ETT）的外径（OD）进行比较，最重要的是，男性的尺寸为7.5ETT（OD10.3毫米），女性的尺寸为7.0ETT（OD9.8毫米）。
结果：调查包括38名男性和16名女性患者，平均年龄为44.1岁和54.3岁，分别。磨牙后区域的尺寸（高×宽）如下：男性，左侧(9.39±1.77)mm×(12.08±0.98)mm,右侧(9.81±2.23)mm×(11.77±1.08)mm,女性,左侧(8.82±1.53)mm×(10.51±1.00)mm,右侧(9.73±1.60)mm×(10.63±1.58)mm。宽度总是大于常规使用的ETT的OD，但高度可以小于1毫米。然而,可以压缩口腔粘膜以允许ETT适合磨牙后区域。
结论：磨牙后区域为需要全身麻醉的颌面部骨折患者提供了适当的空间来放置增强的ETT，该全身麻醉不得干扰颌间结扎术。磨牙后插管可以帮助以咬合为主的颌面部骨折手术恢复。
方法：收集2020年1月至2022年8月在南通市第一人民医院口腔颌面外科就诊的54例颌面骨折患者的病历资料。从冠状CT图像测量每位患者的磨牙后区域，并与患者的年龄相关，性别,骨折类型(即，上颌骨骨折,下颌骨骨折,或多个颌面骨的复杂骨折)，和第三磨牙的存在（从3DCT验证）。最后将磨牙后区域的尺寸与标准气管内导管（ETT）的外径（OD）进行比较，最重要的是，男性的尺寸为7.5ETT（OD10.3毫米），女性的尺寸为7.0ETT（OD9.8毫米）。
结果：调查包括38名男性和16名女性患者，平均年龄为44.1岁和54.3岁，分别。磨牙后区域的尺寸（高×宽）如下：男性，左侧(9.39±1.77)mm×(12.08±0.98)mm,右侧(9.81±2.23)mm×(11.77±1.08)mm,女性,左侧(8.82±1.53)mm×(10.51±1.00)mm,右侧(9.73±1.60)mm×(10.63±1.58)mm。宽度总是大于常规使用的ETT的OD，但高度可以小于1毫米。然而,可以压缩口腔粘膜以允许ETT适合磨牙后区域。
结论：磨牙后区域为需要全身麻醉的颌面部骨折患者提供了适当的空间来放置增强的ETT，该全身麻醉不得干扰颌间结扎术。磨牙后插管可以帮助以咬合为主的颌面部骨折手术恢复。
