Transmylohyoid Orotracheal Intubation in Surgical Management of Canine Maxillofacial Fractures: An Alternative to Pharyngotomy Endotracheal Intubation

Abstract

Objective: To describe the surgical technique of transmylohyoid orotracheal intubation in surgical management of maxillofacial fractures in dogs. Study Design: Case series. Animals: Dogs (n=4) with maxillofacial fractures. Methods: Transmylohyoid orotracheal intubation was used for airway management of dogs undergoing surgical repair of maxillofacial trauma. A stoma was surgically created by an incision through the skin, subcutaneous tissue, and mylohyoideus muscle immediately medial to the lingual cortex of the mandible at the level of the mandibular 1st molar tooth, so that an endotracheal tube could exit the oral cavity between the mandibular bodies bypassing the dentition. Results: Transmylohyoid orotracheal intubation allowed excellent surgical visibility of the oral cavity and intraoperative control of occlusion during surgery. No complications were encountered during the procedure and the stoma healed without complication. Conclusions: Transmylohyoid orotracheal intubation is a safe, simple, and effective technique for bypassing the rostral oral cavity and dentition during surgical management of maxillofacial fractures.