Safe airway management is essential in pediatric craniofacial surgery. In the presence
of deciduous teeth, securing the airway for midface surgery can be difficult. We have
successfully used oral intubation with an armored tube secured by circummandibular
wires to safely manage the airway in over 1200 craniofacial patients without any airway
complications. With this technique, the airway is reliably secured and the possibility
of intraoperative tube transection is lessened. Positioning the tube behind the maxillary
tuberosity allows the application of intermaxillary fixation without the need for
an intraoperative conversion to a nasotracheal tube. Circummandibular wiring of an
armored oral endotracheal tube is a safe and effective method of managing the airway
in children undergoing midface surgery.
Craniofacial surgery - anesthesia - intubation - airway