{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,26]],"date-time":"2025-06-26T23:28:40Z","timestamp":1750980520143},"reference-count":25,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,7,15]],"date-time":"2024-07-15T00:00:00Z","timestamp":1721001600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,7,15]],"date-time":"2024-07-15T00:00:00Z","timestamp":1721001600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Oral Health"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Evaluate the possibility of retromolar intubation for general anesthesia in patients with maxillofacial fractures.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>The medical records of 54 patients with maxillofacial fractures who visited the Oral and Maxillofacial Surgery Department of Nantong First People\u2019s 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\u2019s 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\u00a0mm) for male and the size 7.0 ETT (OD 9.8\u00a0mm) for female.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>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 \u00d7 width) were as follows: male, (9.39\u2009\u00b1\u20091.77) mm \u00d7 (12.08\u2009\u00b1\u20090.98) mm on the left and (9.81\u2009\u00b1\u20092.23) mm \u00d7 (11.77\u2009\u00b1\u20091.08) mm on the right; female, (8.82\u2009\u00b1\u20091.53) mm \u00d7 (10.51\u2009\u00b1\u20091.00) mm on the left and (9.73\u2009\u00b1\u20091.60) mm \u00d7 (10.63\u2009\u00b1\u20091.58) 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\u00a0mm. However, the oral mucosa can be compressed to allow the ETT to fit in the retromolar area.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>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.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12903-024-04583-1","type":"journal-article","created":{"date-parts":[[2024,7,15]],"date-time":"2024-07-15T13:02:01Z","timestamp":1721048521000},"update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Retromolar intubation for the general anesthesia of maxillofacial fracture patients"],"prefix":"10.1186","volume":"24","author":[{"given":"Xiaorong","family":"Tang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lili","family":"Ding","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yitao","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,7,15]]},"reference":[{"issue":"2","key":"4583_CR1","doi-asserted-by":"publisher","first-page":"193","DOI":"10.1177\/0310057X0002800212","volume":"28","author":"A Chandu","year":"2000","unstructured":"Chandu A, Smith AC, Gebert R. Submental intubation: an alternative to short-term tracheostomy. Anaesth Intensive Care. 2000;28(2):193\u20135.","journal-title":"Anaesth Intensive Care"},{"issue":"7","key":"4583_CR2","first-page":"363","volume":"32","author":"P Bonfils","year":"1983","unstructured":"Bonfils P. [Difficult intubation in Pierre-Robin children, a new method: the retromolar route]. Anaesthesist. 1983;32(7):363\u20137.","journal-title":"Anaesthesist"},{"issue":"3","key":"4583_CR3","doi-asserted-by":"publisher","first-page":"302","DOI":"10.1016\/S0278-2391(98)90103-3","volume":"56","author":"JL Martinez-Lage","year":"1998","unstructured":"Martinez-Lage JL, Eslava JM, Cebrecos AI, Marcos O. Retromolar intubation. J Oral Maxillofac Surg. 1998;56(3):302\u20135.","journal-title":"J Oral Maxillofac Surg"},{"issue":"Suppl 1","key":"4583_CR4","first-page":"E638","volume":"38","author":"AT Truong","year":"2016","unstructured":"Truong AT, Ahmad B, Cata JP, Martin JW, Truong DT, Rahlfs TF. Measurement of retromolar space dimensions using dental pantomograms for intubation feasibility. Head Neck. 2016;38(Suppl 1):E638\u2013642.","journal-title":"Head Neck"},{"issue":"12","key":"4583_CR5","doi-asserted-by":"publisher","first-page":"2455","DOI":"10.1016\/j.joms.2021.06.011","volume":"79","author":"S Sittitavornwong","year":"2021","unstructured":"Sittitavornwong S, Mostofi P, DiLuzio K, Kukreja P, Deatherage H, Kukreja P. Does the Retromolar Area provide adequate space for an oral endotracheal tube without interfering with intermaxillary fixation? J Oral Maxillofac Surg. 2021;79(12):2455\u201361.","journal-title":"J Oral Maxillofac Surg"},{"issue":"10","key":"4583_CR6","doi-asserted-by":"publisher","first-page":"1327","DOI":"10.1001\/jama.1989.03430100061018","volume":"262","author":"WP Zmyslowski","year":"1989","unstructured":"Zmyslowski WP, Maloney PL. Nasotracheal intubation in the presence of facial fractures. JAMA. 1989;262(10):1327\u20138.","journal-title":"JAMA"},{"issue":"6","key":"4583_CR7","doi-asserted-by":"publisher","first-page":"1119","DOI":"10.1097\/00006534-199212000-00038","volume":"90","author":"AA Taher","year":"1992","unstructured":"Taher AA. Nasotracheal intubation in patients with facial fractures. Plast Reconstr Surg. 1992;90(6):1119\u201320.","journal-title":"Plast Reconstr Surg"},{"key":"4583_CR8","first-page":"542","volume":"50","author":"CGJ Durbin","year":"2005","unstructured":"Durbin CGJ. Early complications of tracheostomy. Respir Care. 2005;50:542\u20139.","journal-title":"Respir Care"},{"issue":"4","key":"4583_CR9","first-page":"542","volume":"50","author":"SK Epstein","year":"2005","unstructured":"Epstein SK. Late complications of tracheostomy. Respir Care. 2005;50(4):542\u20139.","journal-title":"Respir Care"},{"issue":"2","key":"4583_CR10","doi-asserted-by":"publisher","first-page":"501","DOI":"10.1007\/s12663-014-0679-8","volume":"14","author":"MR Jaisani","year":"2015","unstructured":"Jaisani MR, Pradhan L, Bhattarai B, Sagtani A. Intubation techniques: preferences of maxillofacial trauma surgeons. J Maxillofac Oral Surg. 2015;14(2):501\u20135.","journal-title":"J Maxillofac Oral Surg"},{"issue":"3","key":"4583_CR11","doi-asserted-by":"publisher","first-page":"310","DOI":"10.1016\/S0278-2391(99)90679-1","volume":"57","author":"AC Bernard","year":"1999","unstructured":"Bernard AC, Kenady DE. Conventional surgical tracheostomy as the preferred method of airway management. J Oral Maxillofac Surg. 1999;57(3):310\u20135.","journal-title":"J Oral Maxillofac Surg"},{"issue":"5","key":"4583_CR12","doi-asserted-by":"publisher","first-page":"315","DOI":"10.1055\/s-2007-1023412","volume":"32","author":"A Hafez","year":"1984","unstructured":"Hafez A, Couraud L, Velly JF, Bruneteau A. Late cataclysmic hemorrhage from the innominate artery after tracheostomy. Thorac Cardiovasc Surg. 1984;32(5):315\u20139.","journal-title":"Thorac Cardiovasc Surg"},{"issue":"1","key":"4583_CR13","doi-asserted-by":"publisher","first-page":"46","DOI":"10.1016\/j.ijom.2011.08.002","volume":"41","author":"JS Jundt","year":"2012","unstructured":"Jundt JS, Cattano D, Hagberg CA, Wilson JW. Submental intubation: a literature review. Int J Oral Maxillofac Surg. 2012;41(1):46\u201354.","journal-title":"Int J Oral Maxillofac Surg"},{"issue":"9","key":"4583_CR14","doi-asserted-by":"publisher","first-page":"1161","DOI":"10.1016\/j.ijom.2018.04.015","volume":"47","author":"D Lim","year":"2018","unstructured":"Lim D, Ma BC, Parumo R, Shanmuhasuntharam P. Thirty years of submental intubation: a review. Int J Oral Maxillofac Surg. 2018;47(9):1161\u20135.","journal-title":"Int J Oral Maxillofac Surg"},{"issue":"5","key":"4583_CR15","doi-asserted-by":"publisher","first-page":"515","DOI":"10.1111\/j.1365-2044.2006.04635.x","volume":"61","author":"N Malhotra","year":"2006","unstructured":"Malhotra N. Retromolar intubation\u2013a simple alternative to submental intubation. Anaesthesia. 2006;61(5):515\u20136.","journal-title":"Anaesthesia"},{"issue":"3","key":"4583_CR16","doi-asserted-by":"publisher","first-page":"423","DOI":"10.1002\/hed.23732","volume":"37","author":"AT Truong","year":"2015","unstructured":"Truong AT, Truong DT. Retromolar flexible fiber-optic orotracheal intubation: a novel alternative to nasal intubation and tracheostomy in severe trismus. Head Neck. 2015;37(3):423\u20134.","journal-title":"Head Neck"},{"issue":"1","key":"4583_CR17","first-page":"61","volume":"24","author":"H Liang","year":"2022","unstructured":"Liang H, Feng Y. Research progress in the selection of endotracheaheal intibation approach and its complication. Chin J Med Guide. 2022;24(1):61\u20137.","journal-title":"Chin J Med Guide"},{"issue":"8","key":"4583_CR18","doi-asserted-by":"publisher","first-page":"798","DOI":"10.23736\/S0375-9393.17.11537-3","volume":"83","author":"C Reiterer","year":"2017","unstructured":"Reiterer C, Waltl B, Kabon B, Schramm W. Retromolar laryngoscopy: a randomized crossover vocal cords visualization study. Minerva Anestesiol. 2017;83(8):798\u2013803.","journal-title":"Minerva Anestesiol"},{"issue":"4","key":"4583_CR19","doi-asserted-by":"publisher","first-page":"855","DOI":"10.1213\/ANE.0b013e318265bae2","volume":"115","author":"SY Thong","year":"2012","unstructured":"Thong SY, Wong TG. Clinical uses of the Bonfils Retromolar Intubation Fiberscope: a review. Anesth Analg. 2012;115(4):855\u201366.","journal-title":"Anesth Analg"},{"issue":"1","key":"4583_CR20","doi-asserted-by":"publisher","first-page":"e239817","DOI":"10.1136\/bcr-2020-239817","volume":"14","author":"BM Togioka","year":"2021","unstructured":"Togioka BM, Pinkert V, Geltzeiler M, Chen EM. Retromolar intubation for severe trismus: a less invasive alternative to tracheostomy and submental intubation. BMJ Case Rep. 2021;14(1):e239817.","journal-title":"BMJ Case Rep"},{"key":"4583_CR21","doi-asserted-by":"publisher","first-page":"212","DOI":"10.1016\/j.ajem.2022.02.008","volume":"54","author":"YY Chen","year":"2022","unstructured":"Chen YY, Lin JC, Tsai MJ, Cheng KY. Retromolar intubation with video intubating stylet in difficult airway: a randomized crossover manikin study. Am J Emerg Med. 2022;54:212\u201320.","journal-title":"Am J Emerg Med"},{"key":"4583_CR22","doi-asserted-by":"publisher","first-page":"817","DOI":"10.1136\/bmj.2.3645.817","volume":"2","author":"IW Magill","year":"1930","unstructured":"Magill IW. Technique in endotracheal anaesthesia. Brit Med J. 1930;2:817\u20139.","journal-title":"Brit Med J"},{"issue":"4","key":"4583_CR23","doi-asserted-by":"publisher","first-page":"375","DOI":"10.1093\/bja\/51.4.375","volume":"51","author":"O Stenqvist","year":"1979","unstructured":"Stenqvist O, Sonander H, Nilsson K. Small endotracheal tubes: ventilator and intratracheal pressures during controlled ventilation. Br J Anaesth. 1979;51(4):375\u201381.","journal-title":"Br J Anaesth"},{"issue":"6","key":"4583_CR24","doi-asserted-by":"publisher","first-page":"829","DOI":"10.1902\/jop.2010.100160","volume":"82","author":"D Ueno","year":"2011","unstructured":"Ueno D, Sato J, Igarashi C, Ikeda S, Morita M, Shimoda S, Udagawa T, Shiozaki K, Kobayashi M, Kobayashi K. Accuracy of oral mucosal thickness measurements using spiral computed tomography. J Periodontol. 2011;82(6):829\u201336.","journal-title":"J Periodontol"},{"issue":"3","key":"4583_CR25","doi-asserted-by":"publisher","first-page":"317","DOI":"10.1016\/0022-3913(82)90162-7","volume":"47","author":"WL Kydd","year":"1982","unstructured":"Kydd WL, Daly CH. The biologic and mechanical effects of stress on oral mucosa. J Prosthet Dent. 1982;47(3):317\u201329.","journal-title":"J Prosthet Dent"}],"container-title":["BMC Oral Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12903-024-04583-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12903-024-04583-1\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12903-024-04583-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,15]],"date-time":"2024-07-15T13:03:33Z","timestamp":1721048613000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcoralhealth.biomedcentral.com\/articles\/10.1186\/s12903-024-04583-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,15]]},"references-count":25,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["4583"],"URL":"https:\/\/doi.org\/10.1186\/s12903-024-04583-1","relation":{},"ISSN":["1472-6831"],"issn-type":[{"value":"1472-6831","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7,15]]},"assertion":[{"value":"17 April 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 July 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 July 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was approved by the ethics committee Nantong First People\u2019s Hospital (2024KT066), and the Helsinki Declaration guidelines were followed. Written informed consent for publication was obtained from all the patients.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Informed written consent was obtained from all the patients for the publication of this manuscript and the accompanying images.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"795"}}