{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T06:29:50Z","timestamp":1792477790806,"version":"4.5.0"},"reference-count":58,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2024,11,30]],"date-time":"2024-11-30T00:00:00Z","timestamp":1732924800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Panfacial fractures are complex fractures involving multiple regions of the facial skeleton and may require multiple surgeries over a relatively short period. They are often associated with polytrauma and other injuries including neurotrauma, which require either immediate (ATLS) airway management, prolonged intubation, or repeated intubations for staged surgeries. The choice of airway for the surgical management of these fractures is difficult, as an assessment of the occlusion is required, and the central nasal complex and\/or skull base may be involved, making classical orotracheal or nasotracheal intubation problematic. Submental intubation is increasingly reported as a method of airway management with the aim of avoiding a tracheostomy and its related complications. A review of the different techniques of airway management in the elective treatment of panfacial fractures was performed, focusing on the pros and cons of each method. Most articles were retrospective studies, with only one prospective study comparing submental intubation to tracheostomy in panfacial fractures. An algorithm for the management of the airway in panfacial fractures was presented, based on a sequential assessment of the existing airway, the surgical access required, and the need for prolonged or repeated intubation. Front of neck access, orotracheal and nasotracheal intubation, and submental intubation are all appropriate techniques in different circumstances, and the advantages and disadvantages of each are presented.<\/jats:p>","DOI":"10.3390\/jcm13237294","type":"journal-article","created":{"date-parts":[[2024,12,3]],"date-time":"2024-12-03T11:48:56Z","timestamp":1733226536000},"page":"7294","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Controversies in the Management of the Airway in Panfacial Fractures: A Literature Review and Algorithm Proposal"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7213-0862","authenticated-orcid":false,"given":"Antonio","family":"Mar\u00ed-Roig","sequence":"first","affiliation":[{"name":"Department Oral and Maxillofacial Surgery, Hospital Universitari Bellvitge, 08907 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5795-6482","authenticated-orcid":false,"given":"Niall M. H.","family":"McLeod","sequence":"additional","affiliation":[{"name":"Department Oral and Maxillofacial Surgery, University Hospitals Coventry and Warwickshire, Coventry CV2 2DX, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"De Lange","sequence":"additional","affiliation":[{"name":"Department Oral and Maxillofacial Surgery, Amsterdam UMC, 1012 WX Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leander","family":"Dubois","sequence":"additional","affiliation":[{"name":"Department Oral and Maxillofacial Surgery, Amsterdam UMC, 1012 WX Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4257-0701","authenticated-orcid":false,"given":"Maria Fe","family":"Garc\u00eda Reija","sequence":"additional","affiliation":[{"name":"Department Oral and Maxillofacial Surgery, Hospital Universitario Marqu\u00e9s de Valdecilla, 39008 Santander, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5642-8194","authenticated-orcid":false,"given":"Bauke","family":"Van Minnen","sequence":"additional","affiliation":[{"name":"Department Oral and Maxillofacial Surgery, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1307-0599","authenticated-orcid":false,"given":"Harald","family":"Essig","sequence":"additional","affiliation":[{"name":"Department Oral and Maxillofacial Surgery, University Hospital Z\u00fcrich, 8032 Z\u00fcrich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,11,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1055\/s-0041-1735813","article-title":"Management of Panfacial Trauma: Sequencing and Pitfalls","volume":"35","author":"Massenburg","year":"2021","journal-title":"Semin. 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