Semin Plast Surg 2002; 16(3): 295-298
DOI: 10.1055/s-2002-34436
Copyright © 2002 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Simplified Airway Management in Craniomaxillofacial Surgery and Facial Trauma

Joseph S. Gruss1 , Michael J. Wheatley2 , Kathleen Sie3
  • 1Division of Craniofacial, Plastic and Reconstructive Surgery, Children's Hospital and Regional Medical Center, Seattle, WA
  • 2Portland Veteran's Administration, Portland, OR
  • 3Department of Otolaryngology, Children's Hospital & Regional Medical Center and University of Washington School of Medicine, Seattle, WA
Further Information

Publication History

Publication Date:
01 October 2002 (online)


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.