Management of detachment of pilot balloon during intraoral repositioning of the submental endotracheal tube

Submental endotracheal intubation for surgery was used as an alternative to nasotracheal intubation in patients with craniomaxillofacial injury. Generally extubation was performed in the operation room by pulling the tube through the submental incision site. When extubation is not indicated, intraoral indwelling is preferred to submental intubation. We report a case of a 35-year-old male patient with multiple facial bone fractures. At the end of the surgery, we noticed the oropharyngeal edema, and so the submental intubation was converted into a standard orotracheal intubation. During that procedure, the pilot balloon was accidentally detached from the endotracheal tube. The situation was managed by cutting a pilot tube from a new, unused endotracheal tube and connecting it to the intubated tube using a needle connector.