Abstract
A 12-year-old girl was referred to our Oral and Maxillofacial Surgery Division because of spontaneous bilateral pain in the temporomandibular joint and difficulties in occlusion and mouth opening caused by a bicycle accident. A panoramic radiograph and facial CT scan showed fracture lines at the mandibular symphysis and both mandibular condylar heads. The patient was admitted immediately, and 8 hours after the accident, complained of dyspnea, and swelling of the floor of the mouth due to acute sublingual hematoma. Emergent intubation was performed under intranasal endoscopic guidance, followed by open reduction and internal fixation under general anesthesia. After surgery, she received intermaxillary fixation and was transferred to the intensive care unit. After 2 days, the endotracheal tube was safely removed. She was discharged in good condition after 10 days of active mouth-opening exercises for rehabilitation of both intracapsular condylar heads in the hospital. When evaluating and treating patients with maxillofacial trauma, we should always be aware of potential airway obstruction and means of securing the airway.
