Discover and read the best of Twitter Threads about #sublabeal
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Case study as #MorningPaper to start off the week. 27y cyclist vs car, GCS 15, CSF rhinorrhoea. CT attached. What are the steps of your management plan? What kind of injuries are you seeing? 
My decision here: Lumbar drain initially for yeh CSF leak, Pneumovax but not antibiotics. Lefort III fracture and mandibular needs surgery so planned to cranialise frontal sinus at the same setting. Consent included fascia lata and calvarial grafts, just in case. 1/🧵
2/ #Submental intubation to gain better oral access: cut down onto inferior border of mandible, blunt dissection with artery clip through floor of mouth, dilators and then deliver ETT submetally and reconnect.
