Abstract
Sub-mental intubation is used as an alternative technique for managing airway in cases of panfacial trauma to avoid tracheostomy and make surgical procedures easier. A 33 year male patient with multiple facial fractures was taken for surgery by sub-mental intubation. A modified extubation technique was used, making the procedure the same and easy. In the original Hernandez Altemir technique, extubation is performed by removing the endotracheal tube system with the cuff inflating line and pilot balloon intra-orally. We in the modified extubation procedure did not reverse the pilot balloon and cuff inflating line through the tunnel; we deflated the tracheal balloon first and then cut the cuff inflating line externally, making extubation very easy and safe preventing any damage to the inflating line.