Maxillofacial surgery

Author(s):  
David A. Mitchell ◽  
Laura Mitchell ◽  
Lorna McCaul

Contents. Advanced trauma life support (ATLS). Primary management of maxillofacial trauma. Assessing head injury. Mandibular fractures. Mid-face fractures. Nasal and malar fractures. Treatment of facial fractures. Facial soft-tissue injuries. Surgery and the temporomandibular joint. Major preprosthetic surgery. Clefts and craniofacial anomalies. Orthognathic surgery. Salivary gland tumours. Surgery of the salivary glands. Facial skin cancer. Oral cancer. Neck lumps. Flaps and grafts. Aesthetic facial surgery.

Oral and maxillofacial surgery is largely a post-graduate subject. This chapter begins with a section on advanced trauma life support and goes on to include details of the diagnosis and management of facial trauma, orthognathic surgery, as well as head and neck surgery and reconstruction. Only basic aspects of this specialty have been included here as advanced techniques are beyond the scope of this chapter. However, this chapter provides enough information so as to ensure success for final year dental students but it can also be of use to those working in oral and maxillofacial units.


Author(s):  
Luke Cascarini ◽  
Clare Schilling ◽  
Ben Gurney ◽  
Peter Brennan

This chapter discusses oral and maxillofacial surgery in the A&E department, including, The paediatric OMFS patient, Overview of maxillofacial trauma, Mandibular fractures, Zygomatic fractures, Orbital floor fractures, Maxillary fractures, Nose, naso-ethmoidal, and frontal bone fractures, Face and scalp soft tissue injuries, Penetrating injuries to the neck, Intra-oral injuries, Dento-alveolar trauma, Dento-alveolar infections, Post-extraction complications, Head and neck soft tissue infections, Salivary gland diseases, and Miscellaneous conditions


Author(s):  
Jose E. Barrera

AbstractProjectile injuries to the face deserve particular attention to evaluate for involvement of critical structures and functional elements and treat the devastating effects on facial aesthetics. Ballistic trauma to the maxillofacial region often has significant soft tissue and bony defects, creating a greater challenge to the reconstructive surgeon. The main goals of treatment of projectile injuries to the face are decreasing the amount of contaminants and nonviable tissue at the site, ensuring functionality, and restoring aesthetic appearance. There exists a lack of robust research on the subject. Soft tissue injuries from high-velocity projectiles have changed the perspective on treating acute injuries to the face and neck. Injuries encountered during both Operation Iraqi Freedom and Operation Enduring Freedom give the author pause to reflect upon a different wounding pattern than that encountered in stateside trauma centers. Given the dissemination of high-velocity weaponry by enemy combatants such as the improvised explosive device, mortar round, and high-velocity rifles, a higher incidence of facial wounds has been reported. The mechanism of injury and a stepwise approach for surgical repair are discussed incorporating advanced trauma life support principles and a reconstructive ladder of repair.


POCUS Journal ◽  
2016 ◽  
Vol 1 (3) ◽  
pp. 13-14
Author(s):  
Stuart Douglas, PGY4 ◽  
Joseph Newbigging, MD ◽  
David Robertson, MD

FAST Background: Focused Assessment with Sonography for Trauma (FAST) is an integral adjunct to primary survey in trauma patients (1-4) and is incorporated into Advanced Trauma Life Support (ATLS) algorithms (4). A collection of four discrete ultrasound probe examinations (pericardial sac, hepatorenal fossa (Morison’s pouch), splenorenal fossa, and pelvis/pouch of Douglas), it has been shown to be highly sensitive for detection of as little as 100cm3 of intraabdominal fluid (4,5), with a sensitivity quoted between 60-98%, specificity of 84-98%, and negative predictive value of 97-99% (3).


2010 ◽  
Vol 113 (7) ◽  
pp. 561-567 ◽  
Author(s):  
M. Münzberg ◽  
L. Mahlke ◽  
B. Bouillon ◽  
T. Paffrath ◽  
G. Matthes ◽  
...  

Author(s):  
Oneida A. Arosarena ◽  
Issam N. Eid

AbstractSoft tissue trauma to the face is challenging to manage due to functional and aesthetic concerns. Management requires careful regional considerations to maintain function such as visual fields and oral competence in periorbital and perioral injuries, respectively. Basic wound management principles apply to facial soft tissue injuries including copious irrigation and tension-free closure. There is no consensus and high-level evidence for antibiotic prophylaxis especially in various bite injuries. Ballistic injuries and other mechanisms are briefly reviewed. Scar revision for soft tissue injuries can require multiple procedures and interventions. Surgery as well as office procedures such as resurfacing with lasers can be employed and will be reviewed.


PEDIATRICS ◽  
1989 ◽  
Vol 84 (2) ◽  
pp. 336-342
Author(s):  
Marilyn Li ◽  
M. Douglas Baker ◽  
Leland J. Ropp

Questionnaires were sent to 245 North American institutions with pediatric residency programs. There was a 69% response rate. Pediatric emergency care is provided in three types of facilities: emergency departments in pediatric hospitals, separate pediatric emergency departments or combined pediatric and adult emergency departments, in multidisciplinary hospitals. There are at least 262 pediatricians practicing full-time pediatric emergency medicine. The majority work in pediatric emergency departments, an average of 30.7 clinical hours per week. There are 27 pediatric emergency medicine programs with 46 fellows in training and 117 full-time positions available for emergency pediatricians throughout North America. Varying qualifications for these positions include board eligibility in pediatrics, certification in Basic Life Support or Advanced Trauma Life Support, and a fellowship in pediatric emergency medicine. The demonstrated need for pediatricians, preferably trained in emergency care, clearly indicates that pediatric emergency medicine is a rapidly developing subspecialty of Pediatrics that will be an attractive career choice for future pediatricians.


2021 ◽  
Vol 15 (8) ◽  
pp. 1920-1922
Author(s):  
Nabeela Riaz ◽  
Samreen Younas ◽  
Ijaz Ur Rehman ◽  
Ahmad Abdul Haseeb ◽  
Saba Hanif ◽  
...  

Aim: to explore the mandibular bone fractures in elderly patients with reference to etiology of trauma. Methodology: This was a descriptive study conducted in the department of Oral and Maxillofacial Surgery KEMU/ Mayo Hospital Lahore. Elderly patients (age 60-100years) with mandibular bone fractures. Results: Aetiology of trauma leading to mandibular fractures was as follows; there were 79(65.83%) cases of RTA, 32(26.66%) falls, 4(3.33%) assaults and there were only 3(2.5%) cases of industrial injury. Conclusion: To conclude, this study depicts that road traffic accidents were the predominant cause of injury in the studied age group. Elderly patients need more care and attention, especially after traumatic incidents and lead to financial burden in hospitals Keywords: Maxillofacial trauma, Elderly population, Mandibular injuries, Elderly fractures


2015 ◽  
Author(s):  
David H. Wisner ◽  
Joseph M. Galante

Injuries to the neck can be the result of blunt and penetrating trauma. Both mechanisms can cause devastating injuries, with high associated rates of morbidity and mortality. Airway management in trauma does not differ based on the mechanism of injury, and so the initial priority is to ensure an adequate airway through cricothyrotomy or tracheotomy. For penetrating neck trauma, initial management is evaluated in accordance with Advanced Trauma Life Support (ATLS) guidelines. Thereafter, the management of penetrating trauma of the stable patients is provided and includes carotid artery exploration and repair, vertebral artery exploration and repair, endovascular repair, jugular vein injuries, treatment of the pharynx and esophagus, and treatment of the larynx and trachea. Blunt trauma is described and includes injuries to the aerodigestive tract and cerebrovascular and vertebral injuries. Figures show an algorithm outlining operative management of known or suspected injuries to the carotid arteries, jugular vein, pharynx, and esophagus; the three separate zones of the neck; common incisions made along the sternocleidomastoid muscle; important anatomical structures of the neck; and an algorithm outlining management of known injuries to the vertebral artery. This chapter contains 31 references.


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