scholarly journals TRIGEMINO CARDIAC REFLEX IN ORAL & MAXILLOFACIAL SURGERY – A REVIEW

2021 ◽  
pp. 1-2
Author(s):  
Venu Sameera Panthagada ◽  
Ravi Raja Kumar Saripalli ◽  
Manoj Kumar Kanta
Keyword(s):  
Trigeminal Nerve ◽  
Preventive Measures ◽  
Pressure Effect ◽  
Maxillofacial Surgery ◽  
Strabismus Surgery ◽  
Effective Management ◽  
Le Fort ◽  
Le Fort I ◽  
Maxillary Tuberosity

Trigemino cardiac reflex (TCR) which was originally called as OCCULOCARDIAC REFLEX is a physiological response due to the pressure effect on the largest cranial nerve, the trigeminal nerve. Oral and maxillofacial procedures can induce the development of this reflex. TCR is a triad of bradycardia , bradypnea and gastric motility changes due to the efferent activation of the vagal nerve in response to the pressure distribution in Trigeminal nerve. TCR may be generated as a result of procedures or conditions that increase intraocular pressure, strabismus surgery, nasal packing after rhinoplasty, the reduction of zygoma and zygomatic arch fractures, elevation of bone flap or osteotomies, reflection of a palatal flap for removal of a mesiodens, during Le Fort I downfractures, sagittal split ramus retraction, midface disimpaction, cutting maxillary tuberosity, and temporomandibular joint arthroscopy. The purpose of this paper is to discuss the pathophysiology and to review the main risk factors , treatment, prevention and management with emphasis on the role of maxillofacial surgeons and attending anesthetist. Maxillofacial surgeons should be familiar with presentations, preventive measures for the effective management of this complication.

scholarly journals An atypical case of trigeminal trophic syndrome: A legal medicine perspective in medical responsibility

2017 ◽  
Vol 5 ◽  
pp. 2050313X1772354
Author(s):  
Alessandro di Luca ◽  
Massimo Ralli ◽  
Sara Hemied ◽  
Marco de Vincentiis ◽  
Natale Mario di Luca
Keyword(s):  
Trigeminal Nerve ◽  
Rare Complication ◽  
Maxillofacial Surgery ◽  
Previous History ◽  
Class Iii ◽  
Le Fort I Osteotomy ◽  
Le Fort ◽  
Medical Responsibility ◽  
Trigeminal Trophic Syndrome ◽  
Le Fort I

Background: Trigeminal trophic syndrome is a rare complication of peripheral or central damage to the trigeminal nerve characterized by anesthesia, paresthesia and a secondary persistent facial ulceration. Methods: We describe the case of a 40-year-old woman with previous history of Le Fort I osteotomy for a class III malocclusion who developed trigeminal trophic syndrome. Atypically, the cutaneous symptoms appeared bilaterally and 8 years after surgery. Results: Differential diagnosis was based on clinical history, tissue biopsy and serologic evaluation. Atypical findings could be linked to the surgical burdens of Le Fort I osteotomy, a procedure characterized by a bilateral incision on the maxillofacial bones with a reasonable probability of causing a bilateral injury of the peripheral branches of the trigeminal nerve. Conclusion: Although the long delay between trigeminal trophic syndrome onset and surgery and the absence of adequate medical evidence cannot confirm a link with previous surgery in this case, the increasing number of maxillofacial surgery cases suggests that this complication may be more frequent in the next decades, and thus, involved specialists should be aware of this condition as a possible complication of maxillofacial surgery procedures.

scholarly journals The Role of the Le Fort I Maxillotomy in the Management of Incompletely Resected Pituitary Macroadenomas

Skull Base ◽  
2007 ◽  
Vol 17 (6) ◽  
pp. 369-378 ◽  
Author(s):  
Bruce Mickey ◽  
Leslie Hutchins ◽  
Edward Ellis
Keyword(s):  
Le Fort ◽  
Le Fort I ◽  
Pituitary Macroadenomas

scholarly journals Le Fort I osteotomy facilitated nasotracheal intubation in a patient with concha bullosa and septal deviation: a case report

2021 ◽  
Keyword(s):  
Case Report ◽  
Nasal Cavity ◽  
Orthognathic Surgery ◽  
Nasotracheal Intubation ◽  
Maxillofacial Surgery ◽  
Septal Deviation ◽  
Concha Bullosa ◽  
Le Fort I Osteotomy ◽  
Le Fort ◽  
Le Fort I

Introduction: Nasotracheal intubation (NTI) is preferred for general anesthesia in maxillofacial surgery. However, NTI is often traumatic or even unsuccessful, particularly in patients with a narrow nasal pathway. In this case report, we describe a less traumatic NTI approach using maxillary downfracture of Le Fort I osteotomy. Case presentation: A 19-year-old woman was admitted with a skeletal Class III malocclusion and scheduled to undergo bimaxillary orthognathic surgery. A preoperative evaluation revealed no other medical history and abnormal laboratory findings. Preoperative computed tomography showed nasal septal deviation, concha bullosa, and turbinate hypertrophy. A nasal Ring-Adair-Elwyn endotracheal tube and a tube exchanger could not be inserted via NTI because of her narrow nasal cavity. An oral intubation was performed temporarily and surgery was started. After a maxillary downfracture was performed, which made the nasal cavity wider than before, NTI was successfully conducted without difficulty. The patient was ventilated without any problems, and the operation was continued. Postoperatively, the patient had no further complications and her vital parameters were all stable. Conclusions: This case report suggests that NTI after maxillary downfracture of Le Fort I osteotomy can be a good alternative that can be successfully performed with less trauma in patients undergoing orthognathic surgery who are preoperatively evaluated as having a narrow nasal cavity.

Severe late-onset epistaxis following le Fort I osteotomy: angiographic localization and embolization

1988 ◽  
Vol 102 (3) ◽  
pp. 260-263 ◽  
Author(s):  
Neil B. Solomons ◽  
Ray Blumgart
Keyword(s):  
Late Onset ◽  
Maxillofacial Surgery ◽  
Severe Trauma ◽  
Maxillofacial Trauma ◽  
Maxillary Artery ◽  
Internal Maxillary Artery ◽  
Le Fort I Osteotomy ◽  
Artery Ligation ◽  
Le Fort ◽  
Le Fort I

AbstractEpistaxis following maxillofacial trauma or maxillofacial surgery is uncommon. It usually occurs within 24 hours of the injury and can usually be controlled by packing. Rarely internal maxillary artery ligation is necessary and embolization has been used in some cases of severe trauma.We present a case of severe late-onset epistaxis following Le Fort I osteotomy. The diagnostic approach and treatment are discussed.

scholarly journals Asystole during Le Fort 1 osteotomy: the trigeminovagal reflex

2020 ◽  
Vol 102 (9) ◽  
pp. e1-e3
Author(s):  
K Maharaj ◽  
R Cedrola ◽  
T Mirza
Keyword(s):  
Trigeminal Nerve ◽  
Maxillofacial Surgery ◽  
Le Fort ◽  
Oculocardiac Reflex ◽  
Reflex Arc ◽  
Stimulation Of

The trigeminovagal reflex is a phenomenon that occurs rarely during maxillofacial surgery. Previously described as the oculocardiac reflex, this reflex can occur during ocular and periocular surgery. To be more anatomically precise, it was renamed the trigeminocardiac or trigeminovagal reflex, since stimulation of any part of the trigeminal nerve can elicit this reflex arc. We describe a case of asystole during mobilization of a maxilla following a Le Fort 1 osteotomy.

A Pilot Study Assessing the Incidence of Chronic Sinusitis Following Le Fort I Osteotomy in Maxillofacial Surgery

2019 ◽  
Vol 30 (6) ◽  
pp. 1845-1849
Author(s):  
Michael J. Eliason ◽  
Gregory Capra ◽  
Austin LaBanc ◽  
Jeanelle Braxton ◽  
Erin Hamersley ◽  
...  
Keyword(s):  
Pilot Study ◽  
Chronic Sinusitis ◽  
Maxillofacial Surgery ◽  
Le Fort I Osteotomy ◽  
Le Fort ◽  
Le Fort I

scholarly journals Modified Le Fort I Osteotomy and Genioplasty for Management of Severe Dentofacial Deformity in β-Thalassaemia Major: Case report and review of the literature

2020 ◽  
Vol 20 (3) ◽  
pp. 362
Author(s):  
Khamis M. Al Hasani ◽  
Abdulaziz A. Bakathir ◽  
Ahmed K. Al-Hashmi ◽  
Badar Al Rawahi ◽  
Abdullah Albakri
Keyword(s):  
Case Report ◽  
Maxillofacial Surgery ◽  
Severe Anaemia ◽  
University Hospital ◽  
Thalassaemia Major ◽  
Le Fort I Osteotomy ◽  
Skeletal Deformity ◽  
Le Fort ◽  
Dentofacial Deformities ◽  
Le Fort I

β-thalassaemia major is an autosomal recessive form of haemoglobinopathy that is characterised by complete lack of production of the β-chains resulting in multiple complications that include severe anaemia, failure to thrive and skeletal abnormalities. Facial deformities induced by β-thalassaemia major are rare and are very challenging to treat from a surgical point of view. We report a 33-year-old female patient with β-thalassaemia major who presented to the Dental & Maxillofacial Surgery Department, Sultan Qaboos University Hospital, Muscat, Oman, in 2017 with gross dentofacial skeletal deformity contributing to her psychosocial issues. The facial deformity was corrected surgically by excision of the enlarged maxilla, modified Le Fort I osteotomy and advancement genioplasty. This case highlights the pre-operative preparation, surgical management, encountered complications and treatment outcome within 24 months of follow-up.Keywords: Beta-Thalassaemia; Thalassaemia Major; Cooley's Anemia; Le Fort Osteotomy; Genioplasty; Dentofacial Deformities; Case Report; Oman.

The removal of midface tumors by Le Fort I approach

2019 ◽  
Vol 69 (3) ◽  
Author(s):  
Matteo Brucoli ◽  
Paolo Boffano ◽  
Nicola Baragiotta ◽  
Matteo Nicolotti ◽  
Andrea Pezzana ◽  
...  
Keyword(s):  
Le Fort ◽  
Le Fort I
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