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Flashcards in MaxFax Deck (25)
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1

Define Maxillofacial surgery?

A specialty concerned with diagnosis and surgical correction of diseases affecting the mouth, jaws, face and neck.

2

The 3 major areas Maxfax deals with

Head and neck cancer
Trauma
Facial Deformity

3

Who's involved in treating facial deformity?

A MDT including an orthodontist, maxillofacial technician and a surgeon.

4

How do we investigate and plan facial deformity surgery?

Radiographs
We also make models to plan deformity correction.

We use the rule of 3rd and 5ths (like photography). Split the face into 3rds or 5ths top to bottom and plan reconstructive surgery using the grid to form an aesthetically pleasing/normal face.

5

What kind of cancers does maxfax deal with?

- Oral Malignancy
- Metastatic Skin Cancer
- Maxillary Cancer

6

What histological type of cancer is most oral maligancy?

Mainly Squamous cell Carcinoma

7

Whats survival like for oral malignancy?

Overall 40%
Stage 1 = 90%
Stage 2 = 76%
Stage 3 = 44%
Stage 4 = 20%

8

What are the worrying signs for oral malignancy?

- Redness
- Speckled red/white lesions
(White = Leukoplakia ## Red = Erythroplakia)
- Hardened areas
- Ulceration > 3 wks
- New melanin pigmentation

9

Explain nodal involvement in oral cancer?

Nodal involvement halves 5yr survival
N1 = 1 node <3cm
N2a = 1 node 3-6cm
N2b = 2 nodes same side
N2c = 2 nodes opposite
N3 = Large Lymph Node

10

How do we manage oral canceR?

Surgery:
- Resection & Reconstruction
- Cut out a good margin
- Maintain as much anatomy and function as possible

Radiotherapy
Chemotherapy

Palliation:
- Best supportive Care
- Radiotherapy

11

Where does maxillary cancer tend to spread?

To the infratemporal fossa:
- Thats the space between the pharyngeal wall, mandibular ramus and skull base

12

Whats the aetilogy of facial trauma?

Assault (mostly related to alcohol)
Road Traffic Accidents
Sports
Falls
Industrial accidents

13

How do we assess a facial fracture?

Follow the Advanced Trauma Life Support (ATLS) principles.
- Check the airway
- secure the C-spine
- Check breathing
- Circulation

14

Main subtypes of Facial trauma?

- Soft Tissue
Generally due to penetrating trauma

- Bone Injury

- Combination
Generally a high energy trauma causing a panfacial injury

15

Whats the most common bone injury?

Mandible

16

What are the sections of the mandible?

- Condyle
- Coronoid
- Ramus
- Angle
- Body
- Dentoalveolar Segment
- Symphysis & Parasymphysis

17

What is the presentation of a mandibular injury?

A history of a blow to the lower face

- Pain on biting/swallowing
- Numb Lip
- Tenderness
- Poor occlusion/Teeth dont meet properly
- Haematoma
- Swelling
- Step Deformity
- Gingival laceration

18

What is a step deformity?

Where two normally aligned bones are out of place and dont align, so they appear like steps.

19

How do we investigate and treat a mandibular injury?

- X-ray
- Oral Pantomogram (OPT)

Treat with Osteosynthesis = Implanted plates to reduce and internally fixate the broken bone

20

What is an OPT?

Oral Pantomogram or Panoramic Radiograph.
Its a type of X-ray that shows a 2 dimensional view of a semicircle from ear to ear

21

What kinds of midface fractures are there?

Maxilla
Zygoma
Orbit
Naso-orbito-ethmoidal complex

22

How does a maxilla fracture present?

Panda eyes
Swelling
Open Bite
Sometimes you can get a massive bleed if theres disruption of the maxillary art or its branches

23

How do we classify maxillary fractures?

Le Fort Fractures
1 = across lower maxilla below nose
2 = From lower maxilla in front of zygoma and up over the bridge of the nose
3 = across upper maxilla

24

How does a zygoma fracture present?

Usually after assault
Theres a lot of pain and swelling

It involves the lateral orbit, orbital floor, upper maxilla and the zygomatic arch

25

Whats special about a naso-orbito-ethmoidal fracture?

- They have to be reconstructed very quickly
- You can use a CT scan to diagnose it