Maxillofacial Surgery - Facial Fractures Flashcards Preview

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Flashcards in Maxillofacial Surgery - Facial Fractures Deck (25)
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1

What is the name for not being able to open your mouth?

Trismus

2

Give some examples of maxillofacial surgery

Dentoalveolar (wisdom teeth)
Cleft lip and palate
Facial deformity
Craniofacial surgery
head and neck oncology

3

What is the aim of treatment in maxillofacial surgery?

Restore facial aesthetics and function

4

What is an osteotomy?

Cutting of bone during surgery

5

What is the aetiology of facial fractures?

Assault = 70-80%
RTA
Sports
Industrial
Falls

6

What are some of the signs and symptoms of a facial fracture?

Pain
Swelling
Loss of function
Steps (in bone)
Crepitus

7

Why is anatomy important in symptoms of facial fracture?

Nerve damage
Associated structures
Eyes
Nose
Mouth

8

How are facial fractures classified?

Simple (closed)/ Compound (open)

Displaced/undisplaced

ANATOMICAL

9

How are facial fractures classified anatomically?

Lower third:
-Mandible

Middle Third:
-Contral (maxilla/naso-orbito-ethmoidal complex)
-Lateral (zygomatic-orbital complex)

Upper Third:
-Frontal sinus

Panfacial
-Everything is fucked

10

How do you asses facial fractures?

ATLS (Advanced treatment life support) principles are paramount

Airway? (?C Spine injury)
Breathing?
Circulation?

11

Briefly discuss c-spine injuries in relation to facial fractures

Always bear in mind the possibility

Mechanism of injury important

As high as 3% of cases

12

Briefly discuss head injury in relation to facial face

Always bear in mind the possibility

?Loss of conciousness
?Amnesia - reterograde/anteroretrograde
?Irrational/aggressive
?Alcohol ?Drugs

GCS?

13

What are the common bones of the face to fracture?

Mandible
Zygoma
Nasal
Maxilla

14

Describe mandible fractures

Alcohol in 80%

Assaults more common

RTA more common in S England

Dentition/Occlusion is the key

15

What are the signs and symptoms of a mandible fracture?

Paraesthesia
-Mental nerve distribution

Occlusion problems
The bite is not right

Bilateral fracture in obtunded patient
AIRWAY RISK

16

What do we mean by an obtunded patient?

State similar to lethargy

Less interest in environment
Slow responses to stimulation

17

What are the treatment options for mandibular fractures?

Conservative (Non-Surgical)
Conservative (Surgical)
Surgical

Plates placed at tension zones

18

Describe central middle third facial fractures

High velocity/force
Variable
Complex

19

Describe middle third fractures

Central or lateral

Usually blunt force
Middle - high velocity
Variable
may be complex

Maybe cranial and ocular involvement

20

How do middle third facial fractures present?

Classical facial appearance

CSF leak?
AIRWAY
BLEEDING

Nerve anaesthesia?
Midline split
Anterior open bite (AOB)

21

What is the treatment for middle third fractures?

Conservative treatment possible but usually surgery required.

External fixation rarely used (still useful in some cases)

Nasal reconstruction often required

Primary bone grafting

22

Describe lateral middle third fractures

Zygomatic
May involve orbit/eye
Assault/Sport/Falls/RTA
May go unnoticed

23

What are the treatments for lateral middle third facial fractures?

Conservative (non-surgical)
Conservative (surgical)
Surgical (ORIF)

24

Describe upper third fractures

Often as part of panfacial injury

These are usually compound skull fractures

Associated CNS injury?
Base of skull?
CSF leak?

25

What might be affected in upper third facial fractures?

Frontal sinus injuries
Sense of smell
Orbital roof injuries