Maxillofacial Trauma

Question 1

Pan facial trauma

Answer 1

2+ 3rds of face effected

Question 2

Low energy facial trauma

Answer 2

Often 1 region of face
Soft tissue not confused or torn
Predictable injury patterns
Low condyle fractures

Question 3

High injury facial trauma

Answer 3

Unpredictable injury pattern
Multiple anatomical regions
Median wall of orbit, intracapsular fractures
Often gross soft tissue disruption/loss/infection

Question 4

Management of gross soft tissue disruption, loss, or infection

Answer 4

Debridement and clean

Question 5

Ectropion

Answer 5

Eyelid scarred in an outward turned position, folded away from the eye

Question 6

Entropion

Answer 6

Eyelid scarred in an inward turned position, folded towards the eye causing eyelashes to rub against the eyeball

Question 7

Hypoglobus

Answer 7

Inferior displacement of eyeball within orbit

Question 8

Enopthalmos

Answer 8

Posterior displacement of eyeball within orbit,
Eye appears ‘sunk back’ into orbit

Question 9

What are the 3 aspects of ATLS conducted in the golden hour of maxfax surgery

Answer 9

Stabilisation
Life saving tx - haemorrhage controls airway, aspiration
Sight saving tx - lateral canthotomy

Question 10

What injuries are commonly associated with maxfax injuries

Answer 10

C spine injuries (15%)
Head injury (5%)

Question 11

Purpose of submandibular intubation

Answer 11

Allows oral cavity to be left empty for surgery
Not an emergency procedure - requires normal intubation to be conducted first

Question 12

Hot orbit

Answer 12

Collection or air, blood, or pus within the orbit

Question 13

Hot orbit management

Answer 13

Lateral canthotomy
Steroids
Mannitol
Acetazolamide

Question 14

What is usually the first visual change as a result of a hot orbit

Answer 14

Change to colour vision

Question 15

Telecanthus

Answer 15

Increased distance between eyes

Question 16

Hypertelorism

Answer 16

Increased distance between eyes

Question 17

Trapdoor fracture

Answer 17

type of orbital blowout fracture where the bone snaps back to its original position, trapping orbital contents, especially the extraocular muscles

Question 18

What loss of ocular movement is often caused by a trapdoor fracture and why

Answer 18

Inability to look up due to trapping of fat surrounding inferior rectus

Question 19

Oculo(brady)cardia reflex

Answer 19

bradycardia when pressure is applied to the eyeball or its surrounding structures mediated by CNV and X
Indicated pressure to short ciliary nerves at back of orbit

Question 20

Trapdoor fracture mx

Answer 20

Open eye socket and open trapdoor to release fat or
Remove trapdoor and replace with membrane

Question 21

EUA

Answer 21

Examination under anaesthesia

Question 22

Benefits of soft tissue coverage

Answer 22

Prevents contracture and necrosis

Question 23

Maxfax injury management principles

Answer 23

Restore form and function
Precise hard tissue repair
Precide soft tissue red rape
Cranial cavity sealed from upper digestive tract
Orbital volume restored
Nasal form restored with nasal airway intact
Correct jaw relationship
Fix teeth
Reduced fractures
Excise necrotic tissue

Question 24

What skull structures are used to guide fixation

Answer 24

Vertical and transverse buttresses

Question 25

Vertical buttresses

Answer 25

Lateral maxillary Medial maxillary Posterior maxillary Posterior vertical

Question 26

Transverse buttresses

Answer 26

Upper transverse maxillary Lower transverse maxillary Upper transverse mandibular Lower transverse mandibular

Question 27

Skull buttresses

Answer 27

thickened areas of bone within the skull that provide structural support and protection for the face and brain

Question 28

What happens if blood supply to a fat pad is disrupted

Answer 28

Fat pad degenerates

Question 29

SMAS

Answer 29

Superficial Musculoaponeurotic System - layer of tissue beneath the skin that attaches to muscles and plays a role in facial structure and movement