Lefort 1 #

Question 1

Syn for Lefort 1??

Answer 1

Guerin #...
Low level #...
Floating maxilla #..
Telescopic #...
Horizontal #...

Question 2

Lefort 2 involves?

Answer 2

1. Maxilla
2. Nasal
3. Lacrimal bones

Question 3

Lefort 3 involves?

Answer 3

Ethmoidal

Lacrimal

Nasal

Maxilla

Question 4

Guerin’s sign is?

Answer 4

Ecchymosis at GREATER PALATINE foramen…

Question 5

Bleeding into Max sinus seen in?

Answer 5

Lefort 1..

When sinus gets filled with blood… Blood starts leaking through the nose.. n nasal passages may get blocked with this clotted blood..

Question 6

Forceps used for MAXILLA disimpaction?!

Answer 6

Row’s forceps…

Pn - Six hit MAXimum no. Of ROWS back

Question 7

Lefort 1 osteotomy involves # of how many bones?

Answer 7

5

2 maxillae + dysjunction of vomer + Pterygoid plates… ( Not really clear )

Question 8

Blood supply of Remaining maxilla after Lefort 1 osteotomy is maintained by?

Answer 8

1. Ascending palatine branch of Facial artery..
2. Ant branch of ascending pharyngeal artery…

There is disruption of descending palatine artery following Lefort 1 osteotomy…

Question 9

Panda facies seen after?

Answer 9

Lefort 2

Because of this the pt develops dark circles around the eyes… Known as RACOONs eyes…

Subconjunctival ecchymosis is seen with?? Both Lefort 2 n 3…

Question 10

Clinical feat of Lefort 2?

Answer 10

Malocclusion (Pn - I hv class 2 MALOCCLUSION… Here class 2 means lefort 2) and ( In Lefort 1.. TRUE OPEN BITE is seen… Rm this PT here only)

Paraesthesia

CSF Rhinorrhea

*** Alw Rm…. Enoptholmos is not seen in Lefort 2… It’s seen in Lefort 3…

Question 11

Horizontal fracture of maxilla is?

Answer 11

Lefort 1 #

Question 12

True open bite is caused by?

Answer 12

Horizontal # of maxilla (not clear how…)

Question 13

Lefort 2 syn??

Answer 13

Infrazygomatic..

Pyramidal #…

Question 14

Lefort 3 syn??

Answer 14

Craniofacial dysjunction…
High level #
Suprazygomatic #
High transverse… (Lefort 1 is transverse… Just transverse)

Question 15

B/L subconjuctival ecchymosis is seen in?

Answer 15

Lefort 2
Lefort 3
Naso ethmoidal complex #

But not seen in Lefort 1 (Obv)

Question 16

The first step in Rx of a pt with head injury?

Answer 16

Secure Airway

Question 17

If the pt is unconscious with head inj he should be carried in LEFT LATERAL position… why?

Answer 17

This allows clearing of blood n mucus from mouth n nasopharynx n allows escape of other secretions…

Question 18

In a pt with head inj most imp to note first (among all eye signs) ?

Answer 18

Ability to open eye

Question 19

21. Safest initial approach to open airway of pt with maxillofacial trauma? N explain airway opening in a pt with maxillofacial trauma…

Answer 19

Jaw thrust….
NOT head tilt or chin lift…

Every Tx pt should be considered as a pt withCERVICAL SPINE INJ n treated accordingly…. Here, chin lift with head lift manuers also open the airway, but avoided in ANY PT with a potential CERVICAL SPINE INJ…

Therefore JAW THRUST without head tilt maneuver should be performed WHILE MAINTAINING “CERVICAL SPINE ALIGNMENT”….