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ENT > MaxFax > Flashcards

MaxFax Flashcards

1
Q

Define Maxillofacial surgery?

A

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

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2
Q

The 3 major areas Maxfax deals with

A

Head and neck cancer
Trauma
Facial Deformity

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3
Q

Who’s involved in treating facial deformity?

A

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

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4
Q

How do we investigate and plan facial deformity surgery?

A

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.

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5
Q

What kind of cancers does maxfax deal with? [3]

A
  • Oral Malignancy
  • Metastatic Skin Cancer
  • Maxillary Cancer
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6
Q

What histological type of cancer is most oral maligancy?

A

Mainly Squamous cell Carcinoma

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7
Q

Whats survival like for oral malignancy?

A 
Overall 40%
Stage 1 = 90%
Stage 2 = 76%
Stage 3 = 44%
Stage 4 = 20%
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8
Q

What are the worrying signs for oral malignancy? [5]

A
  • Redness
  • Speckled red/white lesions
    (White = Leukoplakia ## Red = Erythroplakia)
  • Hardened areas
  • Ulceration > 3 wks
  • New melanin pigmentation
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9
Q

Explain nodal involvement in oral cancer? [5]

A 
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
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10
Q

How do we manage oral cancer? [3]

A

Surgery:

  • Resection & Reconstruction
  • Cut out a good margin
  • Maintain as much anatomy and function as possible

Radiotherapy
Chemotherapy

Palliation:

  • Best supportive Care
  • Radiotherapy
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11
Q

Where does maxillary cancer tend to spread?

A

To the infratemporal fossa:

- Thats the space between the pharyngeal wall, mandibular ramus and skull base

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12
Q

Whats the etiology of facial trauma? [5]

A 
Assault (mostly related to alcohol)
Road Traffic Accidents
Sports
Falls
Industrial accidents
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13
Q

How do we assess a facial fracture? [5]

A

Follow the Advanced Trauma Life Support (ATLS) principles.

  • Check the airway
  • secure the C-spine
  • Check breathing
  • Circulation
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14
Q

Main subtypes of Facial trauma? [3]

A
  • Soft Tissue
    Generally due to penetrating trauma
  • Bone Injury
  • Combination
    Generally a high energy trauma causing a panfacial injury
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15
Q

Whats the most common bone injury?

A

Mandible

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16
Q

What are the sections of the mandible?

A
  • Condyle
  • Coronoid
  • Ramus
  • Angle
  • Body
  • Dentoalveolar Segment
  • Symphysis & Parasymphysis
17
Q

What is the mechanism of a mandibular injury (typical)?

What is the presentation of a mandibular injury? [7]

A

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
Q

What is a step deformity?

A

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

19
Q

How do we investigate and treat a mandibular injury? [3]

A
  • X-ray
  • Oral Pantomogram (OPT)

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

20
Q

What is an OPT?

A

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
Q

What kinds of midface fractures are there? [4]

A

Maxilla
Zygoma
Orbit
Naso-orbito-ethmoidal complex

22
Q

How does a maxilla fracture present? [4]

A

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

23
Q

How do we classify maxillary fractures? [4]

A

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
Q

How does a zygoma fracture present? [2]

A

Usually after assault
Theres a lot of pain and swelling

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

25
Q

Whats special about a naso-orbito-ethmoidal fracture?

A
  • They have to be reconstructed very quickly

- You can use a CT scan to diagnose it

ENT (15 decks)

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