OMF Trauma

Question 1

Horizontal fracture of the maxilla extending from the floor of the nose and hard palate through the nasal septum and through the pterygoid plates

Answer 1

Lefort I (palate)

Question 2

A triangular fracture running from the bridge of the midfacial skeleton from the cranial base, traversing the root of the nose, the ethmoid bone, the eye orbits, and the shenopalatine fossa

Answer 2

Lefort II (nose and palate)

Question 3

Fracture totally separates the midfacial skeleton from the cranial base, traversing the root of the nose, the ethmoid bone, the eye orbits, and the shenopalatine fossa

Answer 3

Lefort III (entire face)

Question 4

What can be disrupted in Lefort II/III fx opening up the underside of the cranial cavity?

Answer 4

cribiform plate

Question 5

What are signs that attempting to place an ETT or NG through the nares could lead to inadvertent intracranial placement?

Answer 5

The presence of CSF in the nose, blood behind the tympanic membrane, periorbital edema, or “racoon eyes”

Question 6

with mandibular fractures anesthesia considerations

Answer 6

will usually utilize a nasal intubation in order to wire/band the jaw shut at the end of surgery for intermaxillary fixation (typically at least 6 weeks)

Question 7

what must you have available at all times with wire/banding of jaw?

Answer 7

wire cutters/scissors

Question 8

whats important with dental surgery?

Answer 8

COMMUNICATION!!!

Question 9

what med is helpful with friable tissue in nasal intubations to vasoconstrit

Answer 9

phenylephrine

Question 10

What should you do to all surfaces that enter the nasal passages?

Answer 10

lubricate

Question 11

What be done to dilate nare prior to nasal rae?

Answer 11

nasal airways