OMFS/Dental

Question 1

What are major concerns with Le Fort fractures?–severe soft tissue ___, ___mosis, airway ___

Answer 1

Major concerns with Le Fort fractures–severe soft tissue swelling, ecchymosis, airway obstruction

Question 2

Patients with Le Fort fractures will likely be admitted to hospital, receive IV abx, and require surgical management–T/F?

Answer 2

True

Question 3

Some patients with Le Fort fractures may be discharged to home–T/F?

Answer 3

True

Question 4

What does Le Fort fracture mean?

Answer 4

Maxillary fractures

Question 5

Le Fort I = ___

Answer 5

Le Fort I = palate

Question 6

Le Fort II = ___ + ___

Answer 6

Le Fort II = nose + palate

Question 7

Le Fort III = ___

Answer 7

Le Fort III = entire face

Question 8

Le Fort I (nasomaxillary) fracture signs–mal___; buccal ___; epi___; maxillary ___; maxilla ___

Answer 8

Le Fort I (nasomaxillary) fracture signs–malocclusion; buccal ecchymosis; epistaxis; maxillary crepitus; maxilla mobile

Question 9

Le Fort II (pyramidal) fracture signs–midface ___; facial ___ing; bilateral epi___; infraorbital ___; ___mosis in what (3) areas?

Answer 9

Le Fort II (pyramidal) fracture signs–midface crepitus; facial lengthening; bilateral epistaxis; infraorbital paresthesia; ecchymosis–buccal, periorbital, subconjunctival

Question 10

Le Fort III (craniofacial dysjunction) signs–caved-in or ___, ___ face; CSF ___; bilateral epi___; lateral orbital rim ___; ___mosis in what (2) areas?

Answer 10

Le Fort III (craniofacial dysjunction) signs–caved-in or flattened, lengthened face; CSF rhinorrhea; bilateral epistaxis; lateral orbital rim defect; ecchymosis–periorbital, subconjunctival

Question 11

Where is the most common location of mandibular fracture?

Answer 11

Angle of the mandible–33.4% of mandibular fractures

Question 12

Anesthesia considerations for orthopedic orthognathic procedures–careful consideration of intranasal intubations with active trauma Le Fort ___ and ___ fractures

Answer 12

Careful consideration of intranasal intubations with active trauma Le Fort II and III fractures

Question 13

Anesthesia considerations for orthopedic orthognathic procedures–typical induction = ___lytics, ___ation, muscle ___, significant ___–pretreat with ___

Answer 13

Typical induction = anxiolytics, sedation, muscle relaxation, significant edema–pretreat with steroids

Question 14

Anesthesia considerations for orthopedic orthognathic procedures–consider ___ equipment availability

Answer 14

Consider difficult airway equipment availability

Question 15

Anesthesia considerations for orthopedic orthognathic procedures–blood loss can be significant, so patient should have ___ at minimum, ___ is ideal

Answer 15

Blood loss can be significant, so patient should have T&S at minimum, T&C is ideal

Question 16

Anesthesia considerations for orthopedic orthognathic procedures–___ extubation; patient will likely be ___/___ shut for maxillary fixation

Answer 16

AWAKE extubation; patient will likely be wired/banded shut for maxillary fixation

Question 17

Anesthesia considerations for orthopedic orthognathic procedures–must have ___/___ available at all times…why?

Answer 17

Must have wire cutter/scissors available at all times to cut the bands if patient has airway complications or is vomiting

Question 18

What is key for dental surgery?

Answer 18

Communication! Multiple types of airways may be able to be utilized–i.e.: flexible LMA, oral RAE, nasal ETT

Question 19

Anesthesia considerations with nasal intubation–friable tissue in the nose so vaso___ is helpful; ___ may be utilized in pre-op holding or just prior to intubating

Answer 19

Friable tissue in the nose so vasoconstriction is helpful; phenylephrine may be utilized in pre-op holding or just prior to intubating

Question 20

Anesthesia considerations with nasal intubation–___ to all surfaces which enter the nasal passages

Answer 20

Lubricant to all surfaces which enter the nasal passages

Question 21

Anesthesia considerations with nasal intubation–use ___ to dilate the nare prior to insertion of nasal RAE tube

Answer 21

Use nasal airways to dilate the nare prior to insertion of nasal RAE tube

Question 22

Anesthesia considerations with nasal intubation–place nasal RAE in ___ (warm/cold) fluids to soften the ETT

Answer 22

place nasal RAE in warm fluids to soften the ETT

Question 23

Anesthesia considerations with nasal intubation–will need appropriate size ___ and ___ protection

Answer 23

will need appropriate size MaGill forceps and eye protection