OMFS/Dental Flashcards
What are major concerns with Le Fort fractures?–severe soft tissue ___, ___mosis, airway ___
Major concerns with Le Fort fractures–severe soft tissue swelling, ecchymosis, airway obstruction
Patients with Le Fort fractures will likely be admitted to hospital, receive IV abx, and require surgical management–T/F?
True
Some patients with Le Fort fractures may be discharged to home–T/F?
True
What does Le Fort fracture mean?
Maxillary fractures
Le Fort I = ___
Le Fort I = palate
Le Fort II = ___ + ___
Le Fort II = nose + palate
Le Fort III = ___
Le Fort III = entire face
Le Fort I (nasomaxillary) fracture signs–mal___; buccal ___; epi___; maxillary ___; maxilla ___
Le Fort I (nasomaxillary) fracture signs–malocclusion; buccal ecchymosis; epistaxis; maxillary crepitus; maxilla mobile
Le Fort II (pyramidal) fracture signs–midface ___; facial ___ing; bilateral epi___; infraorbital ___; ___mosis in what (3) areas?
Le Fort II (pyramidal) fracture signs–midface crepitus; facial lengthening; bilateral epistaxis; infraorbital paresthesia; ecchymosis–buccal, periorbital, subconjunctival
Le Fort III (craniofacial dysjunction) signs–caved-in or ___, ___ face; CSF ___; bilateral epi___; lateral orbital rim ___; ___mosis in what (2) areas?
Le Fort III (craniofacial dysjunction) signs–caved-in or flattened, lengthened face; CSF rhinorrhea; bilateral epistaxis; lateral orbital rim defect; ecchymosis–periorbital, subconjunctival
Where is the most common location of mandibular fracture?
Angle of the mandible–33.4% of mandibular fractures
Anesthesia considerations for orthopedic orthognathic procedures–careful consideration of intranasal intubations with active trauma Le Fort ___ and ___ fractures
Careful consideration of intranasal intubations with active trauma Le Fort II and III fractures
Anesthesia considerations for orthopedic orthognathic procedures–typical induction = ___lytics, ___ation, muscle ___, significant ___–pretreat with ___
Typical induction = anxiolytics, sedation, muscle relaxation, significant edema–pretreat with steroids
Anesthesia considerations for orthopedic orthognathic procedures–consider ___ equipment availability
Consider difficult airway equipment availability
Anesthesia considerations for orthopedic orthognathic procedures–blood loss can be significant, so patient should have ___ at minimum, ___ is ideal
Blood loss can be significant, so patient should have T&S at minimum, T&C is ideal
Anesthesia considerations for orthopedic orthognathic procedures–___ extubation; patient will likely be ___/___ shut for maxillary fixation
AWAKE extubation; patient will likely be wired/banded shut for maxillary fixation
Anesthesia considerations for orthopedic orthognathic procedures–must have ___/___ available at all times…why?
Must have wire cutter/scissors available at all times to cut the bands if patient has airway complications or is vomiting
What is key for dental surgery?
Communication! Multiple types of airways may be able to be utilized–i.e.: flexible LMA, oral RAE, nasal ETT
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
Friable tissue in the nose so vasoconstriction is helpful; phenylephrine may be utilized in pre-op holding or just prior to intubating
Anesthesia considerations with nasal intubation–___ to all surfaces which enter the nasal passages
Lubricant to all surfaces which enter the nasal passages
Anesthesia considerations with nasal intubation–use ___ to dilate the nare prior to insertion of nasal RAE tube
Use nasal airways to dilate the nare prior to insertion of nasal RAE tube
Anesthesia considerations with nasal intubation–place nasal RAE in ___ (warm/cold) fluids to soften the ETT
place nasal RAE in warm fluids to soften the ETT
Anesthesia considerations with nasal intubation–will need appropriate size ___ and ___ protection
will need appropriate size MaGill forceps and eye protection
