Surg 105--Chapter 28 (Fuller) Flashcards
Metal plates wired to the teeth to occlude the jaw during maxillofacial surgery or during healing; maintain the patient’s normal bite (occlusion).
arch bars
An incision made between the frontal and the parietal bones bilaterally.
bicoronal incision
Screws that penetrate both cortical layers and the intervening spongy layer of the bone.
bicortical screws
A severe fracture of the orbital cavity in which a portion of the globe may extrude outside the cavity.
blowout fracture
The number, type, and pattern of the teeth.
dentition
A horizontal fracture of the maxilla that causes the hard palate and alveolar process to become separated from the rest of the maxilla. The fracture extends into the lower nasal septum, lateral maxillary sinus, and palatine bones.
Le Fort I fracture
A fracture which extends from the nasal bone to the frontal processes of the maxilla, lacrimal bones, and inferior orbital floor, and it may extend into the orbital foramen. Inferiorly, it extends into the anterior maxillary sinus and the pterygoid plates.
Le Fort II fracture
This fracture involves separation of all the facial bones from their cranial base. It includes fracture of the zygoma, maxilla, and nasal bones.
Le Fort III fracture
Chewing
mastication
What is maxillomandibular fixation (MMF)?
same as arch bars
Normally to “close.” In maxillofacial surgery this refers to the patient’s bite pattern when the jaw is closed.
occlusion
Tooth extraction
odontectomy
Surgery involving the bones of the face, primarily for repair of fractures and reconstruction for congenital anomalies.
oromaxillofacial surgery
Skin incision made approximately 2 mm inferior to the lower eyelashes.
subciliary incision
Incision made through the conjunctiva.
Transconjunctival incision
A bone plate with retaining posts used in the procedure for dental implants.
transosteal implant
How many regions are the bones of the face divided into?
3
What are the regions the face in divided into?
The upper face, the midface, and the lower face
What is the upper face composed of?
the frontal bone
What is the midface composed of?
- the ethmoid
- the nasal bone
- the zygoma
- the maxillary bones
A complex structure that contributes to the floor of the cranium and also contains a number of sinus cavities.
the ethmoid bone
Forms the lateral walls and floor of the bony orbit, which houses the eyeball.
the zygoma
What are the most common causes of injury to the midface?
assault, motor vehicle accidents, and sports injuries
The lower face is composed of?
the mandible
The only movable bone of the face?
the mandible
A U-shaped bone suspended from the temporal bone.
the mandible
The instrumentation for oromaxillofacial surgery may include?
fine orthopedic instruments, implants, and grafting materials
What are the primary means of repairing facial fractures?
plates and screws
For mandibular fractures, the plates and screws are most often at least _____ in size.
2 mm
For midface, orbital, and frontal sinus fractures, the plates and screws are _____.
1 to 2 mm
What is used to prep facial fractures?
Betadine scrub and paint
What solution are not used on the face because they are ototoxic?
hexachlorophine and chorhexadine
What is the prep area for the face?
entire face is prepped, from the hairline to the sternal notch
True or False: If a bicoronal incision is planned, the patient’s head may be shaved.
True
What can be used to irrigate the patient’s mouth after the patient has been draped?
diluted Betadine paint
What sponges are used during maxillofacial surgery?
4 x 4 and cottonoids
What is a fundamental goal of any maxillomandibular procedure?
To preserve the patient’s unique bite pattern or normal occulsion between the mandible (lower jaw), the maxilla (upper jaw), and the midface bones.
What must be kept with patients that have arch bars?
wire cutters
Arch bars are sutured into place using _____.
24- or 26- stainless steel suture wires
When applying arch bars, the stainless steel suture is twisted into a _____ loop.
clockwise
Fractures of the midface are reduced and fixated and the buttressing structures are reinforced.
open reduction/internal fixation: midface fracture
What type of fracture is also associated with leakage of cerebrospinal fluid (CSF) into the nasal sinuses?
Le Fort II fracture
What are weight-bearing structures of the face?
buttresses
Performed to repair CSF leakage, prevent obstruction or the frontal sinus ducts, and restore an aesthetic contour to the forehead.
open reduction/internal fixation: frontal sinus fracture
Fractures of the psoterior wall of the frontal sinus may result in _____.
CSF leakage or herniation of brain tissue
In this procedure, the posterior wall of the sinus is removed, the sinus ducts are plugged, and the frontal sinus mucosa is removed. The brain is allowed to move into the previous frontal sinus space.
cranialization of the sinus
What solution is a fat graft placed into to keep it moist until the surgeon is ready to place it in the frontal sinus?
normal saline
Performed to reduce a fracture of the orbital floor, to prevent entrapment of the extraocular muscles, and to support the orbital contents.
open reduction/internal fixation: orbital floor fracture
During open reduction/internal fixation: orbital floor fracture, what is place into the eye to provide moisture.
BSS
Subciliary incisions are closed with _____.
5-0 absorbable suture
True or False: Transconjunctival incisions are not closed.
True
The mandibular fracture is repaired and occlusion is restored.
open reduction/internal fixation: mandibular fracture
Most mandibular fractures require _____ plates per fracture.
2
What are the three types of dental implants commonly used?
- endosteal implant
- subperiosteal implant
- transosteal implant
A threaded screw, cylinder, or flat blade that is implanted in the alveolus of the maxilla or mandible and then covered with soft tissue.
endosteal implant
Placed beneath the periosteum directly on the alveolar bone. Used primarily when bone is insufficient to support an endosteal implant.
subperiosteal implant
Bone plates with retaining posts. Used only when the patient has severe loss of bone in the mandibular alveolar ridge.
transosteal implant
Performed to correct a bony deformity of the mandible.
mandibular advancement
Performed to correct a bony deformity of the maxilla.
midface (maxillary) advancement
Performed to to reduce pain and increase mobility of the joint.
temporomandibular joint arthroplasty (TMJ)
