Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons
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J. Oral Maxillofac. Surg. · Nov 2008
Randomized Controlled TrialEffects of nasal application of an epinephrine and lidocaine mixture on the hemodynamics and nasal mucosa in oral and maxillofacial surgery.
Our purpose was to investigate the influences of nasal pretreatment with a mixed solution of epinephrine and lidocaine (E-L pretreatment) on the systemic hemodynamics and the mucosa of the inferior nasal concha, which is carried out for expansion of the nasal cavity and the prevention of mucosal injury before nasotracheal intubation. ⋯ The E-L pretreatment provided characteristic evidence for useful expansion of the nasal cavity and for reduction of the nasal mucosal blood flow with less systemic hemodynamic effects, although further investigation is needed for the determination of the proper epinephrine concentration in E-L pretreatment.
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J. Oral Maxillofac. Surg. · Nov 2008
Randomized Controlled TrialInduced hypotension in orthognathic surgery: a comparative study of 2 pharmacological protocols.
The objective of this comparative study was to report on the use of 2 different pharmaceutical protocols involving 2 different anesthetic techniques (IV and balanced) to induce hypotension in patients submitted to orthognathic surgery by assessing the patients' intra- and postoperative physiologic response and hemodynamic stability. ⋯ Both protocols tried in this study proved to be effective and safe, and they seem to be interesting alternatives in longer orthognathic surgeries with the expectation of an important blood loss. The choice for either protocol should be based on the inherent risks involved in their use and their cost-benefit ratio.
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J. Oral Maxillofac. Surg. · Nov 2008
Controlled Clinical TrialMicrovascular free tissue transfer for tongue reconstruction after hemiglossectomy: a functional assessment of radial forearm versus anterolateral thigh flap.
The purpose of this study was to evaluate tongue function and donor site morbidity in patients with oral cancer surgically treated and reconstructed with radial or anterolateral thigh free flaps. ⋯ Anterolateral thigh flap, with its versatility in design, long pedicle with a suitable vessel diameter, and low donor site morbidity, could be the ideal flap for hemiglossectomy defect reconstruction.
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Trauma to the zygomatic arch classically leads to 1 of 3 injury patterns: fracture with medial displacement, fracture with posterior telescoping, or explosive burst with lateral displacement. We identified an additional injury pattern whereby the arch undergoes significant bending in the axial plane without fracture. ⋯ Zygomatic arch deformation without fracture occurs in 19% of zygoma injuries in our group and is likely elastic in nature. We believe this injury pattern is important clinically as it may decrease the need for coronal exposure, facilitate anatomic repair, and provide stability without hardware fixation.