Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons
-
J. Oral Maxillofac. Surg. · Jun 2012
Review Case ReportsCervical necrotizing fasciitis with descending mediastinitis: literature review and case report.
Cervical necrotizing fasciitis (CNF) can develop from odontogenic infections that spread to the deep fascial planes of the neck. This polymicrobial infection is rapidly progressive, destructive, and often fatal. Prompt diagnosis, recognition of acuity, aggressive, repeated surgical treatment, and medical management contribute to improved survival. ⋯ Antibiotic therapy should be adjusted as cultures and sensitivities become available. Advances in interventional radiology might lead to improved survival by allowing guided minimally invasive drainage in critically ill patients who cannot tolerate additional surgical insult. Despite the technologic advances in diagnosis and treatment, CNF complicated by DNM mediastinitis and sepsis still results in astoundingly high mortality.
-
J. Oral Maxillofac. Surg. · Jun 2012
Midazolam is associated with delay in recovery and agitation after ambulatory general anesthesia for dental treatment in patients with disabilities: a retrospective cohort study.
Some patients with intellectual disabilities (IDs) who undergo total intravenous anesthesia (TIVA) have complications associated with the anesthesia such as prolonged recovery. The purposes of this study were to estimate the frequency of TIVA complications among patients with IDs and to identify factors associated with TIVA complications. ⋯ Intravenous midazolam may not have an advantage in ambulatory general anesthesia. Oral midazolam contributes to delayed recovery and is an independent predictor of agitation.
-
J. Oral Maxillofac. Surg. · Jun 2012
Cephalometric predictors of therapeutic response to multilevel surgery in patients with obstructive sleep apnea.
The present study investigated whether cephalometric measurements can predict the therapeutic efficacy of multilevel phase I surgery for patients with obstructive sleep apnea (OSA). ⋯ Some preoperative cephalometric measurements were verified retrospectively to predict the therapeutic response to the multilevel surgery in patients with OSA. This study would contribute not only to establishing selective criteria for the surgical approach to patients with OSA in ear-nose-throat practice but also in deciding on the referral to orthodontists or maxillofacial surgeons.
-
J. Oral Maxillofac. Surg. · May 2012
Small bolus of esmolol effectively prevents sodium nitroprusside-induced reflex tachycardia without adversely affecting blood pressure.
Hypotensive anesthesia with sodium nitroprusside (SNP) often is associated with reflex tachycardia. The purpose of this study was to investigate whether a small bolus of esmolol could counteract SNP-induced reflex tachycardia and sympathetic activation without affecting blood pressure. ⋯ A small bolus of esmolol can suppress reflex tachycardia without significantly changing mean arterial pressure. Thus, esmolol restores the autonomic imbalance induced by SNP during hypotensive anesthesia.