The British journal of oral & maxillofacial surgery
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Br J Oral Maxillofac Surg · Oct 2008
Submental intubation in orthognathic surgery: initial experience.
Submental intubation is a technique for use in maxillofacial trauma, which allows precise assessment of changes to the nasolabial complex, midlines, cants, and incisal display in patients having maxillary orthognathic surgery. We report our initial experience of it used as an adjunct in the management of orthognathic surgery in a series of 44 patients.
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Br J Oral Maxillofac Surg · Sep 2008
How we do it: training in airway management for a head and neck unit.
Experience and confidence in the management of the airway is highly variable among junior surgical trainees, who are usually the first on scene when problems arise, particularly out of hours. Juniors must possess the skills required to recognise and institute appropriate management in an airway emergency. We describe a local training programme, an airway equipment trolley, and a protocol for recognition, stabilisation, and management, in case of an airway emergency.
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Br J Oral Maxillofac Surg · Sep 2008
Case ReportsGreat auricular communication with the marginal mandibular nerve - a previously unreported anatomical variant.
The great auricular nerve that originates from the cervical plexus and supplies sensation to the lower part of the auricle and the skin overlying the angle of the mandible has no motor component. During an elective neck dissection for a squamous cell carcinoma of the tongue, we found that the anterior division of the great auricular nerve divided, with a long branch that passed into the submandibular triangle anterior and superficial to the facial vein, and was joined on its deep surface by the marginal mandibular division of the facial nerve. Although anatomical variants of other branches of the cervical plexus have been described, this is, to our knowledge, the first time a communication between the great auricular nerve and a branch of the facial nerve has been reported outside the parotid gland.
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Br J Oral Maxillofac Surg · Sep 2008
Retained throat packs: results of a national survey and the application of an organisational accident model.
Throat packs are commonly placed in the patient's pharynx before oral surgical procedures under general anaesthesia. The pack is thought to protect the airways from aspiration of surgical debris, but if it is retained after extubation it can obstruct the airway. ⋯ We investigated the management of throat packs in 2007, by sending a questionnaire to maxillofacial surgeons and anaesthetists in the UK. We discuss the results and apply them to an organisational accident model.