Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery
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J Craniomaxillofac Surg · Dec 2000
The submental route revisited using the laryngeal mask airway: a technical note.
The submental route for endotracheal intubation is well known and this paper reports the use of the same route for the laryngeal mask airway. This technique can be used whenever it is considered too awkward to perform submental, transoral or transnasal endotracheal intubations. When the surgery has been completed, the mouth is left open to allow the laryngeal mask to be removed; it cannot be left in place in cases of intermaxillary fixation. It is necessary to detach the laryngeal mask orally, never submentally, as it is impossible to remove the mask via the submental route.
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J Craniomaxillofac Surg · Dec 2000
Case ReportsEvaluating the neck for percutaneous dilatational tracheostomy.
The aims of this article are to study how variations in the anatomy of the neck may influence the success of percutaneous dilatational tracheostomy (PDT). ⋯ Variations in the anatomy of the neck can make PDT both difficult and hazardous. Patients with a deeply lying trachea may need a long shank tube. Open surgical tracheostomy is indicated in some patients with a deeply lying trachea and conditions producing secondary deformity of the trachea. All patients should have a detailed history and thorough clinical examination of the neck and thorax prior to PDT. The selective use of chest radiography, MRI, and ultrasound assessment prior to PDT can assist in the identification of patients unsuitable for this technique.
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A retrospective study was conducted on patients with upper aerodigestive tract foreign bodies requiring operative intervention over a 12-year period to aid in the recognition and management of foreign body associated complications. Oesophagoscopies were performed for the removal of foreign bodies in 37 patients, age one to 82 years with a male to female ratio of 1.2:1. ⋯ An abscess was already present at the time of initial procedure in six cases and developed in two cases after successful removal of the foreign body. A high level of suspicion for a retropharyngeal abscess should be maintained in cases with perforation, and in patients with immunodeficiency.
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J Craniomaxillofac Surg · Aug 2000
Obstructive sleep apnoea: multiple comparisons of cephalometric variables of obese and non-obese patients.
Pathogenesis of obstructive sleep apnoea (OSA) is complex and not yet fully understood. Several factors contribute to OSA severity. Obesity is believed to play an important role. Nevertheless, not all OSA patients are obese. Therefore, the different features that cause nocturnal upper airway obstruction in obese and non-obese OSA patients could be expected. ⋯ The findings imply that there should be different treatment regimens for the two subgroups of OSA patients. Cephalometric analysis together with various considerations of BMI is highly recommended as one of the most important tools in diagnosis and treatment planning for OSA patients.
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J Craniomaxillofac Surg · Apr 2000
Comparative StudyFunctional reconstruction of the TM joint in cases of severely displaced fractures and fracture dislocation.
In a clinical and axiographic study the outcome of patients with severely displaced fractures and fracture dislocations of the mandibular condyle was evaluated. Two operation methods were compared one via an intraoral approach without joint revision and another via a preauricular approach with open reduction of the joint. In the group with joint revision, resorbable material was used for osteosynthesis. ⋯ However, the limits between bony reconstruction with or without joint revision are still not defined. Our results appear to be promising concerning mobility and absence of pain of the joints after open reduction. Further research comparing the two operative treatment regimes in a randomized controlled clinical trial will be necessary.