The Journal of cranio-maxillofacial trauma
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J Craniomaxillofac Trauma · Jan 1996
ReviewAvoiding secondary brain injury after severe head trauma: monitoring and management.
Research has demonstrated that much of the mortality and morbidity in severely head-injured patients is due to secondary injury. The development of techniques to monitor cerebral blood flow, arteriovenous difference of oxygen or saturation of jugular venous blood flow with oxygen, and cerebral metabolic rate of oxygen has led to recognition, treatment, and prevention of secondary insults. ⋯ Special emphasis is given to the factors governing both cerebral blood flow and cerebral blood volume, and how these factors can be monitored and manipulated to strike an optimal balance between the two. This information can aid in determining when it is safe to operate on patients with non-life-threatening conditions.
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J Craniomaxillofac Trauma · Jan 1996
Review Case ReportsTrauma to the temporal bone: diagnosis and management of complications.
The temporal bone contains important sensory and neural structures that may be damaged in patients who experience craniofacial trauma. The most serious complications of temporal bone trauma include facial nerve paralysis, cerebrospinal fluid leak, and hearing loss. ⋯ A high index of suspicion and a thorough knowledge of how to diagnose injury to the temporal bone are paramount in treating patients who present to the emergency room with craniofacial trauma. This article provides an overview of temporal bone trauma, outlines a methodical approach to the patient with temporal bone trauma, details four cases, and describes the treatment of complications.
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J Craniomaxillofac Trauma · Jan 1996
Intraoperative airway management with pan-facial fractures: alternative approaches.
Nasoendotracheal intubation is contraindicated in patients with pan-facial fractures for securing the airway during reconstructive surgery. Oral intubation interferes with intermaxillary fixation during fracture reduction. ⋯ This article presents Bullard laryngoscopy and submandibular intubation techniques as innovative alternative methods of airway management during surgery. These procedures are indicated in those patients with severe injuries who do not require long-term airway management postoperatively and did not require tracheostomy in the emergency room.