The Journal of cranio-maxillofacial trauma
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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.
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J Craniomaxillofac Trauma · Jan 1995
ReviewCarotid-cavernous sinus fistulae in craniofacial trauma: classification and treatment.
Carotid-cavernous sinus fistulae (CCF) represent pathological communications between the intracavernous internal carotid artery and the cavernous venous sinus. Although trauma is the most common cause of high flow carotid cavernous fistulae, they are relatively uncommon in patients sustaining craniofacial trauma. Nevertheless, CCF require early diagnosis and rapid and effective treatment in order to prevent severe and significant morbidity. ⋯ Cerebral angiography is currently the definitive diagnostic study. Obliteration of the fistula by endovascular techniques is the current mainstay treatment, and direct surgery is reserved for cases that have failed endovascular therapy. This article reviews clinical features, pertinent anatomy, and therapeutic approaches to carotid-cavernous sinus fistulae.
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J Craniomaxillofac Trauma · Jan 1995
Case ReportsFatal necrotizing fasciitis following a mandibular fracture.
Necrotizing fasciitis of the head and neck is an uncommon, insidious infection that usually occurs secondarily to odontogenic infections, although blunt and penetrating trauma can be another cause. Of 65 total reported cases of necrotizing fasciitis, 10 (15.4%) have been fatal. ⋯ The clinician must remain suspicious of any infection refractory to antibiotic therapy alone, since necrotizing fasciitis is a rapidly progressing condition with high morbidity and potential for mortality. Rapid diagnosis, surgical treatment, antibiotic therapy, medical management, nutritional support, and early detection and treatment of complications are critical elements in the management of necrotizing fasciitis.
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J Craniomaxillofac Trauma · Jan 1995
Case ReportsPseudo-entrapment of extraocular muscles in patients with orbital fractures.
Diplopia is a prominent finding in patients who have suffered orbital fractures. If the patient's double vision or ocular motility restriction was caused by soft tissue entrapment into the fracture site, surgery is frequently performed in order to release this entrapment and restore normal eye movement. ⋯ Brief case reports are hereby presented to illustrate that the symptoms of diplopia and motility restriction are not always attributable to the presence of orbital fractures that require surgical repair. The purpose of this article is to describe other causes of abnormal ocular motility that are associated with orbital trauma but which are not caused by soft tissue entrapment.