MAXILLO-FACIAL TRAUMA – Mr Kush Patel
Occlusion – “bite”
2 view xray – OPG + PA mandible
Dental floss to stabilise a jaw fracture (delay to OT, transport)
Subconjunctival haemorrhage without limit – suggests underlying fracture
Occulocardiac reflex – bradycardia associated with entrapment of inferior rectus muscle = surgical emergency
Zygomatic/Orbital fracture – no nose blowing for 3 weeks (risk of infection, surgical emphysema)
Admissions:
Fracture dentate portion of mandible
Open fracture
Orbital fracture – retrobulbar haematoma, muscle entrapment
Refer ALL facial trauma to the faciomax team!
MAXILLO-FACIAL INFECTIONS – Dr Owen Ellis
Referrals: Dental infection = Maxfac
Skin infection = Plastics
Tonsil and glands (especially parotid due to anatomy) = ENT
Dangerous teeth – Lower 3rd + 2nd molar on mandible – risk of deep infection and airway compromise
Imaging – OPG + CT Head and neck with contrast for collection
Danger signs:
Trismus
Unable to lie flat
Drooling/Dysphagia
Firm floor of mouth on examination
Stridor
Lower jaw swelling