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