Management of complications in oral and maxillofacial surgery

Description

Cover Title Page Copyright Page Contents Preface List of Contributors Chapter 1 Ambulatory Anesthesia Introduction Prevention of Complications in Ambulatory Anesthesia Patient Characteristics/Selection Procedure Characteristics/Selection Patient Screening Intraoperative Patient Monitoring Personnel Preparedness Equipment and Emergency Supplies Postoperative Monitoring Incidence of Complications in Ambulatory Anesthesia Neurological Complications Syncope Oversedation Seizures Cardiopulmonary Complications Respiratory Depression and Respiratory Arrest Laryngospasm, Bronchospasm, and Acute Asthma Aspiration Preoperative Fasting Period (NPO Guidelines) Acute Vascular Events Cardiac Arrhythmias Hypertension and Hypotension Gastrointestinal Complications Nausea and Vomiting Endocrine Complications Hypoglycemia Adrenal Crisis Immunological Complications Hypersensitivity Reactions Psychiatric and Emotional Complications Complications Related to Patient Positioning Complications Related to IV Line Placement Anesthetic Complications in Pediatric Patients Pediatric Respiratory Complications Pediatric Cardiovascular Complications Other Pediatric Complications Prevention and Management of Pediatric Anesthetic Complications References Chapter 2 Third Molar Surgery Introduction Management of Complications in Third Molar Surgery Alveolar Osteitis Infection Bleeding/Hemorrhage Mandibular Fracture Oral–Antral Communication Injury to Adjacent Teeth/Wrong Tooth Extraction Injury to Adjacent Osseous Structures Pain and Swelling TMJ Injury Displacement of Teeth Aspiration/Ingestion Neurological Complications Osteomyelitis Instrument Breakage/Foreign Body Displacement Conclusions Chapter 3 Implant Surgery Introduction Pre-Operative Planning Patient Assessment Clinical Examination Virtual Surgical Planning Prosthodontic and Surgical Treatment Planning Intra-Operative Complications Nerve Injury Damage to Adjacent Teeth Implant Displacement and Migration Dental Implant Aspiration Dental Implant Ingestion Bleeding Air Embolism Mandible Fracture Post-Operative Complications Infection Peri-implantitis Implant Fracture Zygomatic Implant Complications Conclusions References Chapter 4 Technology and Navigation in Oral and Maxillofacial Surgery Introduction Data Acquisition Phase Complications Preoperative CT Not Taken Using Correct Parameters/Incorrect Postprocessing Inadequate/Incorrect Records Preoperative Planning Complications Complications from Errors Made During Preoperative Planning Phase Manufacturing Complications Inaccurately Manufactured 3D Materials Surgery Phase Complications Patient-Specific Cutting Guide or Splint Does Not Fit Patient-Specific Implant Does Not Fit Intra- and Postoperative Assessment Complications Intraoperative Imaging Complications Intraoperative CT Does Show Area of Interest Navigation Complications Position of Virtual Pointer on Monitor Does Not Reproduce the Position of Instrument on the Patient Dental Implants, Technology, and Associated Complications Unstable or Uncomfortable Fit of Patient Tracker Inaccurate Fit of Patient Tracker Line-of-Sight Between Cameras and Tracking Arrays Is Blocked Dislodgement of Restorations, Including Crowns, Bridge, or Fillings Dislodgement of Patient Tracker Implant or Osteotomy Is Poorly Positioned Direct Injury to Inferior Alveolar Nerve Injury to Adjacent Soft Tissues Poor Bone Quality at Implant Site Conclusions References Chapter 5 Maxillofacial Trauma Soft Tissue Injuries Animal Bites Parotid Duct Injury Peripheral Facial Nerve Injury Nasolacrimal Injury Ectropion Entropion Hard Tissue Injuries Mandibular Fractures (Symphysis, Body, Angle) Principles of Rigid Internal Fixation Teeth in the Line of Mandible Fractures Infection Malunion/Malocclusion Mandibular Angle Fractures Nonunion Atrophic Edentulous Mandibular Fractures Mandibular Widening Facial Asymmetry Mandibular Condyle Fractures Malunion/Malocclusion Facial Asymmetry Mandibular Hypomobility/Temporomandibular Joint Ankylosis Facial Nerve Injury with Approaches or Intraoral Approaches to the Mandible Trigeminal Nerve Injuries Frontal Sinus Fractures Principles of Frontal Sinus Management Infection/Sinusitis Complications of Sinusitis Frontal Osteomyelitis Cerebrospinal Fluid Leak Esthetic Deformity Orbital Fractures Orbital Blow-out/Blow-in Fractures Limitation of Extraocular Muscle Movements Enophthalmos Eyelid Malposition Cranio-orbital Fractures Orbitozygomaticomaxillary Complex Fractures Malar Flattening Neurosensory Complications Ocular Trauma Nasoorbitoethmoidal Fractures Telecanthus Nasolacrimal Duct Obstruction Cosmetic Deformity/Saddle Nose Deformity Nasal Fractures Septal Hematoma Epistaxis Cosmetic Deformities/Saddle Nose Deformity Nasal Airway Obstruction/Septal Deviation Scarring Maxillary Fractures Malocclusion Facial Widening Sinusitis Hemorrhage Temporal Bone Fractures Tracheostomy Conclusions Chapter 6 Orthognathic Surgery Preoperative Complications Diagnosis Motivation Medical Issues Airway Issues Orthodontic Preparation Dental Issues Intraoperative Complications Maxillary Surgery: Intraoperative Complications Dental Trauma Soft Tissue Issues Fixation Issues Maxillary Downfracture Maxillary Mobilization and Repositioning Hemorrhage Nerve Injury During Le Fort Osteotomy Airway Compromise Genioplasty Preoperative Phase Perioperative Phase Postoperative Phase Mandible: Intraoperative Complications Intraoral Vertical Ramus Osteotomy Sagittal Split Ramus Osteotomy Variations of Mandibular Osteotomies “Midline” Split of the Mandible Anterior Segmental Osteotomy Intraoperative Anesthesia-Related Issues Airway Complications Hypotensive Anesthesia Emergence from Anesthesia in the Operating/Recovery Room Postoperative Complications of Orthognathic Surgery (Figure 6.15) Short Term In the Recovery Room Bleeding Blindness First Week Postsurgery Malocclusions Pain Edema Nausea and Vomiting Psychological Neurological Nutrition Wound Healing First Month Hardware Failure Bleeding/Hemorrhage Nasal and Sinus Complications Hearing Devitalized Teeth Range of Motion Splints Transverse Issues Sequestrum Formation Hardware Neural Issues Orthodontic Issues Patient Satisfaction Snoring and Obstructive Sleep Apnea Long-Term Complications Stability Permanent Cranial Nerve Damage Cranial Nerve VII The Temporomandibular Joint: Internal Derangement of the TMJ and Idiopathic Condylar Resorption Pitfalls of Virtual Surgical Planning for Orthognathic Surgery Conclusions Chapter 7 Distraction Osteogenesis Introduction Preoperative Planning Phase Patient Selection Distraction Vector Planning Intraoperative Phase Neurological and Dental Injury Incomplete Osteotomy and Improper Device Placement Postoperative Phase Device Failure Inadequate Distraction Infection Inadequate Bony Regenerate Conclusions References Chapter 8 Obstructive Sleep Apnea Surgery Introduction Complications with Palatal Procedures Complications with Genioglossus Advancement and Hyoid Suspension Complications with Maxillomandibular Advancement Intraoperative Complications in Maxillomandibular Advancement Excessive Bleeding Bad Split Malocclusion Postoperative Complications in Maxillomandibular Advancement Early Medical Complications Infections Malocclusion Hardware Failure/Malunion/Nonunion Paresthesia and Dysesthesia Temporomandibular Joint Disorders Facial Aesthetic Changes Transoral Robotic Surgery Distraction Osteogenesis Hypoglossal Nerve Stimulation Conclusions Chapter 9 Cleft and Craniofacial Surgery Introduction Complications in Cleft Lip and Nose Repair Early Complications Late Complications Cutaneous Lip Problems Complications in Palatoplasty Procedures Palatoplasty Procedures and Outcome Differences Perioperative Complications of Cleft Palate Repair Management of Palatal Fistulas Operative Techniques for Closure of Palatal Fistulas Growth After Palatoplasty Management of Velopharyngeal Dysfunction Operative Techniques for Treatment of VPI Complications Related to Surgical Procedures for VPI Complications of Craniofacial Surgery Intraoperative Complications of Craniofacial Surgery Late Postoperative Complications of Craniofacial Surgery Chapter 10 Minimally Invasive Cosmetic Facial Surgery Introduction Complications of Neurotoxins Bruising and Swelling Injection Site Pain Brow, Eyelid Ptosis, Oral Incompetence Immune/Allergic Reactions, Systemic Absorption Complications of Injectable Fillers Inappropriate Placement of Filler, Early and Late Visible Irregularities Tissue Necrosis/Blindness Discoloration and Granuloma Formation Chemical Peels and Laser Skin Resurfacing Erythema and Pruritis Scars Hyperpigmentation or Hypopigmentation Infection Milia and Acne Eruption Conclusions Chapter 11 Cosmetic Facial Surgery Introduction Surgical Facial Cosmetic Procedures Blepharoplasty Edema, Ecchymosis, Conjunctival Irritation, and Corneal Abrasion Corneal Abrasion and Superficial Punctate Keratitis Ectropion, Entropion, Lid Shortening, Poor Lid Seal, and Ptosis Dry Eyes Acute Angle Glaucoma Retrobulbar Hematoma Blindness Infection Brow Lift Procedures Bleeding and Hematoma Formation Postoperative Pain Edema Neurosensory Disturbances Incisional Alopecia Facial Nerve Weakness Relapse of Brow Ptosis Facelift, Neck Lift, and Submental Liposuction Procedures Hematoma Facial Nerve Injury Superficial Epidermolysis Neurosensory Disturbances Contour Irregularities Pixie-Ear Deformity Facial Implant Procedures Infection Bone Resorption and Visible Implant Implant Mobility Neurosensory Disturbances Rhinoplasty Bleeding Infection Airway Obstruction Intracranial Communication Open Roof Deformity Saddle Nose Deformity Pollybeak Deformity Bossae and Unitip Deformity Rocker Deformity, “Inverted-V” Deformity, and “Keel” Deformity Conclusions References Chapter 12 Temporomandibular Joint Surgery Introduction Preoperative Complications Inappropriate Diagnosis and Treatment Intraoperative TMJ Surgery Complications Minimally Invasive TMJ Surgery and Arthroscopic Complications Minimally Invasive – Instrumentation Complications Minimally Invasive – Neurological Injuries Open TMJ Arthroplasty Procedures Postoperative Complications Malocclusion (Algorithm 12.4) Implant Failure Hypomobility and Ankylosis (Heterotopic Ossification) Conclusions References Chapter 13 Ablative Oral/Head and Neck Surgery Introduction Complications Related to Ablative Surgery for Malignant Tumors Predictive Factors Advanced Age Compromised Nutritional Status Medical Comorbidity Treatment-Related Factors Complications Treatment Failure Second Primary Disease Neurological Dysfunction Wound Infection Chylous Fistula Wound Dehiscence and Exposure of Reconstruction Bone Plates Complications Related to Ablative Surgery for Benign Tumors Predictive Factors Recurrence Nerve Injury References Chapter 14 Lip Cancer Introduction Diagnosis/Staging Complications Associated with Lip Reconstruction Wound Dehiscence Microstomia Neurological Injury Scarring and Poor Cosmetic Outcome Complications Related to Radiation Therapy Conclusions Chapter 15 Dermatopathology and Skin Cancer Introduction Management of Complications in the Acute Healing Stage Hematoma Infection Flap Failure Wound Dehiscence Tumor Recurrence Hyper/Hypopigmentation Surface Irregularities Hypertrophic Scars, Unaesthetic Scar, and Keloid Chapter 16 Hard Tissue Reconstruction Introduction Patient Factors in Complications Perioperative Comorbidity Nutritional Status Issues Intraoral Wound Dehiscence Nasogastric Tube Placement Complications Effects of Diabetes Mellitus and the Use of Corticosteroids Nicotine Effects Risks of Blood Transfusion Hard Tissue Graft Options and Considerations Autogenous Bone Sinus Bone Graft Failure Allografts and Xenografts Bone Morphogenetic Proteins Swelling Associated with Bone Morphogenetic Proteins Specific Donor Site Morbidity and Complications Intraoral Donor Sites Intraoral Donor Site Wound Dehiscence Iliac Crest Harvest Site Infection at Iliac Crest Harvest Site Calvarial Bone Grafts Violation of the Inner Cortical Plate Costochondral Grafts Pain and Atelectasis Violation of the Pleura Tibial Bone Grafts Persistent Exposed Segment of Nonviable Bone Graft Hardware in Hard Tissue Reconstruction Distraction Osteogenesis Distractor Hardware Failure Fixation Schemes Fixation Hardware Failure Conclusions References Chapter 17 Soft Tissue Reconstruction Introduction Total/Partial Flap Loss Infection Salivary Leak and Fistula Hematoma Formation Pedicled Soft Tissue Flaps Pectoralis Major Myocutaneous Flap Submental Island Flap Paramedian Forehead Flap Buccal Fat Pad Vascularized Soft Tissue Free Flaps Conclusions References Chapter 18 Vascularized Reconstruction Introduction Fasciocutaneous and Osteocutaneous Radial Forearm Flap Hand Ischemia Radius Fracture Sensory/Motor Deficit Donor Site Skin Graft Failure Osteocutaneous Fibula Flap Foot Ischemia/Vascular Compromise Gait Disturbance Limited Great Toe Flexion Neurological Injuries Delayed Wound Healing Skin Paddle Loss Osteocutaneous Scapula Flap Shoulder Dysfunction Scapula Winging Osseous Iliac Crest Flap Ventral Hernias Contour Deformity Neurological Sequelae Ambulation/Gait Disturbance Flap Failure Surgical Management Leech Therapy Pharmacological Salvage Radiological Evaluation Conclusions References Chapter 19 Head and Neck Radiotherapy Introduction Complications Xerostomia Trismus Dysphagia Osteonecrosis of the Mandible and Maxilla Soft Tissue Necrosis and Chondral Necrosis Conclusions References Chapter 20 Microneurosurgery Introduction Lack of Functional Sensory Recovery After Nerve Repair Poor Patient Selection Difficult Surgical Access with Inability to Localize Nerve Stumps Iatrogenic Nerve Injury to the LN or IAN Inadequate Neuroma Resection Tension on Nerve Repair Site Fascicular Malalignment Poor Vascularity of Soft Tissue Bed Trismus After Nerve Repair Self-Induced Injury After Nerve Repair Iatrogenic Injury to Nerve(s) No Nerve Injury Identified Pathological Mandible Fracture Malocclusion and Temporomandibular Joint Issues Nerve Graft Complications Neuropathic Pain Development IAN Reconstruction in Ablative Mandibular Resection Miscellaneous Complications Conclusions Suggested Reading Chapter 21 Transoral Robotic Surgery Introduction Sequelae and Complications: Pain Sequelae and Complications: Dysphagia Sequelae and Complications: Airway Edema Sequelae and Complications: Bleeding Sequelae and Complications: Iatrogenic Oral–Cervical Communication and Pharyngocutaneous Fistula Formation Sequelae and Complications: Aspiration Pneumonia Sequelae and Complications: Nerve Injury Sequelae and Complications: Others Trismus and Neck Spasm Cervical Spondylodiscitis Iatrogenic Dental, Corneal, and Soft Tissue Injury Airway Fire TORS “Failure to Cure”: Conversion to Open Approach or Abandon TORS Procedure TORS “Failure to Cure”: Inadequate Surgical Margin Conclusions References Chapter 23 Salivary Gland Surgery Introduction Benign Conditions and Pathology Major Salivary Gland Surgery Complications Conclusions References Index EULA