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The Glasgow Coma Scale measures Disability according to three categories: Best Motor Response, Best Verbal Response, and Eye Opening.
Maxillofacial injuries can be divided into injuries to the soft tissue and injuries to the skeleton underneath.
Soft tissue injuries can be categorized into abrasions, lacerations, and tissue loss.
Bone healing involves four stages: 1) Blood clot and haematoma formation, 2) Fibrocartilage callus formation, 3) Bony callus formation, and 4) Remodelling.
A malunion is the healing of a bone in a nonanatomic position, meaning the bones have healed together incorrectly.
A non-union refers to the failure or delay in the healing of a bone.
An avital non-union is a failure or delay in bone healing due to the presence of foreign material.
The Caldwell-Luc approach has several advantages: 1) It is a trapdoor approach, 2) Provides good access, 3) Preserves alveolar bone, and 4) It is the method of choice for delayed procedures.
The cons of the Caldwell-Luc approach include: 1) Trauma and loss of vitality to adjacent teeth, 2) Fistula formation, 3) Epistaxis, and 4) Infra-orbital nerve damage leading to neuralgia or paraesthesia.
FESS stands for Functional Endoscopic Sinus Surgery, which is often performed by ENT surgeons as a conservative approach.
The FESS approach involves accessing the maxillary sinus via an enlarged middle meatus antrosotomy, using an endoscope to guide the instrument.
The pros of FESS include its minimally invasive nature, while the cons may include complications such as bleeding, infection, and damage to surrounding structures.
The transalveolar approach can be performed in two ways: Method 1 involves filling the sinus with saline and using suction to retrieve the root, while Method 2 involves creating a buccal flap, removing bone, and retrieving the object.
The classic presentation includes nasal deformity, traumatic telecanthus, bilateral 'panda eyes', epistaxis, epiphora, and CSF leaks.
The pathologist provides frozen section diagnosis to determine the completeness of excision, allowing for immediate assessment of tissue samples.
An incisional biopsy can confirm a diagnosis, assess the depth of invasion, determine the pattern of invasion, and evaluate the degree of differentiation of the cancer.
Grading measures the degree to which a tumor differs from the cell of origin, based on the appearance of cancer cells and their resemblance to normal epithelium.
The advantages include a good success rate, low morbidity, and a good blood supply.
A disadvantage is the decrease in vestibular sulcus depth, which can affect patients who wear dentures.
A full thickness mucoperiosteal buccal flap is raised, a periosteal release is performed, the fistula is excised, and Bio-Oss or Bio-Guide is placed to promote healing.
Signs and symptoms of an OAC include purulent discharge, bad taste, liquid regurgitation through the nose, and air escape in both directions.
Management includes promoting spontaneous healing, gentle irrigation and debridement, using Surgicel, suturing loose ends, an antral regime, and review.
The management for an OAC greater than 4mm typically involves surgical repair.
Common early side effects include nausea, lethargy, skin redness and blistering, mucositis, dry mouth, hair loss, and sore swallowing.
Late side effects develop months to years after treatment, are very rare, and are often irreversible and severe.