Management of Complications in Oral and Maxillofacial Surgery: Miloro/Management of Complications in Oral and Maxillofacial Surgery

Management of Complications in Oral and Maxillofacial Surgery is a comprehensive reference that covers the minor and major complications which may occur in all facets of oral maxillofacial surgery. Each chapter covers the potential complications encountered during the routine practice of oral and maxillofacial surgery, from the most commonly encountered complications, to those less frequent and more complex with which every competent oral and maxillofacial surgeon should be familiar. Drs. Miloro and Kolokythas address possible complications in every aspect of OMS, including anesthesia, third molar surgery, implant surgery, maxillofacial trauma, orthognathic surgery, temporomandibular joint surgery, cleft lip and palate surgery, head and neck oncologic surgery, soft and hard tissue reconstruction, free tissue transfer, and cosmetic facial surgery. The contributors to this textbook, recognized experts in their specific topic due to their surgical experience and expertise, focus on the prompt recognition of each complication, and consider preventative measures as well as precise management strategies considering the already compromised clinical circumstances. Content: Chapter 1 Ambulatory Anesthesia (pages 2–24): Vasiliki Karlis, Lauren Bourell and Robert Glickman Chapter 2 Third Molar Surgery (pages 25–40): Thomas Schlieve, Antonia Kolokythas and Michael Miloro Chapter 3 Implant Surgery (pages 41–53): Pamela J. Hughes Chapter 4 Maxillofacial Trauma (pages 55–107): R. Bryan Bell, Michael R. Markiewicz and Savannah Gelesko Chapter 5 Orthognathic Surgery (pages 109–136): Stephanie J. Drew Chapter 6 Distraction Osteogenesis (pages 137–147): Maria J. Troulis, Alexander Katsnelson, Carl Bouchard, Bonnie L. Padwa and Leonard B. Kaban Chapter 7 Obstructive Sleep Apnea (pages 149–174): Peter D. Waite and Kenneth C. Guffey Chapter 8 Cleft and Craniofacial Surgery (pages 175–201): Bernard J. Costello, John F. Caccamese and Ramon L. Ruiz Chapter 9 Cosmetic Surgery (pages 203–232): Jon D. Perenack and Vernon P. Burke Chapter 10 Temporomandibular Joint Surgery (pages 233–246): Helen E. Giannakopoulos and David C. Stanton Chapter 11 Ablative Oral/Head and Neck Surgery (pages 247–266): Eric R. Carlson and Daniel Oreadi Chapter 12 Lip Cancer (pages 267–282): Cole Anderson and Jonathan S. Bailey Chapter 13 Hard Tissue Reconstruction (pages 283–316): Miller Smith, Fayette Williams and Brent B. Ward Chapter 14 Soft Tissue Reconstruction (pages 317–333): Dongsoo David Kim and Daniel Petrisor Chapter 15 Microvascular Composite Bone Flaps (pages 335–345): Rui Fernandes and Phil Pirgousis Title Page ......Page 2 Contents......Page 5 Contributors......Page 6 Preface......Page 11 INTRODUCTION......Page 13 Patient Characteristics/Selection......Page 14 Patient Screening......Page 16 Pulse Oximetry......Page 18 Personnel Preparedness......Page 19 Postoperative Monitoring......Page 20 Oversedation......Page 21 Respiratory Depression and Respiratory Arrest......Page 23 Laryngospasm, Bronchospasm, and Acute Asthma......Page 24 Preoperative Fasting Period NPO Guidelines......Page 25 Cardiac Arrhythmias......Page 26 Hypertension and Hypotension......Page 27 Hypoglycemia......Page 28 PSYCHIATRIC AND EMOTIONAL COMPLICATIONS......Page 29 ANESTHETIC COMPLICATIONS IN PEDIATRIC PATIENTS......Page 30 Pediatric Respiratory Complications......Page 31 PREVENTION AND MANAGEMENT OF PEDIATRIC ANESTHETIC COMPLICATIONS......Page 32 SUGGESTED READINGS......Page 33 ALVEOLAR OSTEITIS......Page 35 INFECTION......Page 36 BLEEDING/HEMORRHAGE......Page 37 MANDIBULAR FRACTURE......Page 38 ORAL-ANTRAL COMMUNICATION......Page 39 INJURY TO ADJACENT TEETH/WRONG TOOTH EXTRACTION......Page 41 INJURY TO ADJACENT OSSEOUS STRUCTURES......Page 42 DISPLACEMENT OF TEETH......Page 43 NEUROLOGIC COMPLICATIONS......Page 45 OSTEOMYELITIS......Page 47 SUGGESTED READINGS......Page 48 Patient Assessment......Page 51 Clinical Assessment of the Patient......Page 52 Prosthodontic and Surgical Treatment Planning......Page 53 INTRAOPERATIVE COMPLICATIONS......Page 55 Early Postoperative Complications......Page 58 Sinusitis......Page 59 Mandible Fracture......Page 60 Peri-implant Disease......Page 61 SUGGESTED READINGS......Page 62 Animal Bites......Page 64 Feline Bites......Page 65 Parotid Duct Injury......Page 66 Peripheral Facial Nerve Injury......Page 68 Nasolacrimal Injury......Page 69 Lateral Ectropion......Page 71 Entropion......Page 72 Teeth in the Line of Fracture......Page 74 Mandibular Symphysis, Parasymphysis, and Body Fractures......Page 75 Mandibular Angle Fractures......Page 77 Nonunion......Page 78 Atrophic Edentulous Mandibular Fractures......Page 79 Facial Asymmetry......Page 80 Mandibular Condyle Fractures......Page 81 Mandibular Hypomobility/Temporomandibular Joint Ankylosis......Page 82 FRONTAL SINUS FRACTURES......Page 85 Infection/Sinusitis......Page 86 Mucocele and Mucopyocele......Page 87 Orbital Complications......Page 88 Meningitis......Page 89 Cavernous Sinus Thrombosis......Page 90 Cerebrospinal Fluid Leak......Page 91 Limitation of Extraocular Muscle Movements......Page 93 Enophthalmos......Page 94 Eyelid Malposition......Page 96 ORBITO-ZYGOMATICOMAXILLARY COMPLEX FRACTURES......Page 98 Malar Flattening......Page 100 Neurosensory Complications......Page 101 NASO-ORBITAL-ETHMOIDAL FRACTURES......Page 102 Nasolacrimal Duct Obstruction......Page 103 Nasal Airway Obstruction/Septal Deviation......Page 104 Nasal Scarring......Page 105 MAXILLARY FRACTURES......Page 106 Malocclusion......Page 107 Hemorrhage......Page 108 TRACHEOSTOMY COMPLICATIONS......Page 109 SUGGESTED READINGS......Page 111 Diagnosis......Page 117 Medical Issues......Page 118 Dental Issues......Page 119 MAXILLARY SURGERY: INTRAOPERATIVE COMPLICATIONS......Page 120 Fixation Issues......Page 121 The Downfracture......Page 123 Maxillary Mobilization and Positioning......Page 124 Nerve Injury During Le Fort Osteotomy......Page 125 Perioperative......Page 126 Postoperative......Page 127 SAGITTAL SPLIT RAMUS OSTEOTOMY......Page 128 Short-Term Complications......Page 132 Nausea......Page 133 Hardware Failure......Page 134 Splints......Page 135 Orthodontic Issues......Page 136 TMJ Issues......Page 138 Permanent Cranial Nerve Damage......Page 137 Patient Selection......Page 145 Distraction Vector Planning......Page 146 Incomplete Osteotomy and Improper Device Placement......Page 147 Device Failure......Page 150 Inadequate Distraction......Page 151 Infection......Page 152 CONCLUSIONS......Page 153 SUGGESTED READINGS......Page 154 INTRODUCTION......Page 156 Medical History Considerations......Page 157 Preoperative CPAP......Page 158 Airway Management......Page 159 Additional Considerations......Page 160 Nasal Cavity......Page 161 Tonsillectomy......Page 162 Palatal Procedures......Page 163 Genioglossus Advancement......Page 164 Maxillomandibular Advancement......Page 167 Distraction Osteogenesis......Page 176 Pain Management and Sedatives......Page 177 Maintaining Adequate Oxygenation......Page 178 SUGGESTED READINGS......Page 179 Early Complications......Page 182 Late Complications......Page 183 Long Upper Lip......Page 184 Philtrum Abnormalities......Page 185 Nostril Stenosis......Page 186 Nasal Asymmetry......Page 187 COMPLICATIONS IN PALATOPLASTY PROCEDURES......Page 188 Palatoplasty Procedures and Outcome Differences......Page 189 Management of Palatal Fistulas......Page 192 Operative Techniques for Closure of Palatal Fistulas......Page 193 Growth After Palatoplasty......Page 194 Management of Velopharyngeal Dysfunction......Page 195 Operative Techniques for Treatment of VPI......Page 196 Intraoperative Complications of Craniofacial Surgery......Page 199 Late Postoperative Complications of Craniofacial Surgery......Page 201 SUGGESTED READINGS......Page 204 Botulinum Toxin......Page 209 Upper Lid Ptosis......Page 210 Injectable Soft Tissue Volumizers and Fillers......Page 211 Injection Hematoma......Page 212 Filler Agent Allergic Reaction and Granuloma Formation......Page 215 Nonablative and Ablative Cosmetic Skin Therapy Complications......Page 216 Herpetic Infection......Page 218 Persistent Erythema......Page 219 Persistent Erythema and Scarring......Page 220 Blepharoplasty......Page 221 Ectropion, Entropion, Lid Shortening, Poor Lid Seal, and Ptosis......Page 222 Dry Eyes Keratoconjunctivitis Sicca......Page 223 Forehead and Brow Procedures......Page 224 Lower Facial Procedures Rhytidectomy, Neck Lift, Liposculpture......Page 225 Bone Resorption and Exposed Implant......Page 230 Rhinoplasty......Page 231 SUGGESTED READINGS......Page 236 VASCULAR INJURY......Page 239 NERVE INJURY......Page 241 OTOLOGIC COMPLICATIONS......Page 244 ALLERGIC REACTIONS......Page 245 Extravasation of Irrigating Fluid......Page 246 Ankylosis......Page 247 Chronic Pain in the Multiply-Operated Patient......Page 249 SUGGESTED READINGS......Page 250 Advanced Age......Page 253 Medical Comorbidity......Page 254 Failure to Cure......Page 255 Local Recurrence......Page 256 Regional Recurrence......Page 257 Distant Metastatic Disease......Page 259 Second Primary Disease......Page 260 Facial Nerve......Page 261 Phrenic Nerve......Page 262 Wound Infection......Page 263 Chylous Fistula......Page 264 Wound Dehiscence, Reconstruction Plate Exposure......Page 265 Odontogenic Tumors......Page 267 Parotid Tumors......Page 268 Motor Nerve Injury......Page 269 SUGGESTED READINGS......Page 270 DIAGNOSIS/STAGING......Page 273 Wound Dehiscence......Page 277 Microstomia......Page 283 Scarring and Poor Cosmetic Outcome......Page 285 COMPLICATIONS RELATED TO RADIATION THERAPY......Page 286 SUGGESTED READINGS......Page 287 Preoperative Comorbidity......Page 289 Nutritional Status Issues......Page 290 Autogenous Bone Grafts......Page 291 Risks of Allografts and Xenografts......Page 292 Intraoral Donor Sites......Page 293 Calvarial Bone Grafts......Page 294 Costochondral Grafts......Page 295 Fibula Myoossesous Cutaneous Flap......Page 297 Deep Circumflex Iliac Artery Myoosseous Cutaneous Flap......Page 299 Distraction Osteogenesis......Page 300 Hyperbaric Oxygen......Page 301 Fixation Schemes......Page 302 Bone Necrosis and Infection......Page 303 Anterior Mandibular Defects......Page 304 COMPUTER-ASSISTED SURGERY......Page 305 Digital Imaging and Communications in Medicine......Page 307 Tactile Rapid-Prototyped Models......Page 308 Navigation and Intraoperative Imaging......Page 310 SUGGESTED READINGS......Page 311 Pectoralis Major Myocutaneous Flap......Page 323 Paramedian Forehead Flap......Page 325 COMPLICATIONS IN MICROVASCULAR FREE FLAPS......Page 326 Flap Salvage......Page 329 Radial Forearm Free Flap......Page 330 Rectus Abdominus Myocutaneous Flap......Page 331 Total/Partial Flap Loss......Page 333 Infection......Page 335 Hematoma Formation......Page 336 SUGGESTED READINGS......Page 338 Hand Ischemia......Page 340 Donor Site Skin Graft Failure......Page 341 OSTEOCUTANEOUS FIBULA FLAP......Page 342 Skin Paddle Loss......Page 343 SCAPULA FREE FLAP......Page 344 ILIAC CREST FREE FLAP......Page 345 Management of the Failing Flap......Page 346 Radiologic Evaluation......Page 347 SUGGESTED READINGS......Page 348 Index......Page 351 __Management of Complications in Oral and Maxillofacial Surgery__ is a comprehensive reference that covers the minor and major complications which may occur in all facets of oral maxillofacial surgery. Each chapter covers the potential complications encountered during the routine practice of oral and maxillofacial surgery, from the most commonly encountered complications, to those less frequent and more complex with which every competent oral and maxillofacial surgeon should be familiar. Drs. Miloro and Kolokythas address possible complications in every aspect of OMS, including anesthesia, third molar surgery, implant surgery, maxillofacial trauma, orthognathic surgery, temporomandibular joint surgery, cleft lip and palate surgery, head and neck oncologic surgery, soft and hard tissue reconstruction, free tissue transfer, and cosmetic facial surgery. The contributors to this textbook, recognized experts in their specific topic due to their surgical experience and expertise, focus on the prompt recognition of each complication, and consider preventative measures as well as precise management strategies considering the already compromised clinical circumstances. Content: Chapter 1 Ambulatory Anesthesia (pages 2–24): Vasiliki Karlis, Lauren Bourell and Robert GlickmanChapter 2 Third Molar Surgery (pages 25–40): Thomas Schlieve, Antonia Kolokythas and Michael MiloroChapter 3 Implant Surgery (pages 41–53): Pamela J. HughesChapter 4 Maxillofacial Trauma (pages 55–107): R. Bryan Bell, Michael R. Markiewicz and Savannah GeleskoChapter 5 Orthognathic Surgery (pages 109–136): Stephanie J. DrewChapter 6 Distraction Osteogenesis (pages 137–147): Maria J. Troulis, Alexander Katsnelson, Carl Bouchard, Bonnie L. Padwa and Leonard B. KabanChapter 7 Obstructive Sleep Apnea (pages 149–174): Peter D. Waite and Kenneth C. GuffeyChapter 8 Cleft and Craniofacial Surgery (pages 175–201): Bernard J. Costello, John F. Caccamese and Ramon L. RuizChapter 9 Cosmetic Surgery (pages 203–232): Jon D. Perenack and Vernon P. BurkeChapter 10 Temporomandibular Joint Surgery (pages 233–246): Helen E. Giannakopoulos and David C. StantonChapter 11 Ablative Oral/Head and Neck Surgery (pages 247–266): Eric R. Carlson and Daniel OreadiChapter 12 Lip Cancer (pages 267–282): Cole Anderson and Jonathan S. BaileyChapter 13 Hard Tissue Reconstruction (pages 283–316): Miller Smith, Fayette Williams and Brent B. WardChapter 14 Soft Tissue Reconstruction (pages 317–333): Dongsoo David Kim and Daniel PetrisorChapter 15 Microvascular Composite Bone Flaps (pages 335–345): Rui Fernandes and Phil Pirgousis Ambulatory Anesthesia -- Third Molar Surgery -- Implant Surgery -- Maxillofacial Trauma -- Orthognathic Surgery -- Distraction Osteogenesis -- Obstructive Sleep Apnea -- Cleft Craniofacial Surgery -- Cosmetic Surgery -- Temporomandibular Joint Surgery -- Ablative Oral/head And Neck Surgery -- Lip Cancer -- Hard Tissue Reconstruction -- Soft Tissue Reconstruction -- Microvascular Composite Bone Flaps. Editors, Michael Miloro, Antonia Kolokythas. Includes Bibliographical References And Index. Ambulatory anesthesia Third molar surgery Implant surgery Maxillofacial trauma Orthognathic surgery Distraction osteogenesis Obstructive sleep apnea Cleft craniofacial surgery Cosmetic surgery TMJ surgery Pathology resection Facial skip path lip cancer Hard tissue reconstruction Soft tissue reconstruction Free tissue transfer surgery.