Professional Documents
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Maxillofacial region
Bag./SMF Bedah
FK UNPAD/RSHS Bandung
Learning objectives :
At the end of the lecture, you will be able to:
Learning objectives :
Introduction
Anatomic
considerations
Anatomic location:
Maxillofacial bones: sinuses, osteomyelitis (rare),
dento-alveolar infection
Soft tissue: oral mucosa, potential spaces, salivary
glands, tonsils, lymph-nodes
Anatomic considerations:
lymphnode
Diagnostic approach
History:
Lump, swelling, pain, fever, bleeding?, halitosis.
Life threatening signs: stridor, tachypneu (signs of
airway obstruction)
Onset? Duration?
Physical Diagnosis:
Determine the nature of the swelling or lump: size,
Diagnostic approach
Oral cavity examination:
Special investigations:
Routine blood examinations
X-rays: Skull, waters, panoramic, CT-scan
MRI
Lymphadenitis
organ infections,
Lymphadenitis
Management:
Look for any primary causes
For non specific infection: antibiotics is adequate
If no, improvement: Biopsy is required to
Sinusitis
can occur in :
maxillary, ethmoid, para nasal, and frontal sinuses
Etiology:
secondary to allergies, viruses, or bacteria.
patients who undergo prolonged nasal intubation.
Fungal infection (less frequent: diabetic, or
immuno-compromised patients)
Sinusitis
Diagnosis:
Routine radiographs
CT scans are often required: sinus opacification
Treatment:
Uncomplicated: antibiotics
Aspiration and drainage
Chronic infection: Cadwell luc operation
Peri-tonsilar abscess
Pathology:
Infection is deep to the tonsillar capsule: forms between the
Manifestations:
Massive edema of the entire soft palate
edema of the lateral pharyngeal wall.
inflammation of the pterygoid muscles can result in trismus.
may be so large that the airway is compromised.
Peri-tonsilar abscess
Management:
Tracheostomy may be necessary before it is safe
Parapharyngeal
abscess
Parapharyngeal
abscess
Management:
Retro-pharyngeal
abscess
are unusual
most often are seen in patients with poor
dental care.
Acute inflammation may be seen when the
salivary duct is obstructed, as with a stone:
usually self-limited and controlled with
antibiotics and removal of the stone.
When unresponsive to antibiotics: excision of
the necrotic gland may be necessary.
Parotitis
can occur in :
The comunitiy (community acquired)
surgical patients, particularly elderly,
dehydrated patients.