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x CONTRIBUTORS
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David L. Hirsch, DDS, MD, FACS
Clinical Assistant Professor Department of Oral and Maxillofacial Surgery College of Dentistry New York University New York, New York
Jason A. Jamali, DDS, MD
Assistant Professor Department of Oral and Maxillofacial Surgery College of Dentistry University of Illinois at Chicago Chicago, Illinois
Michael Jaskolka, DDS, MD
Cleft and Craniomaxillofacial Surgery New Hanover Regional Medical Center Wilmington, North Carolina Adjunct Assistant Professor Department of Oral and Maxillofacial Surgery University of North Carolina Hospitals Chapel Hill, North Carolina
Tong Ji, DDS, MD, PhD
Professor Oral Maxillofacial Surgery-Head and Neck Oncology Shanghai Jiao Tong University Shanghai, China
Amber Johnson, DO, DMD
Resident Department of Oral and Maxillofacial Surgery School of Dentistry Virginia Commonwealth University Richmond, Virginia
Lewis Jones, DMD, MD
Assistant Professor Department of Oral and Maxillofacial Surgery University of Louisville School of Dentistry Louisville, Kentucky
Alia Koch, DDS, MD
Assistant Professor Department of Oral and Maxillofacial Surgery College of Dental Medicine Columbia University New York, New York Attending, Oral and Maxillofacial Surgery New York Presbyterian Hospital Columbia University Medical Center New York, New York
Deepak G. Krishnan, DDS
Assistant Professor of Surgery Residency Program Director Division of Oral Maxillofacial Surgery School of Medicine University of Cincinnati Cincinnati, Ohio
Din Lam, DMD, MD
Private Practice Charlotte, North Carolina
Robert C. Lampert, DMD
Resident Department of Oral and Maxillofacial Surgery School of Dental Medicine Rutgers, The State University of New Jersey Newark, New Jersey
Regina Landesberg, DMD, PhD
Associate Professor Division of Oral and Maxillofacial Surgery School of Dental Medicine University of Connecticut Farmington, Connecticut
Stuart Lieblich, DMD
Clinical Professor Department of Oral and Maxillofacial Surgery University of Connecticut Farmington, Connecticut Private Practice - Avon Oral and Maxillofacial
Surgery Avon, Connecticut
Sapna Lohiya, DDS
Resident Department of Oral and Maxillofacial Surgery School of Dentistry University of Washington Seattle, Washington
David W. Lui, DMD, MD
Private Practice - Yardley Oral Surgery Yardley, Pennsylvania
Renato Mazzonetto, DDS, PhD
Associate Professor Department of Oral and Maxillofacial Surgery Piracicaba Dental School University of Campinas Piracicaba, São Paulo, Brazil
Daniel J. Meara, MS, DMD, MD, FACS
Chair, Department of Oral and Maxillofacial Surgery
and Hospital Dentistry Director, Research and Simulation Training, Oral
and Maxillofacial Surgery Christiana Care Health System Wilmington, Delaware
Andrew T. Meram, DDS, MD
Chief Resident Department of Oral and Maxillofacial Surgery/Head
and Neck Surgery Louisiana State University Health Sciences
Center – Shreveport Shreveport, Louisiana
CONTRIBUTORS xi
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Roman G. Meyliker, DMD
Private Practice - Shore Oral and Maxillofacial
Surgery
Galloway, New Jersey
Naveen Mohan, DDS
Resident Department of Oral and Maxillofacial Surgery The Brooklyn Hospital Center Brooklyn, New York
Sarah Naghibi, DMD
Resident Department of Oral and Maxillofacial Surgery School of Dental Medicine Case Western Reserve University Cleveland, Ohio
Gregory M. Ness, DDS
D.P. Snyder Professor of Oral Surgery Division of Oral and Maxillofacial Surgery and
Anesthesiology College of Dentistry The Ohio State University Columbus, Ohio
Joe Niamtu, III, DMD, FAACS
Private Practice - Cosmetic Facial Surgery
Richmond Richmond, Virginia
Emery Nicholas, DMD
Resident Department of Oral and Maxillofacial Surgery New York-Presbyterian Hospital/Weill Cornell
Medical Center New York, New York
George Obeid, DDS
Chairman and Director of the Residency Training
Program Department of Oral and Maxillofacial Surgery Medstar Washington Hospital Center Washington, DC
Mark A. Oghalai, DDS
Private Practice - Bailey, Peoples and Oghalai: Oral
Maxillofacial Surgery Winston-Salem, North Carolina
Esther S. Oh, DDS, MD
Clinical Assistant Professor Department of Oral and Maxillofacial Surgery College of Dentistry University of Florida Gainesville, Florida
HuiShan Ong, BDS, MD
Department of Oral Maxillofacial-Head and Neck
Oncology Shanghai Ninth People’s Hospital Shanghai Jiao Tong University Shanghai, China
Zachary S. Peacock, DMD, MD, FACS
Assistant Professor Department of Oral and Maxillofacial Surgery Massachusetts General Hospital and Harvard
School of Dental Medicine Boston, Massachusetts
Vincent J. Perciaccante, DDS
Adjunct Associate Professor of Surgery Division of Oral and Maxillofacial Surgery Department of Surgery School of Medicine Emory University Atlanta, Georgia Private Practice - SouthOMS Fayetteville and Peachtree City, Georgia
Faisal A. Quereshy, MD, DDS, FACS
Associate Professor and Residency Program
Director Department of Oral and Maxillofacial Surgery School of Dental Medicine Case Western Reserve University Cleveland, Ohio
Bashar Rajab, DDS, MD
Head of Oral and Maxillofacial Surgery Department Al-Adan Medical Center, Kuwait Kuwait City, Kuwait
Sonali A. Rathore, BDS, MS
Assistant Professor Department of Oral Diagnostic Sciences School of Dentistry Virginia Commonwealth University Richmond, Virginia
Noah Sandler, DMD, MD
Private Practice - Midwest Oral & Maxillofacial
Surgery, PA Savage, Minnesota
Samir Singh, DMD
Chief Resident Department of Oral and Maxillofacial Surgery School of Dentistry Virginia Commonwealth University Richmond, Virginia
xii CONTRIBUTORS
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Christos A. Skouteris, DMD, PhD
Clinical Assistant Professor Department of Surgery School of Medicine Clinical Assistant Professor and Predoctoral
Clinic Director Department of Oral and Maxillofacial Surgery School of Dentistry University of Michigan Ann Arbor, Michigan
Osama Soliman, DMD
Private Practice Toronto, Ontario, Canada
Daniel B. Spagnoli, DDS, PhD
Private Practice – Brunswick Oral and Maxillofacial
Surgery Southport, North Carolina Chairman (retired) Department of Oral and Maxillofacial Surgery School of Dentistry Louisiana State University New Orleans, Louisiana
Robert A. Strauss, DDS, MD
Professor and Director Residency Training Program Department of Oral and Maxillofacial Surgery School of Dentistry Virginia Commonwealth University Richmond, Virginia
David Webb, DDS
Attending Surgeon Department of Oral Maxillofacial/Head and Neck
Surgery David Grant Medical Center Travis Air Force Base Fairfield, California
John Wessel, DMD, MD
Fellow Carolinas Center for Oral and Facial Surgery Charlotte, North Carolina
Graham H. Wilson, DDS
Chief Resident Department of Oral and Maxillofacial Surgery School of Dentistry Virginia Commonwealth University Richmond, Virginia
Jennifer E. Woerner, DMD, MD
Assistant Professor Fellowship Director of Craniofacial and Cleft
Surgery Department of Oral and Maxillofacial Surgery Louisiana State University Health Sciences
Center-Shreveport Shreveport, Louisiana
Andrew Yampolsky, DDS, MD
Resident Department of Oral and Maxillofacial Surgery School of Dental Medicine Rutgers, The State University of New Jersey Newark, New Jersey
Melvyn S. Yeoh, DMD, MD
Assistant Professor Department of Oral and Maxillofacial Surgery/Head
and Neck Surgery
Louisiana State University Health Sciences
Center – Shreveport
Shreveport, Louisiana
Jacob Yetzer, DDS, MD
Consultant Mayo Clinic Rochester, Minnesota
Yedeh Ying, DMD, MD
Resident Massachusetts General Hospital Boston, Massachusetts
Joseph Zeidan, DMD
Resident Department of Oral and Maxillofacial Surgery The Brooklyn Hospital Center Brooklyn, New York
Chen Ping Zhang, DDS, MD, PhD
Professor Department of Oral Maxillofacial-Head Neck
Oncology Faculty of Oral and Maxillofacial Surgery Ninth People’s Hospital Shanghai Jiao Tong University School of Medicine Shanghai Key Laboratory of Stomatology Shanghai, China
Vincent B. Ziccardi, DDS, MD, FACS
Professor, Chair, and Residency Director Department of Oral and Maxillofacial Surgery School of Dental Medicine Rutgers, The State University of New Jersey Newark, New Jersey
PREFACE
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It has been almost eight years since the publication of the last edition, and in a rapidly expanding specialty such as oral and maxillofacial surgery, that is a long time. The third edition of Oral and Maxillofacial Surgery Secrets contains a large number of new chapters, so the readers (including dental students, oral and maxillofacial residents, and clinicians) will find the entire breadth of knowledge relevant and abundant. Also, because the new chapters cover the expanded scope of the specialty, fellows, and those who are preparing for fellowship, will have in this edition a readily available reference. Once again, in keeping with the style of the last edition, and still believing that the best way to teach is to question, this book uses this effective teaching approach to help guide students, residents, and clinicians in acquiring and retaining the significant knowledge in the field.
As with the previous two editions, this edition is intended not only to answer questions residents and student are being asked, but also to provide a quick source of knowledge that an oral and maxillofacial surgery clinician, resident, or dental student needs to take better care of patient problems, whether they be local or systemic in nature. We have also tried, as much as possible, to include only factual information rather than opinion and to have adequate but brief answers to the questions, recognizing that in some instances these goals are not all achievable. With the help of our contributors, we have updated the contents of the previous edition, covered new topics that were not previously covered, and in many instances, combined updated contents and added entirely new questions and answers. Notably, a number of entirely new chapters cover completely new topics. It should be noted that some of the changes in this edition were based on feedback the senior editor of this edition has received in person and in writing from readers of the previous editions, and for that we sincerely thank our readers. Finally, we would like to mention that we recognize that with the continuous expansion of the field, some areas may still not be fully covered. This emphasizes the fact that no one book (including this one) can be the only source of all the knowledge and all the information that a good practitioner needs to know. We do hope this new and updated edition can continue to be the fastest, most concise, and to-the-point way of finding the answers to most questions that students, residents, and clinicians find themselves in need of on a daily basis.
A. Omar Abubaker
Din Lam
Kenneth J. Benson
xiii
ABOUT THE THIRD EDITION
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NEW TO THIS EDITION
FiFteen Chapters
Chapter 9: Anesthesia for Difficult Patients Chapter 13: Introduction to Mechanical Ventilation and ICU Care Chapter 24: Wound Healing Chapter 29: Diagnosis and Management of Dentoalveolar Injuries Chapter 35: Craniofacial Syndromes Chapter 36: Oromandibular Dysostosis Chapter 40: Distraction Osteogenesis Chapter 45: Cancer of the Oral Cavity Chapter 47: Vascular Anomalies Chapter 48: Osteoradionecrosis/Osteonecrosis of the Jaws Chapter 49: Neck Mass Chapter 50: Bone Grafting to Facilitate Dental Implant Placement Chapter 51: Local and Regional Flaps Chapter 52: Reconstruction of the Facial Subunits Chapter 53: Microvascular Surgery
Chapters Dealing with CosmetiC surgery
Chapter 54: Evaluation of the Aging Face Chapter 55: Cosmetic Blepharoplasty Chapter 56: Rhytidectomy Chapter 57: Rhinoplasty Chapter 58: Minimal-Invasive Cosmetic Procedures
KEY FEATURES
• Core knowledge is presented in the popular and trusted Secrets® question-and-answer format.
• Over 2,300 questions and answers provide valuable pearls, tips, memory aids, and secrets from
experts in the field.
• Chapters are written by internationally recognized experts in the field, making this an authoritative
resource for the safe and effective practice of OMS.
xiv
CONTENTS
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I PatIent evaluatIon
CHAPTER 1 ARE YOU READY FOR YOUR SURGERY ROTATION? 11
CHAPTER 2 PREOPERATIVE EVALUATION 15
CHAPTER 3 ELECTROCARDIOGRAM 27
CHAPTER 4 LABORATORY TESTS 45
CHAPTER 5 DIAGNOSTIC IMAGING FOR THE ORAL AND MAXILLOFACIAL
II anesthesIa
CHAPTER 6 LOCAL ANESTHETICS 77
CHAPTER 7 INTRAVENOUS SEDATION 87
CHAPTER 8 INHALATION ANESTHESIA AND NEUROMUSCULAR BLOCKING AGENTS 94
CHAPTER 9 ANESTHESIA FOR DIFFICULT PATIENTS 104
Tabetha R. Harken, Alden H. Harken
Harry Dym, Naveen Mohan, Joseph Zeidan, A. Omar Abubaker
Richard D’Innocenzo, Ruben Figueroa, T.J. Dyer
Joel M. Friedman, Emery Nicholas
SURGERY PATIENT 62
Sonali A. Rathore, A. Omar Abubaker
Ravi Agarwal, George Obeid, A. Omar Abubaker, Kenneth J. Benson
Jason A. Jamali, A. Omar Abubaker
Matthew Cooke
Stuart Lieblich
III PerIoPeratIve Care
CHAPTER 10 FLUID AND ELECTROLYTES 111
Alia Koch
CHAPTER 11 NUTRITIONAL SUPPORT 119
Hani F. Braidy, Vincent B. Ziccardi
CHAPTER 12 POSTOPERATIVE COMPLICATIONS 123
Amber Johnson, Dean M. DeLuke
CHAPTER 13 INTRODUCTION TO MECHANICAL VENTILATION AND ICU CARE 129
Alia Koch
CHAPTER 14 BASIC LIFE SUPPORT, ADVANCED CARDIAC LIFE SUPPORT, AND ADVANCED
TRAUMA LIFE SUPPORT 131
Robert A. Strauss, Amber Johnson, Robert C. Lampert, Shahid R. Aziz, John Wessel
CHAPTER 15 TRACHEOSTOMY AND CRICOTHYROTOMY 155
Andrew Yampolsky, Shahid R. Aziz, A. Omar Abubaker
xv
xvi CONTENTS
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Iv ManageMent ConsIderatIons for the MedICally- CoMProMIsed PatIents
CHAPTER 16 CARDIOVASCULAR DISEASES: ISCHEMIC HEART DISEASE, MYOCARDIAL
INFARCTION, AND VALVULAR HEART DISEASE 167
David W. Lui, A. Omar Abubaker
CHAPTER 17 RESPIRATORY DISORDERS 183
CHAPTER 18 MANAGEMENT OF PATIENTS WITH LIVER DISEASES AND HEMATOLOGICAL
Yedeh Ying, Zachary S. Peacock, Osama Soliman
DISEASES 192
Roman G. Meyliker, Helen Giannakopoulos, Osama Soliman
CHAPTER 19 MANAGEMENT OF PATIENTS WITH RENAL DISEASES 202
CHAPTER 20 MANAGEMENT CONSIDERATIONS TO PATIENTS WITH ENDOCRINE DISEASES
Samir Singh, Mark A. Oghalai
AND THE PREGNANT PATIENTS 208
Sidney Eisig, Vincent Carrao
CHAPTER 21 MANAGEMENT OF THE DIABETIC PATIENT 218
CHAPTER 22 THE IMMUNOCOMPROMISED SURGICAL PATIENT 229
Samir Singh, Bradley A. Gregory
Ludmils Antonos Jr., Osama Soliman, Noah Sandler, A. Omar Abubaker
v oral and MaxIllofaCIal surgery
CHAPTER 23 APPLIED OROFACIAL ANATOMY 243
CHAPTER 24 WOUND HEALING 262
CHAPTER 25 DENTOALVEOLAR SURGERY AND PREPROSTHETIC SURGERY 264
CHAPTER 26 DENTAL IMPLANTS 274
CHAPTER 27 TRIGEMINAL NERVE INJURY 283
CHAPTER 28 OROFACIAL INFECTIONS AND ANTIBIOTIC USE 290
CHAPTER 29 DIAGNOSIS AND MANAGEMENT OF DENTOALVEOLAR INJURIES 319
CHAPTER 30 MANDIBULAR TRAUMA 323
CHAPTER 31 MANAGEMENT OF ZYGOMATICOMAXILLARY COMPLEX AND
CHAPTER 32 MIDFACIAL FRACTURES: NASAL, NASOETHMOIDAL, AND LE FORT
A. Omar Abubaker, Kenneth J. Benson
Din Lam
Dean M. DeLuke, Vincent J. Perciaccante, James A. Giglio
George R. Deeb, Graham H. Wilson, Kenneth J. Benson
David W. Lui, A.Omar Abubaker, Kenneth J. Benson
A. Omar Abubaker
Jason A. Jamali, A. Omar Abubaker
Hani F. Braidy, Vincent B. Ziccardi, A. Omar Abubaker
ORBITAL FRACTURES 329
Siavash Siv Eftekhari, Tuan Bui, Michael J. Grau Jr., Deepak G. Krishnan
FRACTURES 340
A. Omar Abubaker, Deepak G. Krishnan, Michael J. Grau Jr.
CONTENTS xvii
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CHAPTER 33 FRONTAL SINUS FRACTURES 347
A. Omar Abubaker
CHAPTER 34 MANAGEMENT OF SOFT TISSUE FACIAL INJURIES 353
Sapna Lohiya, Jasjit Dillon, Bashar Rajab
CHAPTER 35 CRANIOFACIAL SYNDROMES 362
Michael Jaskolka, Renie Daniel, Lewis Jones
CHAPTER 36 OROMANDIBULAR DYSOSTOSIS 370
Daniel J. Meara, Renie Daniel, Lewis Jones, Michael Jaskolka
CHAPTER 37 SYNDROMES AFFECTING THE OROFACIAL REGION 376
Dean M. DeLuke, A. Omar Abubaker, Kenneth J. Benson
CHAPTER 38 CLEFT LIP AND PALATE 382
Jennifer E. Woerner, A. Omar Abubaker
CHAPTER 39 ORTHOGNATHIC SURGERY 391
David M. Alfi, Ariel Farahi, A. Omar Abubaker, Bashar M. Rajab
CHAPTER 40 DISTRACTION OSTEOGENESIS 401
Din Lam
CHAPTER 41 SLEEP APNEA AND SNORING 404
Robert A. Strauss, Kenneth J. Benson, Roman G. Meyliker
CHAPTER 42 FACIAL PAIN AND MYOFASCIAL DISORDERS 410
Bhavik S. Desai, Steven G. Gollehon, Gregory M. Ness
CHAPTER 43 TEMPOROMANDIBULAR JOINT PATHOPHYSIOLOGY AND SURGICAL
TREATMENT 414
David W. Lui, Renato Mazzonetto, Steven G. Gollehon, Daniel B. Spagnoli, Gregory M. Ness
CHAPTER 44 ORAL AND MAXILLOFACIAL CYSTS AND TUMORS 422
CHAPTER 45 CANCER OF THE ORAL CAVITY 427
CHAPTER 46 SALIVARY GLAND DISEASES 434
CHAPTER 47 VASCULAR ANOMALIES 439
CHAPTER 48 OSTEORADIONECROSIS/OSTEONECROSIS OF THE JAWS 443
CHAPTER 49 NECK MASS 449
CHAPTER 50 BONE GRAFTING TO FACILITATE DENTAL IMPLANT PLACEMENT 452
CHAPTER 51 LOCAL AND REGIONAL FLAPS 458
CHAPTER 52 RECONSTRUCTION OF THE FACIAL SUBUNITS 462
CHAPTER 53 MICROVASCULAR SURGERY 467
David Webb
David L. Hirsch, Lauren G. Bourell, Ray Cheng
Christos A. Skouteris
Shelly Abramowicz, Arin K. Greene
Regina Landesberg, Lisa Marie Di Pasquale
HuiShan Ong, Tong Ji, Chen Ping Zhang
George R. Deeb, Fahad M. Alsaad
Din Lam
Melvyn S. Yeoh, Andrew T. Meram
Srinivasa Chandra, Rui Fernandes, Jacob Yetzer
xviii CONTENTS
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vI CosMetIC surgery
CHAPTER 54 EVALUATION OF THE AGING FACE 475
CHAPTER 55 COSMETIC BLEPHAROPLASTY 478
CHAPTER 56 RHYTIDECTOMY 484
CHAPTER 57 RHINOPLASTY 487
CHAPTER 58 MINIMAL-INVASIVE COSMETIC SURGERY 496
Faisal A. Quereshy, Sarah Naghibi
Joe Niamtu III
Tirbod Fattahi
Shahrokh Bagheri, Behnam Bohluli
Alia Koch
TOP 100 SECRET QUESTIONS
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1. Basal function of most organ systems remains unchanged due to the aging process;
however, the functional reserve and ability to compensate for physiological stress are reduced.
2. Patients who are on beta blockers should take them on the day of surgery and
continue them perioperatively. Abrupt interruption of the regimen can lead to withdrawal symptoms: rebound hypertension, tachycardia, and myocardial ischemia.
3. Blood transfusion should not be based solely on hemoglobin or hematocrit level. The
decision should be individualized to the clinical situation and take into consideration the patient’s health status.
4. Forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), the FEV1/FVC
ratio, and the flow between 25% and 75% of the FVC (mean maximal flow [MMF are the most clinically helpful indices obtained from spirometry.
5. Propofol is the least likely of all induction agents to result in nausea and vomiting.
Termination of the effects of intravenous anesthetics is by redistribution, not biotransformation and breakdown.
6. The systolic blood pressure in the radial artery may be as much as 20 to 50 mm Hg
higher than the pressure in the central aorta.
7. Cocaine sensitizes the cardiovascular system to the effects of endogenous
catecholamine. Ketamine potentiates the cardiovascular toxicity of cocaine and should be avoided.
8. Physiologic alterations in patients during pregnancy include increases in cardiac output,
heart rate, plasma volume, minute ventilation, and oxygen consumption; decreases in SVR; dilutional anemia; loss of functional residual capacity (FRC); and a hypercoagulable state.
9. In the pacemaker coding system, the first letter refers to the chamber paced, the
second letter to the chamber in which sensing occurs, the third letter to the responses to sensing in chambers, and the fourth letter to rate responsiveness.
10. Patients with diabetes have a high incidence of coronary artery disease with an atypical
or silent presentation.
11. When in doubt, remember that a p value less than 0.05 is generally considered
statistically significant, and the finding by chance alone is 1 in 20.
12. In febrile patients, a white blood cell or band count is rarely useful in differentiating
between bacterial and viral illnesses.
13. A septal hematoma must be ruled out in the setting of nasal bone fracture. Failure to
drain a septal hematoma may result in a septal abscess, septal perforation, and/or saddle nose deformity.
14. Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis are
the most common causes of acute bacterial sinusitis.
15. Surgical treatment of TMD is reserved for internal derangement of the TMJ and not for
musculoskeletal disorders.
16. The facial nerve is capable of regeneration. The degree of return to normal is mostly
dependent on the degree of initial injury. The single most important factor is whether the nerve lost function slowly over days or immediately at the time of the trauma.
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