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Contents xi
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10 Craniofacial Surgery 77
Acrocephalosyndactyly and Other Syndromic
Craniosynostoses 77
Barrow Classification for Carotid Cavernous Fistulae 78
Biologic Classification of Vascular Anomalies 78
Classification of Cherubism 79
Curacao Diagnostic Criteria for Hereditary
HaemorrhagicTelangiectasia (HHT) 79
Diagnostic Criteria for Gorlin Syndrome 80
Eye Measurements 80
Tessier’s Classification of Hypertelorism 81
Munro’s Classification of Hypertelorism 81
Marx Classification of Microtia 81
Hemifacial Microsomia (HFM) Classification –
Pruzansky (Modified by Kaban) 82
Levels of Skull Base Access 82
OMENS-Plus – Analysis of Craniofacial and Extra-
Craniofacial Anomalies in Hemifacial Macrosomia 83
Pierre Robin Syndrome (PRS) Severity Grading by
Cole et al. 83
Schobinger Arteriovenous Malformation (AVM)
Classification 84
Further Reading 84
11 Dentoalveolar 87
Ackerman’s Classification of Unicystic Ameloblastoma 87
Branemark’s Five Principles to Ensure Osseointegration 87
Cawood and Howell Classification of Edentulous Ridge 88
Differential Diagnosis for Cystic Lesions/Tumours on
Orthopantomagram (OPG) 88
Ellis Classification of Tooth Fractures 89
Federation Dentaire Internationale (FDI) Notation
(Upper Right Quadrant Clockwise to Upper Left,
Lower Left, Followed by LowerRight) 89
Five Criteria for Implant ‘Success’ by Albrektsson
etal. (1986) and Adapted by the American
Academy of Periodontology 90
Kent Classification of Edentulous Ridge 90
Loading Protocols for Implant Dentistry 91
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Leckholm and Zarb Classification of Bone Density
forImplants 91
National Institute for Health and Care Excellence
(NICE) Indications for Extraction of Third Molars 92
Pell and Gregory Classification of Lower Third Molars 92
Radiographic Zones of Edentulous Maxilla and Their
Management 93
RCS (England) Guidelines on Impacted Canines 93
RCS (England) Guidelines for Surgical Endodontics 94
Rood and Shehab Classification for Inferior Alveolar
Nerve (IAN) Injury Risk – Radiographic Signs
and Indications of Cone Beam Computerised
Tomography (CBCT) 94
Stages of Pericoronitis 95
Siebert’s Classification of Alveolar Bone Loss 95
Waldron and Mustoe’s Classification of Primary
Intraosseous Odontogenic Carcinoma (‘SCC in
Bone with No Ulcer and No Distant Primary at
Diagnosis or 6 Months Afterwards’) 95
WHARFE and Other Assessments to Determine
Difficulty for Local Anaesthetic (LA) versus General
Anaesthetic (GA) 96
Winter Classification for Impacted Third Molars 97
Further Reading 97
12 Critical Conditions (Perioperative and
Emerg encyCa re) 99
Computerised Tomography (CT) of Cervical
SpineIndications 99
Godrinsky and Holyoke Seven Spaces 100
Glasgow Coma Scale (MoVE) 100
Head Injury Severity 100
Management of Anticoagulants and Antiplatelets
inSurgery 101
Managing Carotid Involvement 102
Necrotising Fasciitis (NF) 103
Neurological Observations 103
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Contents xiii
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National Institute for Health and Care Excellence
(NICE) Head CT Criteria for Adults 104
NICE Head CT Criteria for Children 104
Refeeding Syndrome Risk Factors and Management 105
Sepsis Six 106
Systemic Inflammatory Response Syndrome(SIRS) 106
Stages of Haemorrhagic Shock 106
Further Reading 107
13 Miscellaneous 109
Research 109
Anatomy 110
Index 115
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Preface
https://t.me/med1917
Classication systems exist across the spectrum of specialties within medicine and surgery. ey allow for a common
language to exist between specialists.
provide a set of specic characteristics used to group individuals into well-dened and relatively homogeneous populations.
ey can help describe diseases in a comprehensible, measurable,
validated and reproducible manner and are the rst step towards
a systematic approach for treating specic conditions to reduce
complications.
4
Classication systems that are clinically relevant and agreed
upon provide a universal language or code that facilitates global
communication and collaboration.1 ey are invaluable in
research and help in conducting and comparing clinical trials.
Large-scale documentation, institutional comparisons, quality
control, evaluation of treatment and the development of treatment
algorithms are possible with such well-structured systems.
Additionally, diagnostic criteria are also widely applied in
medicine and surgery. Diagnostic criteria are a set of symptoms,
signs and investigation results that help to guide the diagnosis
3
and treatment of patients.
Diagnostic criteria aid management
where it is dicult to dierentiate between disorders that have
similar clinical manifestations. ey are particularly applicable
in diseases for which the aetiology is poorly understood. In such
cases, there are no specic clinical, biochemical or radiological
signs that serve as the gold standard for diagnosis.
1,2
Classication systems
1
3
3
1,3, 5
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xvi Preface
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Finally, there are risk stratication scoring systems which are
typically used to identify groups of patients that are at the highest
risk of an adverse event.
6,7
ey can help to ascertain the benet
of specic prophylactic or therapeutic interventions and prioritise
patient treatment according to the severity of clinical presentation.
Alexander M.C. Goodson
Mohammed S. Sarwar
Umar Rehman
Peter A. Brennan
REFERENCES
1. Audigé L, Cornelius C-P, Di Ieva A, Prein J. The first AO clas-
sification system for fractures of the craniomaxillofacial skeleton: Rationale, methodological background, developmental
process, and objectives. Craniomaxillofac Trauma Reconstr.
2014;7(1_suppl):6–14.
2. Gómez Roselló E, Quiles Granado AM, Artajona Garcia M,
etal. Facial fractures: Classification and highlights for a useful
report. Insights Imaging. 2020;11(1).
3. Aggarwal R, Ringold S, Khanna D, etal. Distinctions between
diagnostic and classification criteria? Arthritis Care Res.
2015;67(7):891–7.
4. Lin C, Wu J, Yang C, etal. Classifying and standardizing
panfacial trauma according to anatomic categories and Facial
Injury Severity Scale: A10-year retrospective study. BMC Oral
Health. 2021;21(1).
5. June RR, Aggarwal R. The use and abuse of diagnostic/
classification criteria. Best Pract Res Clin Rheumatol.
2014;28(6):921–34.
6. Backus BE, Six AJ, Kelder JH, Gibler WB, Moll FL, Doevendans
PA. Risk scores for patients with chest pain: Evaluation in the
emergency department. Curr Cardiol Rev. 2011;7(1):2–8.
7. Zhang Z, Zhang H, Khanal MK. Development of scoring sys-
tem for risk stratification in clinical medicine: Astep-by-step
tutorial. Ann Transl Med. 2017;5(21):436.
t.me/Dr_Mouayyad_AlbtousH
Authors
https://t.me/med1917
Alexander M.C. Goodson [BSc (Hons), MBBS, BDS, PhD, FRCS,
DOHNS] is a consultant maxillofacial surgeon in Portsmouth,
United Kingdom, specialising in head and neck surgery, including ablation and complex reconstruction, facial aesthetic surgery,
facial palsy, implantology and trauma. His academic interests
focus on surgical technology, having developed and patented
patient-specic solutions for jaw reconstruction. He has a keen
interest in education, grass-roots recruitment and improving the
culture of the surgical workplace. He has published and presented
widely, as well as authoring and editing several textbooks for surgeons and physicians.
Mohammad S. Sarwar [MB ChB, BSc (Hons), MRCS (Edin),
DOHNS-1] is a medicine and pharmacology graduate. He is on
the OMFS training pathway and currently studying dentistry at
King’s College London aer completing core surgical training and
MRCS. He is a locum clinical fellow in OMFS at East Grinstead,
United Kingdom. He is passionate about medical education,
global health and research and completing a PG certication in
medical education. He has several publications, has presented
nationally and internationally, and has received a prize for surgicalskills. He was awarded the prestigious A.H.R Rowe Prize in
Clinical Skills and Distinctions thus far at dental school. Over the
years, Sarwar has been actively involved in various initiatives to
widen participation and access to medicine. He is highly driven to
support and mentor junior colleagues and has an avid interest in
head and neck surgery and craniofacial trauma.
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xviii Authors
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Umar Rehman [BMBS, BSc (Hons), PGCME, MRCS (Eng), MSc
(Dist)] is a medicine and neuroscience graduate. He has completed core surgical training in London, the Membership of the
Royal College of Surgeons exams and a master’s degree in trauma
sciences. He is currently pursuing his research interests as a PhD
candidate and clinical research fellow at the University College
London Division of Surgery and Interventional Science. He is particularly interested in the subspecialities of craniofacial, cle and
head and neck surgery.
Peter A. Brennan [MB BS, MD, PhD FRCS (Eng), FRCSI, Hon
FRCS (Glasg), FFST(Ed), FDSRCS] is a consultant maxillofacial
surgeon in Portsmouth, United Kingdom. He has a personal chair
in surgery in recognition of his extensive research and education
prole. To date, Dr. Brennan has published over 800 articles and is
editor of several well-known textbooks, including Gray’s Surgical
Anatomy and the new Bailey & Love’s Essential Operations in
Oral and Maxillofacial Surgery. He has been chair of the MRCS
Court of Examiners and Intercollegiate MRCS chair, responsible
for standards and quality across the UK and Ireland. Dr. Brennan
has been awarded many prestigious prizes, including the coveted
Association of Surgeons in Training (ASiT) Silver Scalpel Award
(2022) for excellence in surgical training. He is well known for his
extensive work on human factors, eective teamwork and empowering trainees.
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Acknowledgements
https://t.me/med1917
We would like to acknowledge all primary authors of the criteria, classications and guidelines within this summary textbook.
Without doubt, the constant striving by these individuals to conceptualise and simplify complex aspects of maxillofacial surgery
has made a signicant impact on the practice of oral and maxillofacial surgery worldwide, as well as on head and neck surgery
in general. In addition, we thank our trainers and colleagues,
both past and present, for their collaborative approach to surgery
and for sharing their knowledge and general surgical know-how.
Finally, we thank our families and partners for their unending
support.
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Human Factors Analysis
https://t.me/med1917
and Classification
System (HFACS)
Adapted for Surgery
is classication summarises many of the important human factors (HF) that contribute to medical and surgical error. With 1
in 20 hospital admissions having some form of preventable error
(1in 20 of these are serious), surgeons should be aware and understand the importance of HF before ever picking up a scalpel. Not
only does the system below improve patient safety, but it can also
optimise personal performance and enhance team working.
ORGANISATIONAL INFLUENCES WITHIN
THEHOSPITAL
●
Failure of management training in recognition of factors
which may lead to error
●
Poor organisational safety culture, process and resource
management
●
Hospital targets, outside pressures and pressures to deliver
results (either perceived or real)
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xxii Human Factors Analysis and Classification System (HFACS)
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UNSAFE SUPERVISION
●
Inadequate supervision of trainees or other sta, or poor skills
mix
●
Failure of briengs/checklist complacency
●
Loss of situation awareness by the team
●
Failure of the team to know what to do when things go wrong
PRECONDITIONS TO UNSAFE ACTS
●
Fatigue, Hunger and nutritional status
●
Emotional inuences (Anger, personal issues), running Late
●
Tiredness, boredom, communication issues remember HALT
●
Environmental Factors: background noise, distractions, lighting, ambient temperature, humidity
●
Panic
UNSAFE ACTS (LESS LIKELY)
●
Unfamiliar with changes from what is seen as a ‘normal event’
●
Distracting and multi-tasking
●
Operating outside of one’s area of expertise or following a
long period of no operating (surgical currency)
REFERENCES
Panagioti M, Khan K, Keers RN, et al. Prevalence, severity, and
nature of preventable patient harm across medical care settings: systematic review and meta-analysis. BMJ. 2019 Jul
17;366:l4185.
Wiegmann DA, Shappell SA. Human error analysis of commercial
aviation accidents: application of the Human Factors Analysis
and Classification system (HFACS). Aviat Space Environ Med.
2001 Nov;72(11):1006–16.
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