Harold K. Tu

Compression osteosynthesis of mandibular fractures: A retrospective study

A retrospective study was performed on 35 patients who had a total of 43 fractures of the mandible that had been treated using bone plates for internal fixation. The data suggest that the procedure has a high degree of success and low rate of morbidity.

Pneumomediastinum, pneumothorax, and cervical emphysema following mandibular fractures.

Subcutaneous emphysema of the neck and pneumomediastinum following facial trauma in the absence of neck, chest, or abdominal injuries is a rare entity. A case report of bilateral cervical subcutaneous emphysema, pneumothorax, and pneumomediastinum secondary to mandibular fractures is presented. The anatomic mechanism of injury, diagnosis, and treatment modalities are discussed.

Morbidity associated with temporomandibular joint arthrography in clinically normal joints

To document the short- and long-term morbidity of arthrograms done on clinically normal temporomandibular joints, 62 arthrograms were performed on 31 asymptomatic volunteers. All subjects kept a record of any joint pain they experienced during the next five days and were examined by one of the authors at five days and again at two months. Maximum interincisal opening distance was recorded before the arthrogram and at both postarthrographic evaluations. No subjects complained of severe (grade 3) joint pain. Sixteen joints were recorded as moderately painful (grade 2), 32 as mildly painful (grade 1), and 14 as not painful (grade 0). Ten of 31 subjects described transient changes in occlusion one week after arthrography but none of the changes persisted until the two-month examination. Maximum interincisal distance was significantly decreased at one week but not at two months. These findings, although gained from asymptomatic subjects, suggest that complications of arthrography are probably minor and transient when performed by an experienced arthrographer.

Normal and abnormal temporomandibular joints: quantitative evaluation of inferior joint space arthrography.

Arthrography has been shown to provide important diagnostic information in patients with temporomandibular joint (TMJ) dysfunction. In this study, 60 arthrograms on totally asymptomatic patients and 64 arthrograms on symptomatic patients were evaluated. Quantitative evaluation of inferior joint space arthrography was performed with the help of a computer digitizing morphometry program. Results indicate a significant difference in the areas of the anterior and posterior recesses between normal and abnormal joints in the closed-mouth position. Differences between the 2 groups also exist in linear measurements of the anterior recess. This data further defines important diagnostic criteria in the arthrographic evaluation of both the normal and abnormal TMJ.

Hematologic management of a patient with Fanconi's anemia undergoing bone grafting and implant surgery

Fanconi’s anemia is a rare autosomal recessive disorder characterized by pancytopenia, progressive bone marrow hypoplasia, chromosomal aberrations, and a multitude of congenital anomalies. It was first described by Fanconi’ in 1927 when he reported three brothers with a progressive lethal anemia. Fanconi’s anemia should be differentiated from Fanconi’s syndrome, which is a proximal renal tubular disorder. According to Glanz,2 congenital malformations can affect the skeletal, ocular, auditory, renal, genital, and central nervous systems (Table 1). Affected persons may have anomalies involving any combination of these systems or, in some cases, may have none of these malformations. Because of the variation and number of malformations, it has not been possible to establish precise diagnostic criteria based on a patient’s clinical presentation. The frequency of occurrence of Fanconi’s anemia is estimated to be one in 360,000, but only about 300 cases have been reported in the literature.’ The male to female ratio is reported to be 2: 1 .4 The diagnosis is usually made in the first decade of life, between the ages of 4 and 7 years, with the typical patient dying of bone marrow complications within the first two decades of life. Most patients, however, succumb within 5 years of the onset of anemia. Fanconi’s anemia has been grouped with other inheritable genetic disorders that involve chromosomal aberrations and are known to cause patients to have a

Pseudoankylosis of the Mandible after Temporal Bone Attached Craniotomy

Mandibular hypomobility after intracranial surgical procedures is seldom encountered. A case of limited oral opening after temporal bone attached craniotomy is described. The condition is due to fibrosis of the temporalis muscle resulting in a pseudoankylosis of the temporomandibular joint. The appropriate operative intervention is transoral coronoidectomy, which restores normal joint function.

Anesthesia for facial plastic surgery

Introduction - the anaesthetic continuum patient selection regional anaesthesia intravenous conscious sedation ambulatory office general anaesthesia monitoring for ambulatory office anaesthesia techniques of regional local anaesthesia for specific procedures anaesthesia-related emergencies post-operative considerations following facial plastic surgery putting it all together. (Part contents)