Оглавление
Группа авторов. Management of Complications in Oral and Maxillofacial Surgery
Table of Contents
List of Tables
List of Illustrations
Guide
Pages
Management of Complications in Oral and Maxillofacial Surgery
Preface
List of Contributors
1 Ambulatory Anesthesia
INTRODUCTION
PREVENTION OF COMPLICATIONS IN AMBULATORY ANESTHESIA. Patient Characteristics/Selection
Procedure Characteristics/Selection
Patient Screening
Intraoperative Patient Monitoring
Pulse Oximetry
Heart Rate and Rhythm Monitoring
Blood Pressure
Capnography
Precordial (Esophageal) Stethoscope
Personnel Preparedness
Equipment and Emergency Supplies
Postoperative Monitoring
INCIDENCE OF COMPLICATIONS IN AMBULATORY ANESTHESIA
NEUROLOGICAL COMPLICATIONS. Syncope
Algorithm 1.1: Loss of Consciousness with Vasovagal Prodrome
Algorithm 1.2: Loss of Consciousness without Vasovagal Prodrome
Oversedation
Seizures
CARDIOPULMONARY COMPLICATIONS. Respiratory Depression and Respiratory Arrest
Algorithm 1.3: Respiratory Compromise
Laryngospasm, Bronchospasm, and Acute Asthma
Aspiration
Preoperative Fasting Period (NPO Guidelines)
Acute Vascular Events
Cardiac Arrhythmias
Hypertension and Hypotension
GASTROINTESTINAL COMPLICATIONS. Nausea and Vomiting
ENDOCRINE COMPLICATIONS. Hypoglycemia
Adrenal Crisis
IMMUNOLOGICAL COMPLICATIONS. Hypersensitivity Reactions
PSYCHIATRIC AND EMOTIONAL COMPLICATIONS
COMPLICATIONS RELATED TO PATIENT POSITIONING
COMPLICATIONS RELATED TO IV LINE PLACEMENT
ANESTHETIC COMPLICATIONS IN PEDIATRIC PATIENTS
Pediatric Respiratory Complications
Pediatric Cardiovascular Complications
Other Pediatric Complications
PREVENTION AND MANAGEMENT OF PEDIATRIC ANESTHETIC COMPLICATIONS
CONCLUSIONS
REFERENCES
2 Third Molar Surgery
INTRODUCTION
MANAGEMENT OF COMPLICATIONS IN THIRD MOLAR SURGERY. Alveolar Osteitis
Algorithm 2.1: Alveolar Osteitis
Infection
Algorithm 2.2: Surgical Site Infection
Bleeding/Hemorrhage
Algorithm 2.3: Hemorrhage
Mandibular Fracture
Oral–Antral Communication
Injury to Adjacent Teeth/Wrong Tooth Extraction
Algorithm 2.4: Oroantral Communication
Injury to Adjacent Osseous Structures
Pain and Swelling
TMJ Injury
Displacement of Teeth
Aspiration/Ingestion
Neurological Complications
Algorithm 2.5: Neurosensory Deficit
Osteomyelitis
Instrument Breakage/Foreign Body Displacement
Algorithm 2.6. Fractured Instrument/Foreign Body
CONCLUSIONS
REFERENCES
SUGGESTED READING
3 Implant Surgery
INTRODUCTION
PRE‐OPERATIVE PLANNING. Patient Assessment
Clinical Examination
Virtual Surgical Planning
Prosthodontic and Surgical Treatment Planning
INTRA‐OPERATIVE COMPLICATIONS
Nerve Injury
Damage to Adjacent Teeth
Algorithm 3.1: Nerve Injury
Algorithm 3.2: Damage to Adjacent Teeth
Implant Displacement and Migration
Algorithm 3.3: Implant Displacement and Migration
Dental Implant Aspiration
Dental Implant Ingestion
Bleeding
Algorithm 3.4: Bleeding
Air Embolism
Mandible Fracture
Algorithm 3.5: Mandible Fracture
POST‐OPERATIVE COMPLICATIONS. Infection
Peri‐implantitis
Algorithm 3.6: Infection
Algorithm 3.7: Peri‐implantitis
Implant Fracture
Algorithm 3.8: Fractured Implants and Components
ZYGOMATIC IMPLANT COMPLICATIONS
CONCLUSIONS
REFERENCES
4 Technology and Navigation in Oral and Maxillofacial Surgery
INTRODUCTION
DATA ACQUISITION PHASE COMPLICATIONS
Preoperative CT Not Taken Using Correct Parameters/Incorrect Postprocessing
Inadequate/Incorrect Records
PREOPERATIVE PLANNING COMPLICATIONS
Complications from Errors Made During Preoperative Planning Phase
MANUFACTURING COMPLICATIONS. Inaccurately Manufactured 3D Materials
SURGERY PHASE COMPLICATIONS
Patient‐Specific Cutting Guide or Splint Does Not Fit
Patient‐Specific Implant Does Not Fit
INTRA‐ AND POSTOPERATIVE ASSESSMENT COMPLICATIONS
Algorithm 4.5: Surgery (Occlusal‐Based Guide or Splint Does Not Fit)
INTRAOPERATIVE IMAGING COMPLICATIONS. Intraoperative CT Does Show Area of Interest
NAVIGATION COMPLICATIONS
Algorithm 4.7: Patient‐Specific Implant Does Not Fit
POSITION OF VIRTUAL POINTER ON MONITOR DOES NOT REPRODUCE THE POSITION OF INSTRUMENT ON THE PATIENT
Algorithm 4.9: Navigation Complications (Optical Tracking System)
DENTAL IMPLANTS, TECHNOLOGY, AND ASSOCIATED COMPLICATIONS
Unstable or Uncomfortable Fit of Patient Tracker
Inaccurate Fit of Patient Tracker
Line‐of‐Sight Between Cameras and Tracking Arrays Is Blocked
Dislodgement of Restorations, Including Crowns, Bridge, or Fillings
Dislodgement of Patient Tracker
Implant or Osteotomy Is Poorly Positioned
Direct Injury to Inferior Alveolar Nerve
Injury to Adjacent Soft Tissues
Poor Bone Quality at Implant Site
CONCLUSIONS
REFERENCES
5 Maxillofacial Trauma
SOFT TISSUE INJURIES
Animal Bites
Canine Bites
Feline Bites
Human Bites
Management
Algorithm 5.1: Soft Tissue Injury
Parotid Duct Injury
Sialocele
Algorithm 5.2: Parotid Duct Injury
Algorithm 5.3: Sialocele Formation
Peripheral Facial Nerve Injury
Nasolacrimal Injury
Algorithm 5.4: Peripheral Facial Nerve Injury
Ectropion
Medial Ectropion
Lateral Ectropion
Algorithm 5.5: Nasolacrimal Injury
Entropion
Algorithm 5.6: Cicatricial Ectropion
Algorithm 5.7: Cicatricial Entropion
HARD TISSUE INJURIES. Mandibular Fractures (Symphysis, Body, Angle)
Principles of Rigid Internal Fixation
Teeth in the Line of Mandible Fractures
Infection
Malunion/Malocclusion
Mandibular Symphysis, Parasymphysis, and Body Fractures
Algorithm 5.8: Malocclusion (No Malunion)
Mandibular Angle Fractures
Nonunion
Atrophic Edentulous Mandibular Fractures
Mandibular Widening
Algorithm 5.9: Mandibular Widening
Facial Asymmetry
Mandibular Condyle Fractures
Malunion/Malocclusion
Facial Asymmetry
Mandibular Hypomobility/Temporomandibular Joint Ankylosis
Facial Nerve Injury with Approaches or Intraoral Approaches to the Mandible
Algorithm 5.10: TMJ Ankylosis
Trigeminal Nerve Injuries
FRONTAL SINUS FRACTURES
Principles of Frontal Sinus Management
Infection/Sinusitis
Complications of Sinusitis. Mucocele and Mucopyocele
Algorithm 5.11: Frontal Mucocele and Mucopyocele
Orbital Complications
Frontal Osteomyelitis
Meningitis
Intracranial Abscess
Cavernous Sinus Thrombosis
Cerebrospinal Fluid Leak
Esthetic Deformity
ORBITAL FRACTURES
Orbital Blow‐out/Blow‐in Fractures
Limitation of Extraocular Muscle Movements
Enophthalmos
Eyelid Malposition
Cranio‐orbital Fractures
ORBITOZYGOMATICOMAXILLARY COMPLEX FRACTURES
Malar Flattening
Neurosensory Complications
Algorithm 5.12: Malar Flattening
OCULAR TRAUMA
NASOORBITOETHMOIDAL FRACTURES
Telecanthus
Algorithm 5.13: Traumatic Telecanthus
Nasolacrimal Duct Obstruction
Cosmetic Deformity/Saddle Nose Deformity
NASAL FRACTURES
Septal Hematoma
Epistaxis
Cosmetic Deformities/Saddle Nose Deformity
Nasal Airway Obstruction/Septal Deviation
Scarring
MAXILLARY FRACTURES
Malocclusion
Facial Widening
Sinusitis
Hemorrhage
TEMPORAL BONE FRACTURES
TRACHEOSTOMY
CONCLUSIONS
REFERENCES
SUGGESTED READING
6 Orthognathic Surgery
PREOPERATIVE COMPLICATIONS
Diagnosis
Motivation
Medical Issues
Airway Issues
Orthodontic Preparation
Dental Issues
INTRAOPERATIVE COMPLICATIONS
MAXILLARY SURGERY: INTRAOPERATIVE COMPLICATIONS
Algorithm 6.1 LeFort I Osteotomy Sequence
Dental Trauma
Soft Tissue Issues
Fixation Issues
Maxillary Downfracture
Maxillary Mobilization and Repositioning
Hemorrhage
Nerve Injury During Le Fort Osteotomy
Airway Compromise
GENIOPLASTY. Preoperative Phase
Perioperative Phase
Postoperative Phase
MANDIBLE: INTRAOPERATIVE COMPLICATIONS
Intraoral Vertical Ramus Osteotomy
Sagittal Split Ramus Osteotomy
Algorithm 6.2: Sagittal Split Osteotomy Sequence
Algorithm 6.3: Sagittal Split Osteotomy Sequence
VARIATIONS OF MANDIBULAR OSTEOTOMIES “Midline” Split of the Mandible
Anterior Segmental Osteotomy
Intraoperative Anesthesia‐Related Issues
Airway Complications
Hypotensive Anesthesia
Emergence from Anesthesia in the Operating/Recovery Room
POSTOPERATIVE COMPLICATIONS OF ORTHOGNATHIC SURGERY (FIGURE 6.15) Short Term
In the Recovery Room
Bleeding
Blindness
FIRST WEEK POSTSURGERY. Malocclusions
Pain
Edema
Nausea and Vomiting
Psychological
Neurological
Nutrition
Wound Healing
FIRST MONTH. Hardware Failure
Bleeding/Hemorrhage
Nasal and Sinus Complications
Hearing
Devitalized Teeth
Range of Motion
Splints
Transverse Issues
Sequestrum Formation
Hardware
Neural Issues. Changes in Taste
Orthodontic Issues
Patient Satisfaction
Snoring and Obstructive Sleep Apnea
Long‐Term Complications
Stability
Permanent Cranial Nerve Damage
Cranial Nerve VII
THE TEMPOROMANDIBULAR JOINT: INTERNAL DERANGEMENT OF THE TMJ AND IDIOPATHIC CONDYLAR RESORPTION
Pitfalls of Virtual Surgical Planning for Orthognathic Surgery
CONCLUSIONS
REFERENCES
SUGGESTED READING
7 Distraction Osteogenesis
INTRODUCTION
PREOPERATIVE PLANNING PHASE
Patient Selection
Distraction Vector Planning
INTRAOPERATIVE PHASE. Neurological and Dental Injury
Incomplete Osteotomy and Improper Device Placement
Algorithm 7.1: Inadequate/Improper Distraction
Algorithm 7.2: Improper Alveolar DO Vector
Algorithm 7.3: Inadequate DO Magnitude
POSTOPERATIVE PHASE. Device Failure
Inadequate Distraction
Infection
Inadequate Bony Regenerate
CONCLUSIONS
REFERENCES
8 Obstructive Sleep Apnea Surgery
INTRODUCTION
COMPLICATIONS WITH PALATAL PROCEDURES
COMPLICATIONS WITH GENIOGLOSSUS ADVANCEMENT AND HYOID SUSPENSION
COMPLICATIONS WITH MAXILLOMANDIBULAR ADVANCEMENT
INTRAOPERATIVE COMPLICATIONS IN MAXILLOMANDIBULAR ADVANCEMENT. Excessive Bleeding
Algorithm 8.1: Bleeding
Bad Split
Algorithm 8.2: Bad Splits
Malocclusion
Algorithm 8.3: Malocclusion
POSTOPERATIVE COMPLICATIONS IN MAXILLOMANDIBULAR ADVANCEMENT. Early Medical Complications
Algorithm 8.4: Postoperative Complications
Infections
Malocclusion
Algorithm 8.5: Malocclusion
Hardware Failure/Malunion/Nonunion
Paresthesia and Dysesthesia
Temporomandibular Joint Disorders
Facial Aesthetic Changes
TRANSORAL ROBOTIC SURGERY
DISTRACTION OSTEOGENESIS
HYPOGLOSSAL NERVE STIMULATION
CONCLUSIONS
Algorithm 8.6: Hypoglossal Nerve Stimulator
REFERENCES
SUGGESTED READING
9 Cleft and Craniofacial Surgery
INTRODUCTION
COMPLICATIONS IN CLEFT LIP AND NOSE REPAIR
Early Complications
Late Complications
Cutaneous Lip Problems. Long Upper Lip
Tight Upper Lip
Short Upper Lip
Philtrum Abnormalities
Cutaneous Problems
Nostril Stenosis
Nasal Asymmetry
Facial Growth
COMPLICATIONS IN PALATOPLASTY PROCEDURES
Palatoplasty Procedures and Outcome Differences
Perioperative Complications of Cleft Palate Repair
Management of Palatal Fistulas
Operative Techniques for Closure of Palatal Fistulas
Algorithm 9.1: Revision Palatoplasty
Growth After Palatoplasty
Management of Velopharyngeal Dysfunction
Operative Techniques for Treatment of VPI
Complications Related to Surgical Procedures for VPI
COMPLICATIONS OF CRANIOFACIAL SURGERY
Intraoperative Complications of Craniofacial Surgery
Late Postoperative Complications of Craniofacial Surgery
Algorithm 9.2: Secondary Cranial Vault Defect Reconstruction
CONCLUSIONS
REFERENCES
SUGGESTED READING
10 Minimally Invasive Cosmetic Facial Surgery
INTRODUCTION
COMPLICATIONS OF NEUROTOXINS
Bruising and Swelling
Injection Site Pain
Brow, Eyelid Ptosis, Oral Incompetence
Algorithm 10.1: Botox‐Induced Upper Eyelid Ptosis Management
Immune/Allergic Reactions, Systemic Absorption
COMPLICATIONS OF INJECTABLE FILLERS
Inappropriate Placement of Filler, Early and Late Visible Irregularities
Algorithm 10.2: Treatment of Mild to Moderate Complications Following Filler Injections
Algorithm 10.3: Filler Injection Hematoma
Algorithm 10.4: Filler Irregularity
Tissue Necrosis/Blindness
Algorithm 10.5: Intra‐arterial Filler Injection Complication
Algorithm 10.6: Treatment of Severe Complications Following Filler Injections
Discoloration and Granuloma Formation
Complications of Skin Resurfacing Procedures. Nonablative and Ablative Skin Therapies
Nonablative, Subsurface Therapies
Edema, Purpura, and Blistering
Hypopigmentation and Hyperpigmentation
Algorithm 10.7: Nonablative, Ablative, and Chemical Exfoliation Management of Scarring
Algorithm 10.8: Nonablative, Ablative, and Chemical Exfoliation Management of Persistent Erythema
Fat Atrophy and Subsurface Irregularity
Allergic Reaction with Attempted Tattoo Removal
Ablative Skin Resurfacing and Chemical Exfoliation
Chemical Peels and Laser Skin Resurfacing
Erythema and Pruritis
Scars
Hyperpigmentation or Hypopigmentation
Infection
Algorithm 10.9: Skin Resurfacing Hypopigmentation andHyperpigmentation Management
Algorithm 10.10: Nonablative, Ablative, and Chemical ExfoliationManagement of Viral and Bacterial Complications
Milia and Acne Eruption
CONCLUSIONS
REFERENCES
SUGGESTED READING
11 Cosmetic Facial Surgery
INTRODUCTION
SURGICAL FACIAL COSMETIC PROCEDURES. Blepharoplasty
Edema, Ecchymosis, Conjunctival Irritation, and Corneal Abrasion
Corneal Abrasion and Superficial Punctate Keratitis
Ectropion, Entropion, Lid Shortening, Poor Lid Seal, and Ptosis
Algorithm 11.1: Blepharoplasty Management of Eyelid Complications
Dry Eyes
Acute Angle Glaucoma
Algorithm 11.2: Blepharoplasty Management of Conjunctival Complications
Retrobulbar Hematoma
Blindness
Algorithm 11.3: Blepharoplasty Lagophthalmos Complication
Algorithm 11.4: Blepharoplasty Management of Ecchymosis and Retrobulbar Hematoma
Infection
BROW LIFT PROCEDURES
Bleeding and Hematoma Formation
Postoperative Pain
Edema
Neurosensory Disturbances
Incisional Alopecia
Facial Nerve Weakness
Relapse of Brow Ptosis
FACELIFT, NECK LIFT, AND SUBMENTAL LIPOSUCTION PROCEDURES
Hematoma
Facial Nerve Injury
Superficial Epidermolysis
Algorithm 11.5: Cervicofacial Rhytidectomy Management of Bleeding
Algorithm 11.6: Cervicofacial Rhytidectomy Management of Facial Nerve Paralysis
Neurosensory Disturbances
Algorithm 11.7: Cervicofacial Rhytidectomy Management of Skin Ischemia
Contour Irregularities
Pixie‐Ear Deformity
Algorithm 11.8: Cervicofacial Rhytidectomy Management of Neurosensory Disturbances
FACIAL IMPLANT PROCEDURES
Infection
Bone Resorption and Visible Implant
Implant Mobility
Neurosensory Disturbances
RHINOPLASTY
Bleeding
Algorithm 11.9: Rhinoplasty Management of Hemorrhage
Infection
Airway Obstruction
Intracranial Communication
Open Roof Deformity
Saddle Nose Deformity
Algorithm 11.10: Rhinoplasty Management of Infections
Pollybeak Deformity
Algorithm 11.11: Rhinoplasty Intracranial Communication Management
Bossae and Unitip Deformity
Rocker Deformity, “Inverted‐V” Deformity, and “Keel” Deformity
Algorithm 11.12: Rhinoplasty Deformities Management
CONCLUSIONS
REFERENCES
12 Temporomandibular Joint Surgery
INTRODUCTION
PREOPERATIVE COMPLICATIONS. Inappropriate Diagnosis and Treatment
INTRAOPERATIVE TMJ SURGERY COMPLICATIONS
Minimally Invasive TMJ Surgery and Arthroscopic Complications
Minimally Invasive – Vascular Injury
Algorithm 12.1: Vascular Injury During Temporomandibular Surgery
Minimally Invasive – Otologic Complications
Minimally Invasive – Fluid Extravasation
Minimally Invasive – Violation of Cranial Base
Minimally Invasive – Instrumentation Complications
Minimally Invasive – Neurological Injuries
Algorithm 12.2: Facial Nerve Injury During Temporomandibular Surgery
Open TMJ Arthroplasty Procedures
Modified Condylotomy – Neurological Injuries
Modified Condylotomy – Vascular Injuries
Open Joint Procedures – Vascular Injuries
Open Joint Procedures – Neurological Injuries
Total Joint Replacement – Vascular Injuries
Total Joint Replacement – Implant Malposition
Total Joint Replacement – Allergic Reactions
Postoperative Complications. Infection
Algorithm 12.3: Alloplastic Total Joint Prosthesis Infection
Malocclusion (Algorithm 12.4)
Algorithm 12.4: Postoperative Malocclusion After Temporomandibular Surgery
Implant Failure
Hypomobility and Ankylosis (Heterotopic Ossification)
Persistent Chronic Pain
Frey's Syndrome
CONCLUSIONS
REFERENCES
13 Ablative Oral/Head and Neck Surgery
INTRODUCTION
COMPLICATIONS RELATED TO ABLATIVE SURGERY FOR MALIGNANT TUMORS. Predictive Factors
Advanced Age
Compromised Nutritional Status
Medical Comorbidity
Treatment‐Related Factors
COMPLICATIONS. Treatment Failure
Local Recurrence
Algorithm 13.1: Treatment Failure for Oral Squamous Cell Carcinoma
Regional Recurrence
Distant Metastatic Disease
Second Primary Disease
Neurological Dysfunction
Spinal Accessory Nerve
Facial Nerve
Algorithm 13.2: Spinal Accessory Nerve Dysfunction Following Neck Dissection
Phrenic Nerve
Miscellaneous Nerve Injuries
Wound Infection
Chylous Fistula
Algorithm 13.3: Thoracic Duct Laceration and Chyle Leak
Wound Dehiscence and Exposure of Reconstruction Bone Plates
COMPLICATIONS RELATED TO ABLATIVE SURGERY FOR BENIGN TUMORS. Predictive Factors
Recurrence. Odontogenic Tumors
Parotid Tumors
Algorithm 13.4: Tumor of the Superficial Lobe of the Parotid Gland
Nerve Injury. Sensory Nerve Injury
Motor Nerve Injury
CONCLUSIONS
REFERENCES
14 Lip Cancer
INTRODUCTION
Diagnosis/Staging
COMPLICATIONS ASSOCIATED WITH LIP RECONSTRUCTION. Wound Dehiscence
Algorithm 14.1: Wound Dehiscence
Microstomia
Algorithm 14.2: Microstomia
Neurological Injury
Algorithm 14.3: Neurological Injury
SCARRING AND POOR COSMETIC OUTCOME
Algorithm 14.4: Cosmetic Outcomes
COMPLICATIONS RELATED TO RADIATION THERAPY
Algorithm 14.5: Radiation Therapy Complications
CONCLUSIONS
REFERENCES
SUGGESTED READING
15 Dermatopathology and Skin Cancer
INTRODUCTION
MANAGEMENT OF COMPLICATIONS IN THE ACUTE HEALING STAGE
Hematoma
Algorithm 15.1: Hematoma Management Including Preoperative Prevention And Intraoperative Measures
Algorithm 15.2: Postoperative Hematoma Evacuation Algorithm
Infection
Flap Failure
Algorithm 15.3: Management of SSI, Including Preoperative Prevention of SSI and Intraoperative Measures
Algorithm 15.4: Postoperative Management of SSI
Wound Dehiscence
Algorithm 15.5: Preoperative and Intraoperative Flap Failure Prevention
Tumor Recurrence
Hyper/Hypopigmentation
Surface Irregularities
Hypertrophic Scars, Unaesthetic Scar, and Keloid
Algorithm 15.6: Complication of Local Flaps
CONCLUSIONS
REFERENCES
SUGGESTED READING
16 Hard Tissue Reconstruction
INTRODUCTION
PATIENT FACTORS IN COMPLICATIONS. Perioperative Comorbidity
Nutritional Status Issues
Algorithm 16.1: Selected Perioperative Comorbidity Considerations
Intraoral Wound Dehiscence
Nasogastric Tube Placement Complications
Effects of Diabetes Mellitus and the Use of Corticosteroids
Nicotine Effects
Risks of Blood Transfusion
HARD TISSUE GRAFT OPTIONS AND CONSIDERATIONS. Autogenous Bone
Sinus Bone Graft Failure
Allografts and Xenografts
BONE MORPHOGENETIC PROTEINS. Swelling Associated with Bone Morphogenetic Proteins
SPECIFIC DONOR SITE MORBIDITY AND COMPLICATIONS
Intraoral Donor Sites
Algorithm 16.2: Bone graft site and selected associated complications
Intraoral Donor Site Wound Dehiscence
Iliac Crest Harvest Site
Infection at Iliac Crest Harvest Site
CALVARIAL BONE GRAFTS. Violation of the Inner Cortical Plate
COSTOCHONDRAL GRAFTS. Pain and Atelectasis
Violation of the Pleura
Tibial Bone Grafts
Persistent Exposed Segment of Nonviable Bone Graft
HARDWARE IN HARD TISSUE RECONSTRUCTION. Distraction Osteogenesis
Distractor Hardware Failure
Fixation Schemes
Fixation Hardware Failure
CONCLUSIONS
Algorithm 16.3: Hardware failure algorithm in hard tissue reconstruction
REFERENCES
17 Soft Tissue Reconstruction
INTRODUCTION
Total/Partial Flap Loss
Infection
Algorithm 17.1: Management of Partial and Total Flap Loss
Algorithm 17.2: Management of Wound Infection
Salivary Leak and Fistula
Hematoma Formation
PEDICLED SOFT TISSUE FLAPS. Pectoralis Major Myocutaneous Flap
Algorithm 17.3: Hematoma in the head and neck region
Submental Island Flap
Paramedian Forehead Flap
Buccal Fat Pad
VASCULARIZED SOFT TISSUE FREE FLAPS
CONCLUSIONS
REFERENCES
18 Vascularized Reconstruction
INTRODUCTION
FASCIOCUTANEOUS AND OSTEOCUTANEOUS RADIAL FOREARM FLAP
Hand Ischemia
Radius Fracture
Algorithm 18.1: Radius Fracture
Sensory/Motor Deficit
Donor Site Skin Graft Failure
Algorithm 18.2: Donor Site Skin Graft Failure
OSTEOCUTANEOUS FIBULA FLAP
Foot Ischemia/Vascular Compromise
Gait Disturbance
Limited Great Toe Flexion
Neurological Injuries
Delayed Wound Healing
Skin Paddle Loss
Algorithm 18.3: Fibula Flap‐Skin Paddle Loss
OSTEOCUTANEOUS SCAPULA FLAP
Shoulder Dysfunction
Scapula Winging
Algorithm 18.4: Scapular Winging
Algorithm 18.5: Ventral Hernia
OSSEOUS ILIAC CREST FLAP
Ventral Hernias
Contour Deformity
Neurological Sequelae
Ambulation/Gait Disturbance
FLAP FAILURE
Surgical Management
Leech Therapy
Pharmacological Salvage
Algorithm 18.6: Free Flap Compromise
Radiological Evaluation
CONCLUSIONS
REFERENCES
19 Head and Neck Radiotherapy
INTRODUCTION
COMPLICATIONS. Xerostomia
Algorithm 19.1: Xerostomia
Trismus
Algorithm 19.2: Trismus
Dysphagia
Algorithm 19.3: Dysphasia
Osteonecrosis of the Mandible and Maxilla
Algorithm 19.4: Osteonecrosis
Soft Tissue Necrosis and Chondral Necrosis
CONCLUSIONS
REFERENCES
20 Microneurosurgery
INTRODUCTION
LACK OF FUNCTIONAL SENSORY RECOVERY AFTER NERVE REPAIR
Algorithm 20.1: Lack of Functional Sensory Recovery (FSR) after Nerve Repair
POOR PATIENT SELECTION
DIFFICULT SURGICAL ACCESS WITH INABILITY TO LOCALIZE NERVE STUMPS
Algorithm 20.2: Difficult Surgical Access of Nerve Stumps
IATROGENIC NERVE INJURY TO THE LN OR IAN
INADEQUATE NEUROMA RESECTION
Algorithm 20.3: Inadequate Neuroma Resection
TENSION ON NERVE REPAIR SITE
Algorithm 20.4: Management of the Nerve Gap
FASCICULAR MALALIGNMENT
POOR VASCULARITY OF SOFT TISSUE BED
TRISMUS AFTER NERVE REPAIR
SELF‐INDUCED INJURY AFTER NERVE REPAIR
IATROGENIC INJURY TO NERVE(s)
NO NERVE INJURY IDENTIFIED
PATHOLOGICAL MANDIBLE FRACTURE
MALOCCLUSION AND TEMPOROMANDIBULAR JOINT ISSUES
NERVE GRAFT COMPLICATIONS
NEUROPATHIC PAIN DEVELOPMENT
IAN RECONSTRUCTION IN ABLATIVE MANDIBULAR RESECTION
MISCELLANEOUS COMPLICATIONS
CONCLUSIONS
SUGGESTED READING
21 Transoral Robotic Surgery
INTRODUCTION
SEQUELAE AND COMPLICATIONS: PAIN
SEQUELAE AND COMPLICATIONS: DYSPHAGIA
SEQUELAE AND COMPLICATIONS: AIRWAY EDEMA
SEQUELAE AND COMPLICATIONS: BLEEDING
Algorithm 21.1: Bleeding
SEQUELAE AND COMPLICATIONS: IATROGENIC ORAL–CERVICAL COMMUNICATION AND PHARYNGOCUTANEOUS FISTULA FORMATION
SEQUELAE AND COMPLICATIONS: ASPIRATION PNEUMONIA
SEQUELAE AND COMPLICATIONS: NERVE INJURY
SEQUELAE AND COMPLICATIONS: OTHERS. Trismus and Neck Spasm
Cervical Spondylodiscitis
Iatrogenic Dental, Corneal, and Soft Tissue Injury
AIRWAY FIRE
Algorithm 21.3: Airway Fire
TORS “FAILURE TO CURE”: CONVERSION TO OPEN APPROACH OR ABANDON TORS PROCEDURE
TORS “FAILURE TO CURE”: INADEQUATE SURGICAL MARGIN
CONCLUSIONS
REFERENCES
22 Sialoendoscopy
INTRODUCTION
SIALOENDOSCOPY VERSUS RADICAL SURGERY
SIALOENDOSCOPY‐RELATED COMPLICATIONS
Complications Associated with Sialoendoscopy
Avulsion of the Duct
Algorithm 22.1: Avulsion of the Duct
Secondary Strictures
Algorithm 22.2: Secondary Strictures
Perforation of the Duct
Immediate Postoperative Gland Swelling
Algorithm 22.3: Perforation of the Duct
Ranula
Algorithm 22.4: Postoperative Swelling
Algorithm 22.5: Ranula
Lingual Nerve Damage
Bleeding and Hematoma
Algorithm 22.6: Lingual Nerve Damage
Complications Associated with the Specific Sialoendoscopic Armamentarium
Algorithm 22.7: Bleeding and Hematoma
Intraoperative Damage to the Scope
Algorithm 22.8: Intraopertive Damage to the Scope
Basket Dislodgement
Grasper Breakdown
Algorithm 22.9: Basket Dislodgement/Grasper Breakdown/Sialoballoon tear
Sialobaloon Tear
CONCLUSIONS
REFERENCES
23 Salivary Gland Surgery
INTRODUCTION
Benign Conditions and Pathology
Recurrence
Algorithm 23.1: Minor Salivary Gland Surgery Complications – Palate
Algorithm 23.2: Mucocele Excision Complication
Mental Nerve Injury
Scar
Bleeding
Palatine Artery Bleeding Algorithm
Oroantral/nasal Fistula Treatment Algorithm
PA Excision Complication Algorithm. Recurrence
Algorithm 23.3: Ductal Injury
Stenson Duct Injury Algorithm
Terminal Branches of Facial Nerve Injury Algorithm
Malignant Pathology
Major Salivary Gland Surgery Complications. Benign Conditions and Pathology of the Submandibular Gland
Sialolithectomy Complication Algorithm. Sialolith Displacement
Duct Injury
Algorithm 23.4: Submandibular Gland Excision Complications
Algorithm 23.5: Submandibular Gland Excision Complications
Algorithm 23.6 Submandibular Gland Excision Complications
Bleeding
Hematoma Formation
Infection
Scar Along the Neck Incision
Injury to the Marginal Mandibular Branch of the Facial Nerve
Injury to the Lingual and Hypoglossal Nerves (Figure 23.9)
Saliva Leak into the Neck with Fistula Formation
Benign Conditions and Pathology of the Sublingual Gland
Ranula Treatment Complication Algorithm. Recurrence
Injury to Wharton Duct
Benign Conditions and Pathology of the Parotid Gland
Algorithm for Facial Nerve Damage
Algorithm 23.7: Parotid Gland Excision Complications
Algorithm 23.8: Parotid Gland Excision Complications
Algorithm for Frey’s Syndrome
Algorithm for Hollowing
Algorithm for Sialoceles
Algorithm for Duct Transection
Algorithm for Fistulas
Malignant Pathology of the Submandibular, Sublingual, and Parotid Glands
CONCLUSIONS
REFERENCES
Index
WILEY END USER LICENSE AGREEMENT
