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S314: Current Concepts of Facial Alloplastic Contouring in Esthetic Surgery
Surgical Clinics
S312 Anatomy and Surgery of Oral and Maxillofacial Infections Thomas R. Flynn, DMD, Boston, MA The principles of the management of deep space head and neck infections include early and rapid assessment of the severity of the infection by anatomic location, rate of progression, and the potential for airway compromise. After evaluation of host defenses, early definitive surgical management is a key to arresting further progression of the infection. The use of drains, medical supportive care, and follow up management of these infections are presented. Unusual and complicated infections are illustrated with cases, including necrotizing fasciitis, brain abscess, mediastinitis, and cavernous sinus thrombosis. Orofacial infections usually spread in a predictable fashion from one anatomic space into another, depending on the site of origin and the causative organism. The ability of the oral and maxillofacial surgeon to predict the clinical behavior of deep space infections of the head and neck make this specialist the expert in the management of these conditions. That anatomic and surgical knowledge is summarized in this lecture, including the borders, contents, relations, and likely causes of infections in the deep fascial spaces. The clinical presentation, diagnosis, and surgical therapy of infections of each of these spaces are illustrated with several cases. Anesthetic and airway considerations in the management of orofacial infections are then discussed. The diagnosis of airway compromise is reviewed, and currently available airway management techniques are compared. These considerations are supported by data resulting from a recently published prospective study of 37 severe odontogenic infections recently completed at the Montefiore Medical Center, Bronx, NY.
Obstructive sleep apnea (OSA) has a significant effect on quality of life with tools and questionnaires available to evaluate outcomes. OSA has been associated with an increase risk for cardiovascular disease, hypertension, stroke, gastroesophageal reflux, impotence, motor vehicle accidents, depression, etc. While the incidence seems to be higher in adult overweight males, OSA affects females and children as well. The treatment should be customized to the patient and to the specific etiology. In the pediatric population the most common cause of OSA is hypertrophic tonsils and adenoids while syndromic patients may require a completely different management. Several treatment modalities have been advocated in the adult population. Uvulopalatopharyngoplasty, genial advancement, hyoid suspension with or without suprahyoid myotomy and bimaxillary advancement have been popularized in recent years. While many surgical techniques are offered, a critical evaluation of their success rates shows suboptimal outcomes. A retrospective analysis of data by the presenter offers an algorithm for the management of OSA. The role of the oral and maxillofacial surgeon in the Sleep Apnea Team has become indispensable due to the high success and predictability of bimaxillary advancement procedures with or without distraction osteogenesis. References C. Moyer, S. Sonnad, S. Garetz, J. Helman, R. Chervin. Quality of life in obstructive sleep apnea: a systematic review of the literature. Sleep Med, 2: 477-491, November 2001 S.S. Sonnad, C. Moyer, S. Patel, J.I. Helman, S. Garetz, R. Chervin. A model to facilitate outcome assessment of obstructive sleep apnea. International Journal of Technology Assessment in Health Care, 19:25360, Winter 2003 K. Magliocca, J.I. Helman. Obstructive Sleep Apnea: Diagnosis, Medical Management and Dental Implications. J. of the American Dental Association, 136:1121-1129, 2005 K. Cottrell, J.I. Helman. “Distraction osteogenesis in the management of Obstructive Sleep Apnea Syndrome.” In Distraction Osteogenesis of the Facial Skeleton. Editors C. Guerrero and W. Bell. B. C. Decker Publisher, 2007
References Flynn TR. Principles of management of odontogenic infections. In: Miloro M, editor. Peterson’s Principles of Oral and Maxillofacial Surgery. 2nd edition. Hamilton: BC Decker; 2005, vol 1, p 277-293 Flynn TR, Shanti RM, Levy M, Adamo, AK, Kraut RA, Trieger N. Severe Odontogenic Infections, Part One: Prospective Report. J Oral Maxillofac Surg 2006;64:1093-1103 Flynn TR, Shanti RM, Hayes C. Severe Odontogenic Infections, Part Two: Prospective Outcomes Study. J Oral Maxillofac Surg 2006;64: 1104-1113
S314 Current Concepts of Facial Alloplastic Contouring in Esthetic Surgery Likith Reddy, DDS, MD, Cincinnati, OH No abstract provided.
S313 Diagnosis and Management of Obstructive Sleep Apnea Syndrome (OSAS) Joseph I. Helman, DMD, Ann Arbor, MI AAOMS • 2007
S315 Management of Lip Cancer Jon D. Holmes, DMD, MD, Birmingham, AL Rui P. Fernandes, DMD, MD, Jacksonville, FL 95
S312 Anatomy and Surgery of Oral and Maxillofacial Infections Thomas R. Flynn, DMD, Boston, MA The principles of the management of deep space head and neck infections include early and rapid assessment of the severity of the infection by anatomic location, rate of progression, and the potential for airway compromise. After evaluation of host defenses, early definitive surgical management is a key to arresting further progression of the infection. The use of drains, medical supportive care, and follow up management of these infections are presented. Unusual and complicated infections are illustrated with cases, including necrotizing fasciitis, brain abscess, mediastinitis, and cavernous sinus thrombosis. Orofacial infections usually spread in a predictable fashion from one anatomic space into another, depending on the site of origin and the causative organism. The ability of the oral and maxillofacial surgeon to predict the clinical behavior of deep space infections of the head and neck make this specialist the expert in the management of these conditions. That anatomic and surgical knowledge is summarized in this lecture, including the borders, contents, relations, and likely causes of infections in the deep fascial spaces. The clinical presentation, diagnosis, and surgical therapy of infections of each of these spaces are illustrated with several cases. Anesthetic and airway considerations in the management of orofacial infections are then discussed. The diagnosis of airway compromise is reviewed, and currently available airway management techniques are compared. These considerations are supported by data resulting from a recently published prospective study of 37 severe odontogenic infections recently completed at the Montefiore Medical Center, Bronx, NY.
Obstructive sleep apnea (OSA) has a significant effect on quality of life with tools and questionnaires available to evaluate outcomes. OSA has been associated with an increase risk for cardiovascular disease, hypertension, stroke, gastroesophageal reflux, impotence, motor vehicle accidents, depression, etc. While the incidence seems to be higher in adult overweight males, OSA affects females and children as well. The treatment should be customized to the patient and to the specific etiology. In the pediatric population the most common cause of OSA is hypertrophic tonsils and adenoids while syndromic patients may require a completely different management. Several treatment modalities have been advocated in the adult population. Uvulopalatopharyngoplasty, genial advancement, hyoid suspension with or without suprahyoid myotomy and bimaxillary advancement have been popularized in recent years. While many surgical techniques are offered, a critical evaluation of their success rates shows suboptimal outcomes. A retrospective analysis of data by the presenter offers an algorithm for the management of OSA. The role of the oral and maxillofacial surgeon in the Sleep Apnea Team has become indispensable due to the high success and predictability of bimaxillary advancement procedures with or without distraction osteogenesis. References C. Moyer, S. Sonnad, S. Garetz, J. Helman, R. Chervin. Quality of life in obstructive sleep apnea: a systematic review of the literature. Sleep Med, 2: 477-491, November 2001 S.S. Sonnad, C. Moyer, S. Patel, J.I. Helman, S. Garetz, R. Chervin. A model to facilitate outcome assessment of obstructive sleep apnea. International Journal of Technology Assessment in Health Care, 19:25360, Winter 2003 K. Magliocca, J.I. Helman. Obstructive Sleep Apnea: Diagnosis, Medical Management and Dental Implications. J. of the American Dental Association, 136:1121-1129, 2005 K. Cottrell, J.I. Helman. “Distraction osteogenesis in the management of Obstructive Sleep Apnea Syndrome.” In Distraction Osteogenesis of the Facial Skeleton. Editors C. Guerrero and W. Bell. B. C. Decker Publisher, 2007
References Flynn TR. Principles of management of odontogenic infections. In: Miloro M, editor. Peterson’s Principles of Oral and Maxillofacial Surgery. 2nd edition. Hamilton: BC Decker; 2005, vol 1, p 277-293 Flynn TR, Shanti RM, Levy M, Adamo, AK, Kraut RA, Trieger N. Severe Odontogenic Infections, Part One: Prospective Report. J Oral Maxillofac Surg 2006;64:1093-1103 Flynn TR, Shanti RM, Hayes C. Severe Odontogenic Infections, Part Two: Prospective Outcomes Study. J Oral Maxillofac Surg 2006;64: 1104-1113
S314 Current Concepts of Facial Alloplastic Contouring in Esthetic Surgery Likith Reddy, DDS, MD, Cincinnati, OH No abstract provided.
S313 Diagnosis and Management of Obstructive Sleep Apnea Syndrome (OSAS) Joseph I. Helman, DMD, Ann Arbor, MI AAOMS • 2007
S315 Management of Lip Cancer Jon D. Holmes, DMD, MD, Birmingham, AL Rui P. Fernandes, DMD, MD, Jacksonville, FL 95