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A modified occlusal splint to avoid tracheotomy for total midface osteotomies
J C Posnick1, P Nakano, M Taylor
1Division of Plastic Surgery (Department of Surgery), Hospital for Sick Children, Toronto, Ontario, Canada.
Annals of Plastic Surgery
|September 1, 1992
Summary
This study introduces a modified occlusal splint to prevent tracheostomy during midface osteotomies. The splint ensures accurate intraoperative occlusal relationships, offering a viable airway management alternative.
Area of Science:
- Oral and Maxillofacial Surgery
- Craniofacial Surgery
- Anesthesiology
Background:
- Total midface osteotomies require precise occlusal control for successful outcomes.
- Airway management is a critical concern during extensive craniofacial procedures.
- Tracheostomy may be necessary but carries potential complications.
Observation:
- A modified occlusal splint was developed to maintain precise bite registration.
- The splint's accuracy was validated using alginate impressions, dental casts, and face-bow transfer.
- Construction on articulated dental models confirmed accuracy within temporomandibular joint rotational range.
Findings:
- The modified occlusal splint accurately guided occlusal relationships during simulated and actual procedures.
- Demonstrated efficacy in a patient with Crouzon's syndrome undergoing complex craniofacial reconstruction.
- The splint facilitated precise intraoperative occlusal management.
Implications:
- Offers a valuable alternative to tracheostomy in specific midface osteotomy cases.
- Enhances surgical safety and predictability in complex craniofacial reconstructions.
- Improves airway management strategies for procedures demanding exact occlusal control.