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Enigma of missing teeth in maxillofacial trauma
Nardy Casap1, Michael Alterman, Sivan Lieberman
1Department of Oral and Maxillofacial Surgery, Hebrew University, Hadassah University Medical Center, Jerusalem, Israel. nard@md.huji.ac.il
Summary
Foreign bodies in the airway complicate trauma care, especially with maxillofacial injuries. Thorough oral and airway inspection before intubation is crucial to prevent life-threatening complications.
Area of Science:
- Emergency Medicine
- Oral and Maxillofacial Surgery
- Trauma Care
Background:
- Airway management is paramount in trauma care, following the Advanced Trauma Life Support protocol.
- Maxillofacial trauma can introduce foreign bodies like teeth or dental devices into the airway, complicating intubation.
- Aspiration of these foreign bodies during endotracheal intubation poses significant risks.
Observation:
- A retrospective review of 1,411 facial trauma patients was conducted.
- Seven patients (0.5%) experienced aspirated foreign bodies lodging in their upper airway.
- These incidents were linked to blunt maxillofacial trauma or emergency endotracheal intubation.
Findings:
- Foreign bodies from the oral cavity can obstruct the upper airway in trauma patients.
- Endotracheal intubation can exacerbate this by pushing foreign bodies deeper into the respiratory tract.
- Diagnostic and management challenges arise from these airway foreign bodies.
Implications:
- Pre-intubation inspection of the oral cavity and airway is essential in trauma patients.
- Removal of any foreign bodies from the mouth and throat is critical before intubation.
- Implementing these preventive measures is vital even in stressful emergency settings.
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