ABSTRACT
Toxic epidermal necrolysis (TEN) is a rare and severe mucocutaneous disorder characterized by mucosal and epidermal necrosis and sloughing. This potentially life-threatening condition, together with the less severe Stevens-Johnson syndrome, is commonly caused by an immunologic reaction to medications and can lead to many long-term complications. The disorder initially presents with fever, malaise, and painful mucosal ulcerations (most commonly oral) but progresses to widespread cutaneous lesions. A 14-year-old male patient was prescribed minocycline for treatment of his acne by his primary care doctor. Three weeks into the antibiotic treatment, he was admitted in distress, with a diagnosis of Stevens-Johnson syndrome that subsequently progressed to TEN. We present a discussion of the importance of early recognition and diagnosis of this condition by oral and maxillofacial surgeons and a description of our patient's treatment and management during his hospital stay.
Subject(s)
Oral and Maxillofacial Surgeons , Physician's Role , Stevens-Johnson Syndrome/diagnosis , Stevens-Johnson Syndrome/therapy , Adolescent , Combined Modality Therapy , Emergencies , Humans , MaleABSTRACT
PURPOSE: To evaluate submental intubation compared with secure airways of patients who have sustained significant maxillofacial trauma. PATIENTS AND METHODS: Patient series of 3 patients who underwent submental intubation prior to open reduction internal fixation of fractures associated with the mid and lower face. All of these patients were initially orally intubated, and then converted to submental intubation prior to the reparative procedure. Detailed description of the procedure is discussed in each patient. RESULTS: All the patients received appropriate reduction of facial fractures following submental intubation with no intraoperative complications. Two of the 3 patients were extubated immediately postoperatively and 1 was extubated on the second postoperative day. None of the patients had any complications associated with submental intubation. CONCLUSIONS: Submental intubation is a safe and expedient technique to divert the airway in patients who require operative repair of panfacial injuries. This procedure is preferable over tracheostomy in selected patients of maxillofacial trauma without indication for prolonged ventilation support.
Subject(s)
Airway Management/methods , Chin/surgery , Facial Bones/injuries , Fracture Fixation, Internal/methods , Intubation, Intratracheal/methods , Maxillofacial Injuries/surgery , Skull Fractures/surgery , Adult , Airway Extubation , Facial Bones/surgery , Humans , Male , Middle Aged , Retrospective Studies , Tracheostomy/methods , Trauma CentersABSTRACT
Acetaminophen is one of the most commonly ingested medications both in the US and throughout the world. While generally considered to be one of the safer drugs on the market, life threatening hepatotoxicity occurs in patients who overdose, either intentionally or unintentionally, and fail to receive diagnosis and treatment in a timely manner. Prevention of overdose through proper patient education, coupled with timely recognition and treatment, is critical in patient management.
Subject(s)
Acetaminophen/adverse effects , Analgesics, Non-Narcotic/adverse effects , Chemical and Drug Induced Liver Injury/diagnosis , Chemical and Drug Induced Liver Injury/prevention & control , Drug Overdose/diagnosis , Drug Overdose/prevention & control , Humans , Risk FactorsABSTRACT
This is the report of a case of arteriovenous malformation (AVM) of the tongue in a 13-year-old female patient. The clinical course is outlined; an intraoperative dilemma is discussed; and a review of the literature is presented. Vascular lesions demand heightened attention by all practitioners throughout the planning and diagnostic phase, during surgical treatment, as well as postoperatively. Careful attention to detail can help avoid poor patient outcomes and, even, fatal consequences.
Subject(s)
Arteriovenous Malformations/diagnosis , Tongue/abnormalities , Tongue/blood supply , Adolescent , Arteriovenous Malformations/surgery , Female , Humans , Tongue/surgery , Vascular Surgical ProceduresABSTRACT
Necrotizing fasciitis is a rare, rapidly progressing infection with significant morbidity and high mortality rates. Rarely does necrotizing fasciitis appear in the head and neck region; rather, it usually affects the limbs and abdomen of patients. This article presents our institution's experience with the disease and provides a discussion of propoied treatment options.
Subject(s)
Face , Fasciitis, Necrotizing/diagnostic imaging , Fasciitis, Necrotizing/therapy , Anti-Bacterial Agents/therapeutic use , Combined Modality Therapy , Debridement , Diagnosis, Differential , Drainage , Fasciitis, Necrotizing/microbiology , Humans , Male , Middle Aged , Oral Surgical ProceduresABSTRACT
Necrotizing fasciitis is a rare, rapidly progressing in- fection with significant morbidity and high mortality rates. Rarely does necrotizing fasciitis appear in the head and neck region; rather, it usually affects the limbs and abdomen of patients. This article presents our institution's experience with the disease and pro- vides a discussion of proposed treatment options.
Subject(s)
Fasciitis, Necrotizing/diagnosis , Debridement , Dental Caries/diagnosis , Diagnosis, Differential , Fasciitis, Necrotizing/surgery , Focal Infection, Dental/diagnosis , Follow-Up Studies , Humans , Hypertension/complications , Kidney Failure, Chronic/complications , Male , Middle Aged , Shock, Septic/diagnosisABSTRACT
Sodium hypochlorite (NaOCl) is a well documented and widely accepted intracanal irrigant used to disinfect the pulp space in endodontic therapy. NaOCl can be an extremely cytotoxic material; therefore, care must be taken with its use. The authors present a case of periradicular extravasation of NaOCl with sequelae of pain, swelling, ecchymosis and parasthesia consistent with a chemical burn. The patient was treated with a nonsurgical medical management approach. She experienced a complete resolution of signs and symptoms, aside from a persistent residual focal parasthesia.
Subject(s)
Burns, Chemical/etiology , Periapical Tissue/injuries , Root Canal Irrigants/adverse effects , Sodium Hypochlorite/adverse effects , Bicuspid , Ecchymosis/chemically induced , Edema/chemically induced , Extravasation of Diagnostic and Therapeutic Materials/complications , Face , Female , Humans , Maxilla , Middle Aged , Paresthesia/chemically induced , Periapical Tissue/drug effectsABSTRACT
Diffuse sclerosing osteomyelitis (DSO) is an interesting and debilitating entity with a disputed, unknown or unproven etiology. This case report illustrates the complexity of managing these cases, which are refractory to multiple therapeutic modalities.
Subject(s)
Mandibular Diseases/diagnosis , Osteomyelitis/diagnosis , Adult , Biopsy , Follow-Up Studies , Humans , Hyperbaric Oxygenation , Male , Mandibular Diseases/surgery , Osteomyelitis/surgery , Osteosclerosis/diagnosis , Osteosclerosis/surgery , Tomography, X-Ray ComputedABSTRACT
Emergency cricothyrotomy is a potentially lifesaving surgical procedure used to gain prompt access to an otherwise compromised and inaccessible airway. The purpose of this photoessay is to demonstrate the technique of the procedure in a step-by-step manner so that the physician can perform this intervention with ease and facility in the most stressful of circumstances.
