Generality
Maxillofacial surgery is the medical-surgical branch specialized in the diagnosis and treatment of diseases and injuries affecting the skull, face, mouth, jaw, mandible and / or neck.
Its field of action is very broad and includes: dentoalveolar surgery operations, the removal of cysts or tumors located in the mouth or in another part of the face, cosmetic surgery operations on the face, fractures of the mandible or maxilla, orthognathic surgery operations, repair of malformations such as cleft lip, etc.
The most complex maxillofacial surgery operations require special preparation.
Duration, healing and recovery times, and risks of the operation depend on the type of surgery.
Thanks to modern instruments and the remarkable skills of current surgeons, maxillofacial surgery operations have more than a good chance of ending positively.
What's this?
Maxillofacial surgery is a medical and surgical discipline specializing in the diagnosis and treatment of diseases and injuries affecting the skull, face, mouth, jaw, mandible and / or neck.
Skull, face, mouth, jaw, mandible and neck make up the so-called cranio-maxillofacial complex.
IS IT A SURGICAL SPECIALTY?
In Italy and in most of Europe, maxillofacial surgery is a surgical specialty, on a par with general surgery, cardiac surgery, neurosurgery, plastic and reconstructive surgery, etc.
In countries such as the United States, Canada, Australia or Israel, on the other hand, it represents a dental specialty (ie dentistry).
WHO IS THE MAXILLO FACIAL SURGERY SPECIALIST?
As it can be understood, the surgeon specializing in maxillofacial surgery takes the name of maxillofacial surgeon.
Indications
The fields of action of maxillofacial surgery are innumerable.
In fact, the list of possible tasks of a maxillofacial surgeon includes:
- Dentoalveolar surgery operations, such as for example the extraction of decayed teeth for which there is no possibility of recovery, the removal of impacted teeth, the extraction of teeth that are no longer vital, the installation of dental prostheses, "installation of dental implants or the treatment of dental granulomas and dental abscesses;
- Removal of cysts or tumors located in a part of the face, mouth, jaw, or jaw;
- Biopsies of cysts or tumors located in the mouth;
- Treatment of fractures of the jaw or jaw;
- Surgery operations involving the temporomandibular joint;
- Surgery operations aimed at modifying the shape and size of the facial bones;
- The orthognathic surgery operations. Orthognathic surgery is that branch of medicine which mainly has as its object the anomalies and dysfunctions of the jaw;
- Surgical reconstruction of parts of the face (eg lips);
- Surgical repair of congenital malformations of the mouth, such as cleft lip (or cleft lip or cleft lip), cleft palate or cleft lip;
- Surgical repair of congenital anomalies of the cranial vault, such as craniosynostoses;
- Cosmetic surgery operations involving parts of the face (e.g. nose, mouth, ears, eyes, etc.). Among the best known cosmetic surgery operations performed by a maxillofacial surgeon, the following deserve a mention: otoplasty, blepharoplasty, rhytidectomy, rhinoplasty, genioplasty, oculoplasty and liposuction of the neck.
It should be noted that the aforementioned list contains examples of invasive operations, or in any case very delicate from an executive point of view, and examples of minimally invasive and not particularly complex operations.
Preparation
While less invasive maxillofacial surgery operations require only some pre-operative attention, all delicate and complex maxillofacial surgeries require a very specific preparation.
This preparation generally consists of:
- An accurate medical history. It is used by the doctor to know the general health of the patient, his past pathologies, and so on.
- Diagnostic tests for the measurement of vital signs. These include blood pressure measurements, blood tests and electrocardiograms.
They are used by the doctor to understand if the patient is capable of undergoing surgery. - Radiological investigations (nuclear magnetic resonance, X-rays, CT scans, etc.). They are used by the doctor to understand and clarify the exact anatomy of the future site of intervention.
They are also useful tests for minimally invasive operations. - The suspension of any drug treatment based on anticoagulants (warfarin and derivatives) and / or antiplatelet drugs (aspirin and derivatives). By diluting the blood, these medicines represent a factor promoting bleeding, in case of wounds, surgical incisions, etc.
This preparatory measure is also valid on the occasion of minimally invasive operations, in which there is the need to incise a portion of tissue. - Complete fasting presentation, on the day of surgery, from at least the previous evening. Patients are required to follow fasting whenever the operation, which they are about to face, involves general anesthesia or local anesthesia associated with a strong sedation.
Procedure
As a rule, maxillofacial surgery operations foresee, in this sequence, the "accommodation of the patient in a special bed or in a" special chair, the realization of sedation and anesthesia and, finally, the execution of the real intervention. is exactly.
SITES OF INTERVENTION AND ENVIRONMENT
Generally, maxillofacial surgery operations take place in the operating theaters of clinics or hospitals, or in the best equipped dental offices.
The most important aspect of the environments assigned to maxillofacial surgery is their sterilization and the maintenance of their sterilization (surgical asepsis).
Maxillofacial surgery tools:
- Dental surgical bone file
- Hemostat
- Scalpel
- Surgical curettes
- Surgical forceps
- Surgical scissors
- Suture scissors
- Needle holder
- Retractors
- Mouth opener
- Surgical Mallet
- Surgical drills
DURATION OF THE OPERATIONS
The duration of maxillofacial surgery operations varies according to the type of surgery.
There are, in fact, very long types of intervention, which also require several hours, and types of short duration, which do not exceed 60 minutes.
POST-OPERATIVE PHASE AND RECOVERY
The post-operative phase and the recovery from a maxilloflastic surgery mainly depend on the "invasiveness of the procedure. In fact, the more invasive an" operation is, the more the post-operative phase and recovery require attention, time and rehabilitation therapies. .
It should be remembered that the use of general anesthesia (N.B: it is used in more invasive or more complex interventions) makes it essential to hospitalize the patient; this hospitalization must have a minimum duration of 24 hours.
Risks and complications
Maxillofacial surgery presents the classic risks of any surgical practice, plus those that characterize each specific intervention (specific risks).
Risks of surgical practice in general:- Infections
- Hemorrhages
- Adverse reactions to anesthesia
- Prolonged pain
- Atelectasis
- Formations of blood clots
- Confusion
Contraindications
Contraindications to maxillofacial surgery depend on the type of intervention.
For some operations, the list of contraindications is minimal; for other procedures, however, it includes different health conditions.
Results
Thanks to the continuous advances in medical and surgical technology, which provides increasingly efficient and practical tools, today's maxillofacial surgery operations are highly likely to end successfully.
