No abstract

The objective of this prospective study was to determine the incidence of injury to the inferior alveolar and lingual nerves following surgical removal of impacted mandibular third molars and to evaluate the various factors contributing to the same. A total of 119 patients underwent mandibular third-molar removal during the period of 11 months. Of 119, 3 inferior alveolar nerve and 5 lingual nerve injuries were encountered. Various factors such as lingual retraction, surgical time, operator experience, radiologic findings contributing to the injury were correlated and analyzed.

The role of prophylactic antibiotics to prevent surgical wound infection (SWI) in the management of maxillofacial fractures is controversial. We carried out a retrospective study in 67 patients with 114 maxillofacial fractures, of which 9 patients each were in group 1 (no antibiotic) and group 3 (cefotaxime) and 49 in group 2 (penicillin). We had an overall SWI rate of 16.66%, of which 3 of group 1 (33.33%), 12 of group 2 (24.48%), and 2 of group 3 (22.22%) constituted the SWIs. Statistical analysis showed no significant difference between the infection rates. A strong positive correlation was found between infection rate and the delay in treatment, and a similar correlation was found in the use of catgut and SWI. Our study suggests that prophylactic antibiotic therapy may not alter the incidence of surgical wound infection.

Our study failed to show any advantage in the routine use of prophylactic antibiotics because we found no statistically significant difference between the groups.

We designed a prospective study with the objective to evaluate the efficacy, indications and our experience of submental intubation in different types of maxillofacial surgeries. From May 2008 to August 2010, 23 patients with different conditions were intubated by submental route of tracheal intubation and patients were evaluated on different parameters during and after surgery to find its efficacy, indications and utilization in maxillofacial surgeries. All the patients were managed well with this technique of intubation with no significant difference in intubation and extubation time. We did not face any uneventful complication. There was only one reported complication that is rupture of the bulb of cuffed flexometallic tube but was managed well by changing tube. We found skull base access surgery as a new indication for submental intubation. The submental route for endotracheal intubation may be utilized as an alternative to blind nasal intubation or tracheostomy in the surgical management of patients involving complex maxillofacial surgeries. We hypothesized that the submental intubation should not be used where long term ventilation support is needed. We did a technique modification to deliver the endotracheal tube out from the submental region to avoid pilot cuff damage. Our study proposes that skull base access surgery is a safe and potential indication for submental intubation. In our experience submental intubation is a simple, secure and effective procedure for operative airway control in major maxillofacial surgeries.