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Face and Jaw Emergencies

Face and Jaw Emergencies. Chapter 238. Facial Infections. Impetigo: Grp B strep & S. aureus Ersyipelas: S.pyogens Cellulitis. Salivary Glands. Parotid Submandibular Sublingual Disorders Infectious Neoplastic Immunologic Traumatic. Viral Parotitis. Mumps: paramyxovirus

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Face and Jaw Emergencies

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  1. Face and Jaw Emergencies Chapter 238

  2. Facial Infections • Impetigo: Grp B strep & S. aureus • Ersyipelas: S.pyogens • Cellulitis

  3. Salivary Glands • Parotid • Submandibular • Sublingual • Disorders • Infectious • Neoplastic • Immunologic • Traumatic

  4. Viral Parotitis • Mumps: paramyxovirus • Bilateral involvement in 75% • Clinical diagnosis • Assoc with malaise, fever, h/a, arthralgias • Usually benign • Complications: • 20-30% unilateral orchitis • Pancreatitis, mastitis, aseptic meningitis, hearing loss, myocarditis, polyarthritis, anemia

  5. Suppurative Parotitis • Potentially fatal bacterial infection • Rapid onset • Compromised salivary flow • Pus drainage from Stensen duct • Staph aureus • Treat with antibiotics and warm compresses/massage

  6. Sialolithiasis • Salivary calculi • 80% in submandibular gland • 20% in parotid • Men 30-60yo • Unilateral pain, swelling & tenderness, worse with meals • Tx: with analgesics, +/- antibiotics, “milk” the duct

  7. Salivary Gland Enlargement • Causes • Neoplasms • Most in parotids, most benign • Nutritional, toxic, metabolic causes • Vit deficiency, DM, alcoholism, hypothyroid, pregnancy • Infection • HIV, TB, actinomycosis, cat scratch fever, brachial cleft abscess

  8. Masticator Space Infection • Most from third molar sx and mandibular fractures • Polymicrobial and anaerobic • Facial swelling, pain, erythema and trismus • CT with contrast • IV clinda and ENT consult

  9. TMJ Dysfunction and Fracture • Hinge and gliding action • Injury from direct blow or chronic injury from jaw hyper mobility • Pain localized to one of the muscles of mastication, clicking noise, trismus • Panoramic xray or CT • Refer to oral maxillofacial surgeon

  10. Dislocation of Mandible • Anterior most common • Present in severe pain, malocclusion, difficulty speaking/swallowing • Tx: analgesia (pre-auricular injection) and muscle relaxation

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