1/4. Use of an orthopaedic fixator for external fixation of the mandible.A patient presented with a chronically infected, non-united fracture of the mandible, with considerable bone loss. He was treated with a metacarpal fixator, the miniPennig external fixator. The fixator is stable and smaller than conventional mandibular fixators. It can be applied and removed under local anaesthesia, if necessary, requires little maintenance and produces minimal scarring. The successful outcome in this patient is encouraging and we commend the use of the fixator in similar difficult cases.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
2/4. Prolonged myoclonus and meningism following propofol.The purpose of this report is to describe a new complication of propofol administration. A previously fit patient underwent intravenous anaesthesia with propofol for removal of dental wires. Postoperatively he developed myoclonic jerking of his limbs. On regaining consciousness he complained of an occipital headache, neck stiffness and photophobia, and was found to have nuchal rigidity on examination. These clinical features resolved over the following week. Subsequent investigations failed to explain the aetiology of the symptoms of meningeal irritation, which suggests that propofol was the causative agent. While prolonged myoclonus has been previously described with propofol administration, this is the first report of meningism occurring with its use.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
3/4. Awake fibreoptic intubation in the semi-prone position following facial trauma.A fit 27-year-old man presented with severe facial trauma following an industrial accident. Initial assessment showed severe swelling around the lower jaw and haemorrhage from the mouth, nose, scalp and left ear. The patient was conscious with a Glasgow coma Score of 13 but in respiratory distress. Following adoption of the prone position his airway improved. Relief of the patient's airway obstruction was a priority and the patient underwent awake fibreoptic intubation in the prone position prior to induction of anaesthesia. Computed tomography scans of his head and neck were unremarkable and after fixation of a bilateral mandibular fracture he made an uneventful recovery. intubation in the semi-prone position may be a useful technique in injuries of this type.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
4/4. Mental nerve dysfunction: a symptom of diverse mandibular disease.Paraesthesia and anaesthesia of the mental nerve may result from a variety of pathological conditions, and in persistent cases of orofacial sensory disturbance thorough clinical assessment, including CT scanning, is vital to exclude underlying systemic or neoplastic disease. This paper presents three patients with right mental nerve dysfunction, and reviews the aetiology of mental nerve paraesthesia and anaesthesia.- - - - - - - - - - ranking = 2keywords = anaesthesia (Clic here for more details about this article) |