Eponyms and maxillofacial
Eponyms and maxillofacial syndromes 294
CHAPTER13 Eponyms and maxillofacial syndromes
Eponyms and maxillofacial syndromes
Apert syndrome is a craniosynostosis plus syndactyly leading to lack of
anterior growth of the midface, raised intracranial pressure, and blindness
due to subluxation and lack of corneal cover of theeye.
Behçet syndrome is a multisystem autoimmune condition associated with
HLA- B5. Patients have oral and genital ulceration and uveitis. Treatment is
highly specialized; mainly immunosuppressant.
Binder syndrome Patients have severe underdevelopment of the nose and
Cleidocranial dysostosis is a condition mainly of membranous bone for-
mation leading to hypoplastic or aplastic clavicles, and frontal and parietal
bossing on a large but shortened skull with midface retrusion, clefting, and
failure of tooth eruption common.
Crouzon syndrome These patients have craniosynostosis and a hypo-
plastic midface which may lead to blindness. The increased intracranial pres-
sure will lead to mental retardation, if left untreated.
DiGeorge syndrome is a combination of cardiac anomalies, velopharyngeal
anomalies, thymic aplasia, and hypocalcaemia. It is due to deletion of part
Eagle syndrome is a painful condition due to elongation of the styloid pro-
cess which causes pain on turning thehead.
Ehlers– Danlos syndrome involves a group of inherited connective tis-
sue disorders resulting in, among other things, hyperexibility of joints,
increased bleeding sometimes, possibly more TMJ problems, and highly
Fanconi anaemia is a genetic disorder which aects a group of proteins
responsible for DNA repair. 1/ 130,000 births. Most develop cancer, most
commonly acute myeloid leukaemia. 90% develop bone marrow failure.
Look for it in head and neck cancer patients who present under age40.
Frey syndrome Gustatory sweating after parotid surgery. Asimilar thing can
happen with a running nose after nasal surgery and sweating over the face
after submandibular surgery.
Gardner syndrome is familial colorectal polyposis plus craniofacial osteo-
mas, epidermoid cysts, and bromas ofskin.
Goldenhar syndrome is a syndrome of rst and second branchial arch
anomalies with hemifacial microsomia and other anomalies of the internal
Gorlin– Goltz syndrome, or multiple basal cell naevi syndrome. Suerers
from this condition have multiple BCCs, keratocystic odontogenic tumours,
bid ribs, and calcication of the falx cerebri.
Heerfordt syndrome results from sarcoidosis aecting the parotid and lac-
rimal glands with facial nerve weakness andfever.
EPONYMS AND MAXILLOFACIAL SYNDROMES
Histiocytosis X is the general term for a group of syndromes involving
• Langerhans cell histiocytosis, which is also called histiocytosis X.This
comprises three groups:
Solitary eosinophilic granuloma— may aect the mandible.
Hand– Schuller– Christian disease— multifocal and aects younger
children. Treatment is cytotoxic.
Letterer– Siwe disease is generalized and often rapidlyfatal.
• Malignant histiocytosis syndrome (now known as T- cell lymphoma).
• Non- Langerhans cell histiocytosis (also known as haemophagocytic
Horner syndrome is a combination of miosis, ptosis, anhidrosis, and enoph-
thalmos. It is due to ipsilateral sympathetic dysfunction such as iatrogenic,
after neck surgery, or lung cancer.
Hurler syndrome or mucopolysaccharidosis type 1.It consists of hepato-
splenomegaly, dwarsm, frontal bossing, enlarged tongue, coarse features,
and mental retardation.
Larsen syndrome is an autosomal dominant congenital disorder com-
prising cleft palate, with other anomalies including hypermobility and
MAGIC syndrome involves mouth and genital ulcers and interstitial chon-
dritis. It seems to overlap Behçet syndrome and relapsing poly- chondritis.
Marcus Gunn phenomenon or trigemino- oculomotor synkinesis. This is an
inherited condition of eyelid retraction on moving thejaw.
Marfan syndrome is a disorder of connective tissue which results in aortic
root dilatation, long limbs and digits, high- arched palate, and tall thin stature.
It is common in basket- ball players.
McCune– Albright syndrome is a combination of polyostotic brous dys-
plasia, café au lait spots, and endocrine anomaly, which is most commonly
Melkerson– Rosenthal syndrome comprises facial nerve weakness, ssured
tongue, and facial swelling. It is a type of orofacial granulomatosis.
Paterson– Brown– Kelly syndrome or Plummer– Vinson syndrome com-
prises anaemia, post- cricoid webbing, and dysphagia which usually aects
middle- aged women. There is a dangerous tendency to develop cancer in
Peutz– Jeghers syndrome results in intestinal polyps, with perioral
and intra-oral pigmentation. The polyps are hamartomas and are not
Ramsay Hunt syndrome type 2 is one of three syndromes named after
Ramsay Hunt. It is the other non- iatrogenic cause of lower facial nerve
weakness (other than Bell’s palsy and tumour) that you are most likely to
encounter and is otherwise known as herpes zoster oticus. It is the result of
herpes zoster infection of the geniculate ganglion, causing ipsilateral facial
nerve palsy and vesicles in the external auditorycanal.
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293 Chapter13Eponyms and maxillofacial syndromesEponyms and maxillofacial syndromes 294 294CHAPTER13 Eponyms and maxillofacial syndromes294Eponyms and maxillofacial syndromesApert syndrome is a craniosynostosis plus syndactyly leading to lack of anterior growth of the midface, raised intracranial pressure, and blindness due to subluxation and lack of corneal cover of theeye.Behçet syndrome is a multisystem autoimmune condition associated with HLA- B5. Patients have oral and genital ulceration and uveitis. Treatment is highly specialized; mainly immunosuppressant.Binder syndrome Patients have severe underdevelopment of the nose and maxilla.Cleidocranial dysostosis is a condition mainly of membranous bone for-mation leading to hypoplastic or aplastic clavicles, and frontal and parietal bossing on a large but shortened skull with midface retrusion, clefting, and failure of tooth eruption common.Crouzon syndrome These patients have craniosynostosis and a hypo- plastic midface which may lead to blindness. The increased intracranial pres-sure will lead to mental retardation, if left untreated.DiGeorge syndrome is a combination of cardiac anomalies, velopharyngeal anomalies, thymic aplasia, and hypocalcaemia. It is due to deletion of part of chromosome22.Eagle syndrome is a painful condition due to elongation of the styloid pro-cess which causes pain on turning thehead.Ehlers– Danlos syndrome involves a group of inherited connective tis-sue disorders resulting in, among other things, hyperexibility of joints, increased bleeding sometimes, possibly more TMJ problems, and highly elasticskin.Fanconi anaemia is a genetic disorder which aects a group of proteins responsible for DNA repair. 1/ 130,000 births. Most develop cancer, most commonly acute myeloid leukaemia. 90% develop bone marrow failure. Look for it in head and neck cancer patients who present under age40.Frey syndrome Gustatory sweating after parotid surgery. Asimilar thing can happen with a running nose after nasal surgery and sweating over the face after submandibular surgery.Gardner syndrome is familial colorectal polyposis plus craniofacial osteo-mas, epidermoid cysts, and bromas ofskin.Goldenhar syndrome is a syndrome of rst and second branchial arch anomalies with hemifacial microsomia and other anomalies of the internal organs.Gorlin– Goltz syndrome, or multiple basal cell naevi syndrome. Suerers from this condition have multiple BCCs, keratocystic odontogenic tumours, bid ribs, and calcication of the falx cerebri.Heerfordt syndrome results from sarcoidosis aecting the parotid and lac-rimal glands with facial nerve weakness andfever. EPONYMS AND MAXILLOFACIAL SYNDROMES295 Histiocytosis X is the general term for a group of syndromes involving histiocytes.• Langerhans cell histiocytosis, which is also called histiocytosis X.This comprises three groups:• Solitary eosinophilic granuloma— may aect the mandible.• Hand– Schuller– Christian disease— multifocal and aects younger children. Treatment is cytotoxic.• Letterer– Siwe disease is generalized and often rapidlyfatal.• Malignant histiocytosis syndrome (now known as T- cell lymphoma).• Non- Langerhans cell histiocytosis (also known as haemophagocytic syndrome).Horner syndrome is a combination of miosis, ptosis, anhidrosis, and enoph-thalmos. It is due to ipsilateral sympathetic dysfunction such as iatrogenic, after neck surgery, or lung cancer.Hurler syndrome or mucopolysaccharidosis type 1.It consists of hepato-splenomegaly, dwarsm, frontal bossing, enlarged tongue, coarse features, and mental retardation.Larsen syndrome is an autosomal dominant congenital disorder com-prising cleft palate, with other anomalies including hypermobility and brachycephaly.MAGIC syndrome involves mouth and genital ulcers and interstitial chon-dritis. It seems to overlap Behçet syndrome and relapsing poly- chondritis.Marcus Gunn phenomenon or trigemino- oculomotor synkinesis. This is an inherited condition of eyelid retraction on moving thejaw.Marfan syndrome is a disorder of connective tissue which results in aortic root dilatation, long limbs and digits, high- arched palate, and tall thin stature. It is common in basket- ball players.McCune– Albright syndrome is a combination of polyostotic brous dys-plasia, café au lait spots, and endocrine anomaly, which is most commonly precocious puberty.Melkerson– Rosenthal syndrome comprises facial nerve weakness, ssured tongue, and facial swelling. It is a type of orofacial granulomatosis.Paterson– Brown– Kelly syndrome or Plummer– Vinson syndrome com-prises anaemia, post- cricoid webbing, and dysphagia which usually aects middle- aged women. There is a dangerous tendency to develop cancer in the webbedarea.Peutz– Jeghers syndrome results in intestinal polyps, with perioral and intra-oral pigmentation. The polyps are hamartomas and are not pre- malignant.Ramsay Hunt syndrome type 2 is one of three syndromes named after Ramsay Hunt. It is the other non- iatrogenic cause of lower facial nerve weakness (other than Bell’s palsy and tumour) that you are most likely to encounter and is otherwise known as herpes zoster oticus. It is the result of herpes zoster infection of the geniculate ganglion, causing ipsilateral facial nerve palsy and vesicles in the external auditorycanal. 296CHAPTER13 Eponyms and maxillofacial syndromes296Robin sequence or Pierre Robin sequence is a congenital condition resulting in a severely small lower jaw, cleft palate, and glossoptosis. It can be fatal if the tongue is not prevented from obstructing the airway.Romberg syndrome or Parry– Romberg syndrome is a rare disguring disease with progressive hemifacial atrophy, wasting of the soft tissues of the face, epilepsy, and trigeminal neuralgia. It tends to burn out after a few years, but leaves a facial asymmetry which is very dicult to treat. It is of unknown aetiology.Sjögren syndrome• Primary Sjögren syndrome or sicca syndrome is dry mouth andeyes.• Secondary Sjögren syndrome is as primary plus another autoimmune disease such as rheumatoid arthritis or systemic lupus erythematosus.Stevens– Johnson syndrome is a type of toxic epidermal necrolysis. It is an autoimmune condition usually triggered by an exogenous agent such as her-pesvirus or one of many drugs. It results in ulceration of the oral, genital, anal, and conjunctival membranes, and also aects the skin. Amilder form is erythema multiforme.Stickler syndrome is a connective tissue disorder which results in a at face, cleft palate, myopia, cataracts, hearing loss, arthritis, and hypermobility.Sturge– Weber syndrome comprises a large port wine stain of the upper face, epilepsy, mental retardation, and glaucoma.Treacher Collins syndrome or mandibulofacial dysostosis comprises under-development of the mandible, zygoma, and ears with a downward- sloping palpebral ssure.Trotter syndrome is a combination of symptoms of malignancy invading the infratemporal fossa and lateral pharynx and includes pain in the mandibular division of the trigeminal nerve, trismus and immobility of palate, and uni-lateral conductive hearing loss. It is possible that TMJ pain could be confused with this condition and viceversa.von Recklinghausen neurobromatosis includes neurobromas with pre-malignant potential, café au lait spots, and skeletal anomalies. 297 Aabdominal examination 37– 8abrasions 95,138abscesseschildren 75compromised airway 263incision and drainage 234– 5ultrasound 60ward care 206abusechildren 74,103domestic 79aciclovir 281acromegaly 257acute apical periodontitis 244acute bacterial sialadenitis 118acute candidiasis 246acute erythematous candidiasis 246acute myeloid leukaemia 121acute (necrotizing) ulcerative gingivitis 120– 1, 245,246acute pseudomembranous candidiasis 246acute pulpitis 244adenoid cystic carcinoma 164admitting fromA&E 73airway compromise 262– 3alarm clock headache 151alcohol consumption 73,79alcohol withdrawal 201alginate 283alveolar osteitis 113Alvogyl® 282amalgam tattoo 283ameloblastomas 258amelogenesis imperfecta 245amoxicillin 280analgesics 278– 9aneurysmal bone cysts 258angular cheilitis 247animal bites 95anterior open bite 14,90anterolateral thigh ap 161antibacterials 280antidepressants 278antifungals 280– 1antimicrobials 280– 1antivirals 281Apert syndrome 294– 6aphthous stomatitis 256aphthous ulcers 153arch bar removal 132articaine 277tatypical facial pain 151atypical odontalgia 151avulsed teeth 74, 104t,106Bbarber’s itch 116Bartholin’s duct 20basal cell carcinoma 156basal cell nevus syndrome 156,157fbat ears 170Behçet syndrome 294– 6benzocaine lozenges 278benzydamine mouthwash 278benzylpenicillin 280betel nut chewing 254Binder syndrome 294– 6biopsy 236– 7bite injuries 95bitewing radiographs 48– 50,49fblack eyes, bilateral 90bleed, massive 268– 9,270– 1bleeding around tracheostomy tubes 266bleeding gums 120– 1bleeding socket 112,225blepharoplasty 196blistering disease 250– 1blow- out fracture 88– 90body examination 37– 8bonding materials 282– 3bone biopsy 237bone cysts 258bones of face 22– 8, 24fbotulinum toxin 284bridge 106tbridle wiring 233British Association of Dermatologists 156– 60British Association of Oral and Maxillofacial Surgeons 5,8brow- lift 197BSI classication of occlusion 14– 15,15fbullous lichen planus 251burning mouth syndrome 151,259buttress fracture 84CCampbell’s lines 58f,85cancercompromised airway 263oral 153, 254– 5,255tsee also head and neckcancercandidiasis 246– 7,280– 1canine fossa 234canine impaction 51– 4, 52f,143carbamazepine 278carbuncle 116cardiovascular examination 37career pathways 8carotid blow- out 201,270– 1carotid body tumour 155carotid sheath 32cat bites 95cat scratch disease 155cellulitis 108– 9,117periorbital 22– 4, 110,117cementum 10centric occlusion 14cervical tuberculous lymphadenitis 155charting teeth 11cheek injuries 96chemotherapy 163,256child abuse 74,103child patients 74– 6chlorhexidine 280,284chronic atrophic candidiasis 246– 7chronic candidiasis 246– 7chronic draining sinus 116chronic hyperplastic candidiasis 247chronic periodontitis 244cingulum 14– 15cleft surgery 198cleidocranial dysostosis 294– 6clerking 36– 8clindamycin 280IndexNote: Tables, gures, and boxes are indicated by an italic t , f , and b following the page number. INDEX298298clinical nurse specialist 291clinical oncologist 290clotting disorders 121cluster headache 151co- codamol 278Coe- Pak® 283coeliac disease 256cold sore 281complex craniofacial trauma 186composite 282compression test 81compromised airway 262– 3computed tomography, see CTconcussion injuries 105condylar fractures 75, 81, 127,178cone beam CT (CBCT) 66consent 83contact sport 131cracked tooth syndrome 244craniofacial radiographs 56– 9craniofacial trauma, complex 186cribiform plate fracture 90cricothyroidotomy 240– 1, 241fCrohn’s disease 256crossbite 14Crouzon syndrome 294– 6crown fracture 105tcrowns 106tCSF leak 90CT 62– 6,64finfection 63neck lumps 155orbital oor fractures 89trauma 62tumours 63CT angiograms 62,63– 6cutaneous squamous cell carcinoma 156,157fDdecannulation cap 216deciduous teeth 11tinjuries 74trauma 104deep cervical fascia 32deep circumex iliac artery ap 161de- gloving injuries 103dental amalgam 283dental caries 244– 5dental impressions 239dental materials 282– 3dental nurses 124dental occlusion 14– 16dental panoramic tomogram 54– 6,55fdental radiographsbitewings 48– 50,49fguidelines 46occlusal 50– 1parallax technique 51– 4,52fperiapical 48,49fpregnancy 46dental specialists 288– 9dental surgeons 288dentigerous cysts 258dentine 10dentinogenesis imperfecta 245dentistry practice 4– 5dentoalveolar fractures 187dentoalveolar infections 108– 10,109fdentoalveolar surgery 188– 9dentoalveolartraumadeciduous teeth 104emergency department 104– 8postoperative care 205ward care 206dentures 106tdermal adhesive 228diabetes 150,257diazepam 279diclofenac sodium 278dietician 291DiGeorge syndrome 294– 6dihydrocodeine 278diplopia 88,129dish face 90dog bites 95domestic abuse 79drains and drainageabscesses 234– 5head and neck oncology patients 210infection 110dressings 282dry socket 113,226duct of Bartholin 20ducts of Rivinus 20dysplasia 254EEagle syndrome 294– 6earring tear 121earsbat ears 170examination 43injuries 96suturing lacerations 229ectropion 129Ehlers– Danlos syndrome 294– 6elastomers 283emergency department 72– 3enamel 10,245endocrine disease 257endodontists 288enophthalmos 88,129ENT surgeons 286entropion 129epidermoid cyst 116,170epiglottitis 76epistaxis 269unilateral 84eruption cyst 75erysipelas 116– 17erythema multiforme 250– 1erythromycin 280erythroplakia 253,254ethmoid cells 22– 4examinationears 43eyes 42,86face 42– 3full body 37– 8major facial trauma 78– 9neck 43nose 42oral cavity 40– 1eye examination 42,86eyebrowsoft tissue injuries 95suturing lacerations 229eyelidinjuries 94suturing lacerations 229Ffaceexamination 42– 3local aps 196massive bleed 268– 9muscles 28– 9pain 150– 1plastic surgery 196– 7radiographs 56– 9skeleton 22– 8, 24fsoft tissue injuries 94– 6,136– 8suturing lacerations 228– 9swellings in children 75trauma, examination, and investigations 78– 9face- lifts 197facial nerve 30,31ffrontal branch 181palsy 120Fanconi anaemia 254, 294– 6‘fat face’ 117bula ap 161,208llers (plastic surgery) 197 INDEX299 lling materials (dental) 282– 3ne needle aspiration cytology, neck lumps 154apslocal face aps 196monitoring 212– 13mucoperiosteal 189pre- operative investigations 161oor of the mouth 20ucloxacillin 280uconazole 281uoxetine 278folate deciency 256folliculitis 116forehead soft tissue injuries 95foreign bodies 76,138Frey syndrome 165,294– 6friction- induced hyperkeratosis 252– 3frontal bone 22frontal fractures 93– 4, 135,186– 7frontal sinus fractures 93– 4full body examination 37– 8furuncle 116Ggabapentin 278gagging, posterior 90Gardner syndrome 294– 6gastrointestinal disease 256General Dental Council statement 4general dental practitioners 288general practice dentists 288Gillies lift 181gingivaeanatomy 18bleeding 120– 1injuries 102gingivitis 120– 1,245HIV 256glands 30– 2,34Glasgow Coma Scale insidefrontcoverglass ionomer cement 282glossopharyngeal neuralgia 150Goldenhar syndrome 294– 6gonorrhoea 247Gorlin– Goltz syndrome 294– 6Gorlin syndrome 156greater palatine nerve and vessels 19greater palatine nerve block 221Guardsman fracture 83Gunning splint 90gutta percha 283Hhaematological disease 256haematoma 138haemophagocytic syndrome 295hairy leucoplakia 256Hand– Schuller– Christian disease 295hard palate 19hard tissue trauma, surgery 175head and neck abscess 235head and neckcancerchemotherapy 163multidisciplinary team meetings 160multidisciplinary team members 290– 1osteoradionecrosis 163patient review 162– 3postoperative care 191,209– 10postoperative function 162postoperative recurrence 162preoperative care 208quality of life 163radiotherapy 163reconstructive investigations 161surgery 190– 1work- up for surgery 160– 1head and neck soft tissue infections 116– 17headache 151Heerfordt syndrome 294– 6herpes labialis 281herpes zoster 117,281herpes zoster osicus 295herpetic gingivostomatitis 281herpetiform aphthous stomatitis 249histiocytosisX 295histopathologist 290history taking 36HIV 155,256Horner syndrome 295horse face 90hospital dentist 73hot potato voice 108– 9human papilloma virus (HPV) 153Hurler syndrome 295hyperkeratosis 252– 3hyperparathyroidism 257hypertrophic scars 137hypoglobus 88hypoplasia 245Iibuprofen 278ideal occlusion 14impacted teeth 142– 3impetigo 116implants 106timpression material 283impression taking 239incisive nerve block 221infectionchildren 75CT 63dentoalveolar 108– 10, 109fhead and neck soft tissue 116oral mucosal 246– 7post- extraction 113salivary glands 118inferior alveolar nerve 28inferior alveolar nerve block 220inferior dental block 220inferior orbital ssure 88– 90inammatory dental cysts 258infrahyoid muscle 35finfra- orbital canal 88– 90infra- orbital nerve block 221infra- orbital nerve paraesthesia 84inspection, general 37intercanthal distance 92intermaxillary xation 233removal 127intra- oral abscesses 234intra- oral injuries 102– 3intra- oral sutures 224intravenous cannula 62,240– 1investing fascia 32iron deciency 256iron- deciency anaemia 256Jjaw 144– 6,145cysts 258de- gloving injuries 103medication- related osteonecrosis 260osteoradionecrosis 259KKaposi’s sarcoma 256keloid scars 137 INDEX300300keratocystic odontogenic tumours 258keratocysts 258Llacerationschildren 74– 5clinical review 136massive bleed 268– 9suturing 228– 9typesof 94lacrimal gland and duct injuries 95Langerhans cell histiocytosis 295Larsen syndrome 295lateral cephalogram 58lateral excursion 14lateral open bite 14Le Fort diagram 91fLedermix® 282legal issues 4– 5Letterer– Siwe disease 295leucoplakia 252,254leukaemia 121,256lichen planus 251, 252,254lidocaine 277tlidocaine– benzocaine ointment 278lingual artery 20lingual nerve 20,28lingual papillae 20lingual veins 20lip injuries 96,102suturing 229load- bearing osteosynthesis 175load- sharing osteosynthesis 175local anaesthesia 220– 2local anaesthetics 276– 7,277tallergy 277toxicity 276– 7localized osteitis, see drysocketLudwig’s angina 110,117luxation injuries 105lymph nodes 34– 6, 35f,75MMAGIC syndrome 295magnetic resonance imaging (MRI) 67– 8neck lumps 155major aphthous stomatitis 249malar bone 24malignant histiocytosis syndrome 295malignant melanoma 158– 60malocclusion 14,15– 16mandibleanatomy 25– 8bleeding from 268dislocation, post- extraction 114lateral oblique view 58mandibular fractureschildren 75,83complex 177compression test 81condylar fractures 75, 81, 127,178conservative management 127emergency department 80– 4history 80management 81postoperative care 126– 7, 177,205radiographs 81,82fremoval of intermaxillary xation 127signs 81surgery 176– 8,177fsymptoms 80– 1mandibulofacial dysostosis 296Marcus Gunn phenomenon 295Marfan syndrome 295marsupialization 189massivebleedface and mouth 268– 9neck 270– 1mastication, muscles of 29f,147tmaxilla, anatomy 24– 5maxillary fractures 186arch bar removal 132emergency department 90history 90management 90postoperative care 132,205radiology 90signs 90maxillofacial trauma 78– 9,174– 5McCune– Albright syndrome 295meal- time syndrome 119median rhomboid glossitis 247medical clerking 36– 8medication- related osteonecrosis of jaw 260Melkerson– Rosenthal syndrome 295mental nerve 28mental nerve block 221mepivacaine 277tmercury poisoning 283metronidazole 280Michelet– Champy principles 175,176Michigan splint 148tmiconazole gel 281midazolam 279midfacebleeding 268fractures 186packing 230miniplates 175minor aphthous stomatitis 249morphate sulphate solution 278mouthoor 20injuries 96local anaesthesia 221massive bleed 268– 9mouth proper 18– 22MR angiography 67– 8MR sialograms 67– 8MRI 67– 8neck lumps 155mucocoele 75, 119,165mucoperiosteal aps 189mucopolysaccharidosis (type1) 295mucosabiopsy 236infections 246– 7lacerations 74– 5mucous membrane pemphigoid 250mucous retention cysts 119multidisciplinary team meetings 160multidisciplinary team members 290– 1multilocular radiolucency 144,145fmultiple basal cell naevi syndrome 294– 6multiple sclerosis 150mumps 75,118musclesfacial 28– 9mastication 29f,147tneck 32– 4Nnasal septum 22– 4,23fnasendoscopy 41,238nasoethmoidal complex 22– 4 INDEX301 nasoethmoidal fractures 92,134nasopalatine nerve 19neckabscesses 235anatomy 32– 6, 35fexamination 43fascial layers 32,33fglands 34lumps 154– 5lymph nodes 34– 6, 35f,75massive bleed 270– 1muscles 32– 4penetrating injuries 98– 100,270soft tissue infections 116– 17triangles 32,33fultrasound 60,154zones 98– 100, 99f,270necrotizing fasciitis 117needle cricothyroidotomy 240– 1nerve blocks 220– 1nerves, oral, and facial 28– 30,31fneurological examination 38NHS provider number 8nicorandil 249Nikolsky’s sign 251nitrous oxide 279non- accidental injuries 74,103non- Langerhans cell histiocytosis 295non- steroidal anti- inammatory drugs (NSAIDs) 278noseexamination 42fractures 92, 134,187packing 230soft tissue injuries 96suturing lacerations 229nosebleed 269unilateral 84NSAIDs 278nuclear imaging 68– 9nurses 124,201nystatin 281Ooccipitomental views 56,57– 8occlusal radiographs 50– 1occlusion 14– 16oculoplastic surgeons 286oedema 108– 9ophthalmic surgeons 286opiate analgesia 278oral analgesics 278oral and maxillofacial surgerycareer pathways 8clinics 124– 5duties of OMFS doctor 6emergency department 72– 3futureof 7legal aspects 4– 5operations 172– 4specialty 3ward work 200oral cancer 254– 5,255toralcavityanatomy 18– 22,19fexamination 40– 1injuries 102– 3oral dysaesthesias 151oral infections 75oral medicine specialists 289oralmucosabiopsy 236infections 246– 7lacerations 74– 5oral pain 150– 1oral submucosal brosis 254oral surgeons 289oral swellings 75oral ulcers 152– 3,248– 9orbit anatomy 22orbital oor anatomy 185orbital oor fractureschildren 88– 9clinical review 128– 9diagnosis 128emergency department 88– 90indications for surgical repair 89– 90management 89postoperative care 129, 185,205radiology 89signs 88surgery 184– 5white eye blow- out fracture 88– 9,185oro- antral communication 113orofacial granulomatosis 256oropharynx 18– 22orthodontists 288orthognathic surgery 168– 9, 194– 5,218orthopantomogram 54– 6, 55fosteitis, localized 226osteogenesis imperfecta 245osteonecrosis 114of jaw 259– 60osteoradionecrosis 163of jaw 259overbite 14overjet 14Ppacking nose and midface 230paediatric dentists 289paediatric patients 74– 6paindental pain in children 75oral and facial 150– 1post- extraction 112,113toothache 202,244palatal haematoma 90palate 19palliative care consultant 291panoramic radiography 54– 6,55fparacetamol 278paraganglioma 155parallax technique 51– 4, 52fparathyroid glands 34parotidglandacute bacterial sialadenitis 118anatomy 30post- operative complications 165surgery 193trauma 119parotitis 75Parry– Romberg syndrome 296Paterson– Brown– Kelly syndrome 295pemphigoid 250pemphigus 251pemphigus vulgaris 251penetrating injuriesintra- oral 102neck 98– 100,270pentoxifylline and tocopherol 284percussion of teeth 41periapical pain 244periapical radiographs 48,49fpericoronitis 121,245periodic migrainous headache 151periodontal ligament 10periodontists 288periodontitis 244,245periorbital cellulitis 22– 4, 110,117permanent teeth 11ttrauma 104– 8PET 68PET- CT 68 INDEX302302Peutz– Jeughers syndrome 295pharyngeal injuries 75,102Pierre Robin sequence 296pigmented lesions 253pilar cysts 170plastic surgeons 286plastic surgery 196– 7platysma muscle 32platysma placation 197pleomorphic salivary adenomas 164Plummer– Vinson syndrome 295positron emission tomography (PET) 68post- extraction complications 112– 14post- herpetic neuralgia 117post- septal cellulitis 22– 4,117posterior gagging 90posteroanterior view of jaws 56pre- admission clinics 124– 5pre- auricular pit 170pre- septal cellulitis 117pre- tracheal fascia 32pregabalin 278premalignant conditions 254prevertebral fascia 32prilocaine 277tprimary haemorrhage 112primary teeth 11tinjuries 74trauma 104probes 41prognathic 14prosthodontists 289protocols 201provider number 8pseudocysts 258pulp 10pulpal pain 244pulpitis 244Qquality of life 163Rradial ap 161radicular cysts 258radiographs 41, 56– 9jaw pathologies 144,145mandibular fractures 81,82fmaxillary fractures 90ward rounds 200zygomatic fractures 85see also dental radiographsradiologist 290radiotherapy 163,259– 60Ramsay Hunt syndrome 117,281type2: 295ranula 119,165re- implanting teeth 12,231reactionary haemorrhage 112reconstructive ladder 174brecurrent aphthous stomatitis 248– 9recurrent laryngeal nerves 34red lesions 152– 3, 253research nurse 291residual cysts 258respiratory examination 37restorative dentists 289retained root 114,189retinoic acid 137retrobulbar haemorrhage 84– 8, 272– 4,273fretrognathic 14retromolar trigone 20– 2reverse overjet 14rhinoplasty 196Rivinus ducts 20Robin sequence 296Romberg syndrome 296roots of teeth 12fracture 105tpost- extraction retention 114,189Ssalivaryglandsadenoid cystic carcinoma 164biopsy 237diuse swelling 165emergency department 118– 19infection 118monomorphic adenoma 164mucocoele 75, 119,165mucous retention cysts 119obstruction 119pleomorphic salivary adenomas 164postoperative review 165– 6preoperative assessment 164ranula 119,165stones 119,193surgery 192– 3trauma 119tumours 164ultrasound 60scalp soft tissue injuries 94– 6,136– 8scarsclinical course 136optimal result 137revision 197unsightly/ hypertrophic/ keloid 137sebaceous cyst 116,170second premolar impaction 143secondary haemorrhage 112secondary teeth 11ttrauma 104– 8sedatives 279septal haematoma 92shingles 117,281sialadenitis 118sialography 69sideropenic dysphagia 254single photon- emission computed tomography (SPECT) 68– 9sinus, chronic draining 116sinusitis 170Sjögren syndrome 164– 5,296skinabscesses 235biopsy 236lacerations 74– 5local anaesthesia 222tumours 156– 60,170Snellen chart inside backcoversoft palate 19injuries 102softtissueexamination 42face and scalp injuries 94– 6,136– 8head and neck infections 116– 17trauma surgery 174solitary bone cysts 258solitary eosinophilic granuloma 295space- occupying lesion 150speaking valve 216speckled leucoplakia 253,254SPECT 68– 9speech and language therapist (SALT) 290sphenopalatine artery 19spinal accessory nerve 191splinting teeth 231squamous cell car-cinoma 153, 156, 157f,254 INDEX303 Stenson’s duct 30sternocleidomastoid muscle 32Stevens– Johnson syndrome 296Stickler syndrome 296Sturge– Weber syndrome 296subconjunctival haemorrhage 84, 88,42sublingual caruncle 20sublingual glands 20surgical removal 193subluxated teeth 74,105submandibularglandacute bacterial sialadenitis 118anatomy 30– 2examination 43post- operative complications 166stones 119,193surgery 192,193SUNCT 151supercial cervical fascia 32suprahyoid muscle 35fsupraorbital nerve block 221surgical cricothyroidotomy 240– 1suture removal 136suturingbleeding socket 225facial lacerations 228– 9intra- oral 224swellingfacial and oral in children 75post- extraction 113salivary gland 165sycosis vulgaris 116syphilis 247,254systemic disease 256– 7TT- cell lymphoma 295Tanner splint 148ttaste buds 20tattooing 95,283teardrop sign 88– 9teethanaesthetizing 221anatomy 10avulsion 74, 104t,106charting 11complicated fracture 105tconcussion 105cracked tooth syndrome 244crown fracture 105tdeciduous (primary) 11tdentine 10enamel 10,245extractions 140– 1,188extrusion 105fracture 104t, 105t,106fimpacted 142– 3intrusion 104t,105lateral luxation 105luxation 105missing 106– 8morphology 12paediatric injuries 74percussion 41permanent (secondary) 11tpost- extraction complications 112– 14pulp 10re- implanting 12,231retained root 114,189root fracture 105troots 12splinting 231subluxation 74,105terminology 10– 11toothache 202,244vitality testing 40telecanthus, traumatic 92temazepam 279temporal arteritis 151temporal artery biopsy 237temporal fascia 181temporary lling materials 282temporomandibular joint 67– 8,146– 8relocation 232tetracycline 245,280theatre tips 172– 4third molar impaction 142– 3thrush 246thyroidglandanatomy 34examination 43tumours 170thyroidectomy, parathyroid preservation 34titanium miniplates 175TNM classication 255ttocopherol and pentoxifylline 284tongueanatomy 18f,19– 20laceration 74– 5,102studs 102tongue tie 258tonsillar fossae 19tonsils 19,102toothache 202,244topical analgesics 278topical vitaminA 137topical vitaminE 137toxoplasmosis 155tracheostomy 198,214– 18bleeding around tubes 266blocked tubes 264– 6breathing around blocked tube 265decannulation cap 216displaced tubes 266protocols 201speaking valve 216tube care 216tube position 265ftube types 214– 16, 215f,264fweaning 187tranexamic acid 284trauma 72complex craniofacial 186compromised airway 262CT 62overview of maxillofacial trauma 78– 9,174– 5postoperative care 205preoperative care 204ward care 204– 5traumatic telecanthus 92Treacher Collins syndrome 296trench mouth (AUG) 120– 1, 245,246triamcinolone 137triangles of neck 32,33ftricyclic antidepressants 278trigeminal nerve 25– 8,26fintracranial vascular compression 150trigeminal neuralgia 150trigemino- oculomotor synkinesis 295tripod fracture 84– 8,180– 1trisomy 21: 245Trotter syndrome 296tuberculosis 155,247Uulcerative colitis 256ulcers 152– 3,248– 9ultrasonography 60,154unerupted canines 51– 4, 52f,143uvula 19Vvariable radiodensity lesion 144, 145fvestibule 18– 22viral infections 117visual acuity 42vitality testing 40vitamin A, topical 137 INDEX304304vitamin B12 deciency 256vitamin E, topical 137von Recklinghausen neurobromatosis 296Wward protocols 201ward referrals 201– 2ward round essentials 200ward work 200Warthin’s tumour 164Wharton’s duct 20,30– 2white eye blow- out fracture 88– 9,185white lesions 152– 3, 252Whitehead’s varnish 282wisdom tooth extraction 112wound types 94– 5Xxerostomia 164Zzoster 117,281zygomatic complex 24zygomatic fracturesavoiding nose blowing 85– 8clinical review 130complex 181tcontact sport 131depressed zygomatic body 181temergency department 84– 8Gillies lift 181indications for surgery 130investigations 85,130management 85– 8postoperative care 131, 182,205radiographs 85reassessment 130signs 84simple arch 181tsurgery 180– 2tripod fracture 84– 8, 180– 1 306