Veidlapa Nr. M-3 (8)
Study Course Description
Face and Jaw Injuries
Course Code
RMS_043
Branch of Science
Anatomy; Clinical medicine
ECTS
19.00
Target Audience
Medicine
LQF
Level 8
Study Course Implementer
Course Supervisor
Ģirts Šalms
Residency Speciality
Speciality
Maxillofacial Surgeon
Supervisor of Medical Speciality
Ģirts Šalms
Contacts
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About Study Course
Objective
To provide oral-facial and maxillofacial surgery residents with theoretical and practical knowledge for work in traumatology with patients of this profile.
Learning Outcomes
Knowledge
1.Must know: 1. etiology of facial soft tissue and bone injuries, mechanism, diagnosis, first aid and treatment; historical and contemporary problems; 2 The anatomy of face and jaw area (motor, sensory nerves, major blood vessels); 3. Practical applications of the preventive and therapeutic vaccination according to the situation (anti-tetanus, antirrabies); 4. Antibacterial, analgesic therapy. 5. Clinical nutrition issues in the face - jaw injury. Indications for additional investigation: • Computerized tomography and magnetic resonance imaging • peripheral nervous electrodiagnostics • Doppler • serological testing.
Skills
1.Be able to: 1. investigate of the patient, face - jaw area, CNS status; 2. To evaluate a patient with severe facial - jaw and head injury; investigation and treatment priorities, the need for interdisciplinary treatment; 3. Cardiac and respiratory monitoring, pulse oximetry; 4. Interpret radiographs, CT investigation, results. 5. Interpret the clinical, biochemical analysis. 6. Determine the blood group and Rh factor with express method. Medical manipulations: - Anesthesia; oral and parenteral premedication and potentiation; - Local and regional anesthesia; - The infusions and transfusions; shock, etc. urgent conditions that; - Cardio - pulmonary intensive care. Operations: - primary and secondary care of facial or oral wound; - Conservative treatment with bimaxillar fixation of jaw fractures or splint as stable fixation; - Stable osteosynthesis with intraoral and extraoral approach; - Isolated nose, cheek bone fracture reposition and fixation; - Surgical treatment of the middle face fractures with stable osteosynthesis or fixation by ligature; - Surgical treatment of orbit wall fracture; enophthalmus or diplopia, material transplantation; - Complicated facial soft tissue and bone fractures, surgical treatment; - Facial bone fractures; early and late complications of treatment.
Competences
1.Able to examine and analyze patients with soft and bone tissue injuries of the mouth, face and jaws; Able to participate in the work of interdisciplinary consultants; Interprets X-ray and computed tomography data; Interprets clinical analysis, blood group determination data; Preventive vaccination measures for patients with facial soft tissue wounds are analyzed.
Assessment
Individual work
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Title
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% from total grade
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Grade
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1.
Individual work |
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Presentations (during the course 4) on the theme given.
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Examination
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Title
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% from total grade
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Grade
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1.
Examination |
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-
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The minimum number of mandatory operations and assisted operations has been qualitatively fulfilled. See section attached below.
Participation (min. number in parentheses: operates independently/ assists):
- in the primary or secondary treatment of facial soft tissue wounds (3/3);
- in the development and implementation of measures for the treatment of alveolar growth, dental injuries. (2/1)
- in the treatment of mandibular fractures:
• splinting - as a primary measure - in combination with stable osteosynthesis (10/2)
• stable osteosynthesis with i/oral approach (2/7)
• stable osteosynthesis with e/oral approach (2/7)
• stable osteosynthesis of the joint head (1/4)
- surgical treatment of nasal fractures (5/7)
- cheek bone, arch:
• reposition (1/2)
• osteosynthesis (2/4)
- surgical treatment of isolated fractures of the upper jaw:
• bimax. extension (1/1)
• Adams ligature (1/2)
• Stable osteosynthesis (0/2)
- surgical treatment of complicated mid-face fractures through coronary incision (0/1)
- treatment of orbital wall fracture (0/2)
- bone transplantation from the cranial vault or crista illiaca at the site of traumatic facial defects (0/2)
- clinical examination of late complications of facial injuries, analysis of prospective treatment plan, treatment (0/1).
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Study Course Theme Plan
FULL-TIME
Part 1
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Seminar
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Modality
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Location
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On site
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Auditorium
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Topics
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Epidemiology of maxillofacial trauma. General principles of maxillofacial fracture management. Radiological examinations and their interpretation in case of maxillofacial injuries.
Description
Annotation: The resident learns the epidemiology, causes, diagnostic and treatment principles of oral, maxillofacial and maxillofacial trauma. The resident learns to interpret radiological examinations in case of oral, maxillofacial trauma.
Topics covered during the class: Epidemiology of maxillofacial injuries. Mechanisms of injury origin. Low and high energy trauma. Interpretation of radiological examinations in maxillofacial injuries.
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Seminar
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Modality
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Location
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On site
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Auditorium
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Topics
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Craniofacial trauma in childhood. Etiology, diagnostics. Surgical anatomy. Classification. Comparison of maxillofacial trauma in adults and children. Differences in treatment. Bite wounds in children. Dentoalveolar trauma. Subluxation and avulsion. Surgical treatment.
Description
Annotation: Knowledge is acquired about craniofacial injuries in childhood, their aetiology, diagnosis, surgical anatomy, classification. Comparison of maxillofacial trauma in adults and children, differences in treatment. Bite wounds in children. Dentoalveolar trauma. Subluxation and avulsion. Surgical treatment.
Topics covered during the class: Craniofacial trauma in childhood. Etiology, diagnostics. Surgical anatomy. Classification. Comparison of maxillofacial trauma in adults and children. Differences in treatment. Bite wounds in children. Dentoalveolar trauma. Subluxation and avulsion. Surgical treatment.
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Seminar
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Modality
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Location
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On site
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Auditorium
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Topics
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Orbital fractures. Etiology, diagnosis. Surgical anatomy. Classification. Isolated and combined fractures. Surgical treatment of orbital bone fractures. Complications. Prevention of retrobulbar hematoma, revisions. Orbital fractures in children.
Description
Annotation: Knowledge of orbital fractures, etiology, diagnosis, surgical anatomy, and classification. Isolated and combined fractures, their surgical treatment, possible complications, management of retrobulbar hematoma, and revision are discussed. Orbital fractures in children.
Topics covered during the class: Orbital bone fractures. Etiology, diagnostics. Surgical anatomy. Classification. Isolated and combined fractures. Surgical treatment of orbital fractures. Choice of materials for orbital reconstruction. Complications. Prevention of retrobulbar hematoma, revision. Orbital fractures in children.
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Seminar
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Modality
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Location
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On site
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Auditorium
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Topics
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Biomaterials for the treatment of maxillofacial trauma. Metal implants. Bio-absorbable fixation plates. Bone distraction devices, principles of their application.
Description
Annotation: Knowledge is gained about biomaterials for the treatment of maxillofacial trauma, metal implants, bioabsorbable fixation plates, bone distraction devices and the principles of their application.
Topics covered during the class: Biomaterials for the treatment of maxillofacial trauma. Metal implants. Bio-absorbable fixation plates. Bone distraction devices, principles of their application.
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Seminar
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Modality
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Location
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On site
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Auditorium
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Topics
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Acute maxillofacial trauma. Life-threatening conditions, their prevention, and treatment tactics. Primary maxillofacial trauma care according to guidelines for acute trauma life-support (ATLS).
Description
Annotation: Gain knowledge of emergency care for a patient with MF injury. First aid, and primary trauma care according to ATLS guidelines. Patient transport to the hospital.
Topics covered during the class: Primary care of a patient with MF trauma: stopping bleeding, evacuation of a foreign body from the airway, and immobilization of the jaws. Transporting the patient to the hospital. Application of specialized equipment to assist MSF injuries.
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Seminar
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Modality
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Location
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On site
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Auditorium
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Topics
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Trauma to the nose, orbit, and ethmoid facial complex. Etiology, diagnostics. Surgical anatomy. Classification. Isolated and combined fractures. Anatomy of the canthal ligament and lacrimal apparatus. Methods of reconstruction of the canthal ligaments. Methods of treatment of the lacrimal duct. Gunshot wounds.
Description
Annotation: Knowledge is acquired about injuries of the nose, orbit, and ethmoid facial complex, their etiology, diagnosis, surgical anatomy, and classification. Isolated and combined fractures are covered. The anatomy of the canthal ligament and lacrimal apparatus, methods of canthal ligament reconstruction, methods of lacrimal canal treatment, and gunshot wounds and their treatment are covered.
Topics covered during the class: Trauma to the nose, orbit, and ethmoid facial complex. Etiology, diagnostics. Surgical anatomy. Classification. Isolated and combined fractures. Anatomy of the canthal ligament and lacrimal apparatus. Methods of reconstruction of the canthal ligaments. Methods of treatment of the lacrimal duct. Gunshot wounds.
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Seminar
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Modality
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Location
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On site
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Auditorium
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Topics
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Multiple facial bone fractures. Etiology, diagnostics. Surgical anatomy. Classification. Facial fractures with cranial involvement. The sequence of treatment of craniofacial fractures. Prevention of cerebrospinal fluid leakage. Treatment features of the forehead. Complications.
Description
Annotation: Knowledge is acquired about multiple facial bone fractures, their etiology, diagnosis, surgical anatomy, and classification. Knowledge of facial fractures with cranial involvement. The sequence of treatment of craniofacial fractures. Prevention of cerebrospinal fluid leakage. Specific features of the treatment of the forehead. Complications.
Topics covered during the class: Multiple facial bone fractures. Etiology, diagnostics. Surgical anatomy. Classification. Facial fractures with cranial involvement. The sequence of treatment of craniofacial fractures. Prevention of cerebrospinal fluid leakage. Treatment features of the forehead. Complications.
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Seminar
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Modality
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Location
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On site
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Auditorium
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Topics
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Maxillary fractures. Etiology, diagnosis. Surgical anatomy. Classification. Surgical treatment of maxillary fractures. Surgical approaches to midface fractures.
Description
Annotation: Gain knowledge of the etiology, diagnosis, surgical anatomy, classification, surgical treatment, and surgical approaches to midface fractures.
Topics covered during the class: Fractures of the upper jaw. Etiology, diagnostics. Surgical anatomy. Classification. Surgical treatment of maxillary fractures. Principles of osteosynthesis and choice of materials. Surgical approaches to midface fractures.
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Seminar
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Modality
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Location
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On site
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Auditorium
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Topics
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History of osteosynthesis. Fixation principles of maxillofacial fractures, types of osteosynthesis, advantages, disadvantages, principles of biomechanics.
Description
Annotation: Knowledge is gained on the history of the development of treatment of MF fractures, biomechanics, types of osteosynthesis, and treatment principles.
Topics covered during the class: Contributions of outstanding personalities to the development of surgical techniques for MFS. Basic principles of treatment of maxillofacial fractures. Types of osteosynthesis, characteristics of devices, advantages, disadvantages. Bone biomechanics of the facial region. Principles of Champy osteosynthesis.
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Seminar
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Modality
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Location
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On site
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Auditorium
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Topics
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Fractures of the condylar process. Classification. Etiology, diagnosis. Surgical treatment of condylar fractures. Contradictions. Condylar fracture treatment results, complications, audits.
Description
Annotation: Gain knowledge about mandibular condylar process fractures: classification, etiology, diagnosis, surgical treatment, treatment results, complications, and revisions.
Topics covered during the class: Mechanisms of origin of fractures of the condylar process. Classification. Surgical approaches. Osteosynthetic materials used for the treatment of the condylar process. Treatment results, complications, revisions.
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Seminar
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Modality
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Location
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On site
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Auditorium
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Topics
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Mandibular fractures. Surgical anatomy, classification, fracture evaluation, and diagnosis. Classification of mandibular fractures. Basic principles of treatment. Atrophic and edentulous mandibular fractures.
Description
Annotation: Gain knowledge about the causes, aetiology, classification, diagnosis and treatment principles of mandibular fractures.
Topics covered during the class: Mechanisms of origin of mandibular fractures. CSN, violence, domestic and sports injuries. Classification of mandibular fractures. Basic principles of treatment. Atrophic and edentulous mandibular fractures.
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Seminar
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Modality
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Location
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On site
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Auditorium
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Topics
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Zygomatic fractures. Etiology, diagnosis. Surgical anatomy. Classification. Isolated and combined fractures. Surgical treatment of zygomatic bone fractures. Complications, and revisions.
Description
Annotation: Knowledge is acquired about fractures of the cheekbones, their etiology, diagnosis, surgical anatomy, and classification. Isolated and combined fractures of the cheekbones and their surgical treatment, complications, and revision are discussed.
Topics covered during the class: Or bone fractures. Etiology, diagnostics. Surgical anatomy. Classification. Isolated and combined fractures. Surgical treatment of fractures of the cheek bones. Selection of materials. Complications, revision.
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Total ECTS (Creditpoints):
19.00
Number of Residency Seminars:
12
Length (weeks):
14
Final Examination:
Residency exam (Theory and practice)
Bibliography
Required Reading
1.
Maxillofacial Trauma. A Clinical Guide. Editors: Akhilesh Kumar Singh, Naresh Kumar Sharma. Published: 02 May 2021
2.
Raymond Fonseca, H. Dexter Barber, Micahel Powers, David Frost. Oral and Maxillofacial Trauma. 4th Edition. November 27, 2012.
Additional Reading
1.
Booth P.W., Schendel S.A., Hausamen J.E. Maxillofacial surgery. Churchill Livingstone Elsevier, 2007. V. 1.-2.
2.
Booth P.W., Eppley B.L., Schmelzeisen R. Maxillofacial trauma and esthetic facial reconstruction. Churchill Livingstone, 2003 (2004).