Airway Management in Patients with Maxillofacial Trauma – Part 1

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Airway Management in Patients with Maxillofacial Trauma – Part 1 – ATOTW 541

May 04, 2025

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1) Developed countries mainly attribute maxillofacial trauma to interpersonal violence.

True False

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In developed nations, interpersonal violence is often the primary cause of maxillofacial trauma, whereas in developing nations, the occurrence of such injuries is more frequently due to road traffic accidents.

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2) Facial bone fractures usually involve areas of denser bone and present with characteristic fracture patterns.

True False

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Facial bone fractures tend to occur at structurally vulnerable sites, while high-energy trauma can affect denser bone areas.

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3) The face is exceptionally vascular.

True False

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The face has exceptional vascularity with the potential for significant haemorrhage in trauma, especially in mid-face fractures.

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4) Tumbling/yawing of high-velocity projectiles is associated with significant maxillofacial trauma.

True False

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Comminuted fractures and large explosive exit wounds are associated with tumbling/yawing of high-velocity projectiles.

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5) Restricted mouth opening due to maxillofacial trauma is expected to resolve with general anaesthesia but often requires the administration of neuromuscular blocking agents.

True False

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Restricted mouth opening due to temporomandibular joint involvement and zygomatic arch fractures will remain limited despite general anaesthesia and paralysis.

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6) The Le Fort classification is used to categorise maxillary fractures.

True False

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Maxillary fractures are classified using the Le Fort classification system, with Class II and Class III fractures being of particular significance to anaesthetists.

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7) Class I Le Fort fractures are of particular importance to the anaesthetist.

True False

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Class I is a horizontal fracture isolating the tooth-bearing section of the maxilla that typically does not complicate airway management.

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8) It is advised against inserting any tubes through the nose in cases of fractures involving the frontal bone and mid-face areas.

True False

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The risk of intracranial penetration through the nasal passages is noteworthy in cases of frontal bone and mid-face fractures.

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9) Bilateral and comminuted mandibular fractures are regarded as unstable fractures.

True False

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Bilateral and comminuted mandibular fractures may present with airway obstruction.

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10) Laryngotracheal trauma in association with maxillofacial trauma should be managed promptly by endotracheal intubation.

True False

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The combination of laryngotracheal and maxillofacial trauma frequently leads to significant airway obstruction and challenges in standard airway management.

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11) Airway obstruction associated with maxillofacial trauma is usually multifactorial.

True False

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Airway obstruction associated with maxillofacial trauma may be a result of a direct occlusion or anatomical narrowing of the airway.

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12) An impaired level of consciousness and intoxication are recognised causes of dysphagia.

True False

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Causes of dysphagia also include pain and oedema.

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13) A conscious patient’s effort to lie down flat could signal a partial blockage of the airway.

True False

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In an awake patient, partial obstruction may be evidenced by the patient attempting to sit up and lean forward.

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14) Signs of impending airway obstruction include stridor, voice changes, haemoptysis and dyspnoea.

True False

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Identification of these features should prompt rapid evaluation and airway management.

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15) The patient with complete airway obstruction may still be able to speak and breathe.

True False

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The patient with complete obstruction will be unable to speak or breathe, and severe respiratory distress will rapidly deteriorate into respiratory failure.

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16) Trauma patients are initially assessed and treated systematically according to the Advanced Trauma Life Support (ATLS) protocol.

True False

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Assessing and managing a traumatised airway in emergencies is challenging, with trauma patients being systematically evaluated and treated following the Advanced Trauma Life Support (ATLS) protocol.

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17) Ultrasound is a portable imaging modality that can be utilised for both airway assessment and management.

True False

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Ultrasound is used to identify the cricothyroid membrane and confirm the correct placement of an endotracheal tube in the trachea.

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18) C-spine immobilisation is a common constraint for airway evaluation in maxillofacial trauma patients.

True False

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It might be impossible to assess the Mallampati score or the neck mobility due to C-spine immobilisation.

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19) C-spine injury can be ruled out clinically by an experienced physician.

True False

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Complete C-spine assessment requires a comprehensive clinical evaluation accompanied by radiographic investigations to rule out injury.

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20) Findings from individual airway assessments are very sensitive in predicting difficult intubation.

True False

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Findings from individual airway assessments may not be particularly sensitive. However, the absence of such findings is predictive of the relative ease of intubation.

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