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AN EXPERIMENTAL STUDY OF EFFECT OF INTERMAXILLARY FIXATION AND OCCUSAL SPLINT ON PULMONARY FUNCTION  

Lee, Joong-Kyou (Department of Oral & Maxillofacial Surgery, Collage of Dentistry, Dankook University)
Kim, Kyung-Wook (Department of Oral & Maxillofacial Surgery, Collage of Dentistry, Dankook University)
Lee, Jae-Hoon (Department of Oral & Maxillofacial Surgery, Collage of Dentistry, Dankook University)
Publication Information
Journal of the Korean Association of Oral and Maxillofacial Surgeons / v.28, no.3, 2002 , pp. 175-181 More about this Journal
Abstract
Intermaxillary fixation and occusal splint are routine procedure for maxillofacial fracture and orthognathic surgery. When these methods could obstruct oral airway the patients who kept intermaxillary fixation and occusal splint in their mouth, are very difficult to breath after surgery. Nasal bleeding and pharyngeal edema due to nasotracheal intubation, residual effect of muscle relaxants, and anesthetic agent could be contributing factor of airway obstruction. In this study, pulmonary function test was evaluated before and after intermaxillary fixation, and intermaxillary fixation with occusal splint in 22 volunteers. The results were as follows 1. FVC, %FVC, $FEV_1$, $FEV_1%$, PEF, $PEF_{50}$, MVV without intermaxillary fixtion were 4.45L, 88%, 4.03L, 90.9%, 10.26L/s, 5.53L/s, and 136.14L/min, and with intermaxillary fixation were 3.51L, 68.67%, 3.06L, 69.39L, 6.52L/s, 3.94L/s, and 69.39L/min. The results with intermaxillary fixation and occusal splint were 2.15L, 42.41%, 1.71L, 38.81%, 2.83L/s, 1.74L/s, and 37.14L/min. 2. Compared with before and after intermaxillary fixation, all values of pulmonary function test were decreased and after intermaxillary fixation and intermaixillary fixation with occulasal splint, the results were decreased. 3. MVV and PEF were decreased significantly with interaxillary fixtion and occusal splint, and FVC was less decreased. It meant that intermaxillary fixation and occluasal splint induced reduction of respiratory flow significantly, but less reduction of respiratory volume. 4. Intermaxillary fixation and occulsal splint induced increase of airway resistance, decrease of expiratory volume and air flow. So severe respiratory difficulty could be seen to all volunteers who kept intermaxillary fixtion and occusal splint. 5. In classification of respiratory difficulty, intermaxillary fixation with occulsal splint induced complex respiratory difficulty more than intermaxillary fixation only did. From the above results, doctors who care patients kept intermaxillary fixation and occusal splint should be aware of respiratory depression caused by these treatment.
Keywords
Intermaxillary fixation; Occlusal splint; Pulmonary function test;
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1 Choby WA, Ung KA, Abadir AR: Management of the post-extubation airway in patients with intermaxillary fixation. Anesthesia progress. sep-oct: 124-125, 1979
2 Kim CH, Kim MS: A clincal study on pulmonary function after intermaxillary fixation. J. of Korean Oral and Maxillofac.surg. 25 no4: 361-366, 1999
3 Kim DS: Practical respiratory administration. Chap 7. Evaluation of pulmonary function. Koon Ja publishing INC. P207-233, 1995
4 Stoelting, RK Miller, RD: Respiratory therapy in basics of anesthesia, ed2. New York, Churchill Livingstone. p446, 1989
5 John. MC: Respiratory problems in surgical patients. The American J Surgery. 116: 362-368, 1968
6 Robinson, BC & Jarret, WJ: Post operative complication after blind nasotracheal intubation for reduction of fractured mandible report of a case. J Oral Surg. 29: 340, 1971
7 Ferlic RM: Tracheostomy or endotracheal intubation. Ann Otol 83: 739, 1974
8 Gross AN, Chau KK, and Mayne LH: Intermaxillary fixation: How practicable is emergency jaw release? Anesth. Intens. 7: 253-257, 1979
9 Steven EW, Jeffrey MD: Harrison’s principles of internal medicine chap.214 Jung dam publishing INC. p1242-1250, 1997
10 Willams JG, Cawood JI: Effect of intermaxillary fixation on pulmonary function. Int. J. Oral Maxillofac. Surg. 19: 76-78, 1990
11 Smith RA, Dodson TB, Cohen NH: Postoperative pulse oximetry of patient in maxillomandibular fixation. J. Oral Maxillofac. Surg. 47: 684-688, 1989
12 Arunasalam K, Davenport HT, Painter S et al: Ventilatory response to morphine in young and old subjects. Anesthesia 38: 529-533, 1983
13 Barton PR, Harris AW :An investigation of efficiency of the oral airway and a technique for improving the airway in the early post operative period fallowing mandibular osteotomy. Br J Oral Surg. 8: 16, 1980
14 Fisher SE: Respiratory/cardiac arrest complicating intermaxillary fixation. Br J Oral Surg. 20: 192-195, 1982
15 Niinimaa V, Cole P, Mints S et al: The switching point from nasal to oronasal breathing. Respiration Physiology. 42: 61-71, 1980
16 Winstock. D : Some complications of major oral surgery and their prevention and management. Br J Oral Surg. 1: 42, 1963
17 Douglas B. Craig: Post operative recovery of pulmonary function. Anesthesia and analgesia. 60: 46-52, 1981
18 Barclay JK: Intermaxillary fixation-A safty measure. Br. J Oral Surg 17: 77, 1979
19 Kang MS, Min SG, Um IW, et al : Incidence of post operative hypoxemia of patients in oral and maxillofacial surgery using arterial blood gas analysis. J. of Korean Oral and Maxillofac. Surg. 18 no2: 1-8, 1992
20 Banks P: Fixation of facial fractures. Br. Dent 138: 129, 1975
21 Hierl T, Dyrna A, Hemprich A: Impact of short time nasal intubation on post operative respiration. rhinology: 38 P79-82, 2000
22 Maisels DO, Holbrook LA: A quick release connecting rod for craniomandibular fixation Br. J. Plast surg. 23: 398, 1970
23 Kohno M, Nakajima T, Someya G: Effects of maxillomandibular fixation on respiration. J. Oral Maxillofac. Surg. 51: 992-996, 1993