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Chapter-33 Prescribing for Children

BOOK TITLE: Hutchison's Paediatrics

Author
1. Wallace James
ISBN
9788184485868
DOI
10.5005/jp/books/10367_33
Edition
1/e
Publishing Year
2009
Pages
6
Author Affiliations
1. Yorkhill Hospitals, Glasgow, Scotland, UK, Royal Hospital for Sick Children, Yorkhill, Glasgow, Scotland, UK
Chapter keywords

Abstract

Advances in oral and maxillofacial surgery applicable to the child are not always seen by the general paediatrician, and therefore an attempt here has been made to identify those areas where help from an oral and maxillofacial surgeon would be appropriate. This would be principally in the management of maxillofacial trauma and head (craniofacial) and neck deformity and to indicate when early, staged and definitive treatment can most effectively be undertaken. Other paediatric specialties also may be involved in the management of maxillofacial infections and pathology, but especially for odontogenic lesions of the jaws early involvement of the interested oral and maxillofacial surgeon can be valuable, especially when continuity of care from birth to adulthood is required in relation to jaw reconstruction and the dental occlusion as this can lead to significant psychological trauma for the child. On the other hand facial bone trauma often requires less surgical intervention than in the adult as minor post-traumatic deformity is frequently self correcting. Often invasive surgical treatment will be complicated by the presence of tooth germs in the jaws with the necessity to avoid damaging them and creating aesthetic problems in the dental occlusion which later would be difficult to satisfactorily correct. Acute problems with airway require an expeditious approach in the child and especially when there are growth abnormalities. Severe mandibular and maxillary retrusion can often be corrected by early jaw repositioning using distraction osteogenesis thus increasing the jaw length and volume and this can lead to the avoidance of a long term tracheostomy and sleep apnoea, reducing long term morbidity and mortality. Similar problems arise with ankylosis in the condylar areas resulting from infection and trauma. The close proximity of the cranial cavity, the cranial nerves and major blood vessels as well as the special sense organs of sight, hearing, smell and taste, and mastication need to be taken into consideration with trauma and tumour management as well as spreading infections and throughout thought needs to be given to the restoration of function and aesthetics in this always exposed head and neck area.

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