2 Preassessment and optimization of oral and maxillofacial patients
Oral and maxillofacial surgery encompasses a vast array of surgical procedures involving a diverse patient population. At one extreme is surgery for infants with congenital craniofacial malformations while at the other is cancer surgery with microvascular reconstruction for elderly patients with multiple comorbidities. Similarly, there is variability in acuity. Management of the polytrauma victim requiring timely surgical intervention contrasts with elective day case dental surgery for children with learning disabilities. This variety plus the need for a shared airway frequently provides an anaesthetic challenge.
This chapter will deal with the systematic assessment and optimization of the patient listed for oral and maxillofacial surgery. Assessment of the airway is dealt with in detail in Chapter 4. Emphasis will be placed upon some of the difficult issues the anaesthetist may encounter.
