Topics Discussed: ear, nose, and throat; mouth injury; neck injuries; oral cavity.
Sections: Emergencies of the Oral Cavity and Neck: Introduction, Oral and Dental Anatomy, Dentoalveolar Trauma, Oropharyngeal Trauma, Dentoalveolar Infections, Infections of the Oral Soft Tissue, Pharyngitis, Peritonsillar Abscess, Retropharyngeal Abscess, Oral Piercings, References.
- Avulsed primary teeth should not be replaced. Avulsed permanent teeth should be reimplanted as soon as possible.
- Always consider aspiration when a tooth/tooth fragment cannot be located.
- Fractures of primary teeth may be a sign of child abuse. The presence of Neisseria gonorrhoeae pharyngitis in a child suggests sexual abuse.
- Physicians should maintain a high index of suspicion for carotid injury in a patient with trauma to the oropharynx.
- Uncomplicated dental infections are treated on an outpatient basis. Deep fascial space infections often require hospitalization, IV antibiotics, and surgical drainage.
- Suppurative complications of pharyngitis include peritonsillar abscess, Lemierre's postanginal sepsis, and Ludwig's angina.
- Needle aspiration may be employed diagnostically to differentiate between peritonsillar cellulitis and peritonsillar abscess. Definitive treatment may be achieved via aspiration, incision and drainage, or tonsillectomy in selected cases.
- Airway assessment is important in suspected cases of peritonsillar abscess, retropharyngeal abscess (RPA), and Ludwig's angina. Definitive management of unstable airways is best achieved in the operating room with the assistance of an anesthesiologist or an ENT specialist. Emergency airway equipment should be available at the bedside.
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