Preoperative Evaluation and Investigations for Maxillofacial Surgery

Patients undergoing oral and maxillofacial surgeries have unique perioperative considerations as the surgical field is in proximity to the airway and poses a challenge to the anesthesiologist in the matter of airway management. A well-structured preoperative evaluation plays a decisive role for the successful performance of the planned surgical intervention, as well as to overcome any challenges posed due to the pre-existing health condition of the patient. Each physiologic system can be adversely affected by associated comorbidities that may or may not have clinical importance for the surgeons. Thus, the effects of coexisting diseases on the cardiovascular, respiratory, gastrointestinal, renal, and endocrine systems may be significant. Moreover, to mitigate risks related to these associated comorbidities, as well as to the impact of surgery/anesthesia on the patient, specific risk reduction strategies for the entire perioperative period need to be implemented. Risk management and optimization strategies involve the rational use of adjunctive laboratory and imaging studies and professional opinions of consultants of other specialties. A team approach is critical in establishing a working framework of perioperative management that would be able to keep morbidity and mortality related to the maxillofacial surgery, to an absolute minimum.