Maxillofacial Surgery Unit Referral Guidelines



Download 39.12 Kb.
Date conversion28.01.2017
Size39.12 Kb.

http://hub/assets/files/austin%20health%20jpeg.jpg


Maxillofacial Surgery Unit Referral Guidelines
Austin Health Maxillofacial Surgery Clinic holds two sessions per week to discuss and plan the treatment of patients with Oral and Maxillofacial Surgery conditions.


Department of Health clinical urgency categories for specialist clinics







Urgent: Referrals should be categorised as urgent if the patient has a condition that has the potential to deteriorate quickly, with significant consequences for health and quality of life, if not managed promptly. These patients should be seen within 30 days of referral receipt. For emergency cases please send the patient to the Emergency department.

Routine: Referrals should be categorised as routine if the patient’s condition is unlikely to deteriorate quickly or have significant consequences for the person’s health and quality of life if specialist assessment is delayed beyond one month.

Exclusions: Routine Dental treatment e.g. fillings, dentures etc., removal of wisdom teeth unless patient has an underlying medical disorder e.g. Warfarin, immunocompromised.

Temporomandibular joint dysfunction (these conditions should be referred to an Oral Medicine Specialist, Physiotherapist or Dentist).




Condition / Symptom

GP Management

Investigations Required Prior to Referral

Expected Triage Outcome

Expected Specialist Intervention Outcome

Expected number of Specialist Appointments

All facial fractures including those involving the
Mandible
Maxilla
Nasal Bones
Zygoma
Orbit
Ethmoid
Frontal Bone


When to Refer:

All patients with facial fracture for assessment even if deemed un-displaced


Previous treatment already tried:

If prior treatment has been attempted and a second opinion is required, patient may be referred.



To be included in referral:

Clinical history and examination


Imaging
OPG, PA Mandible if mandible
CT Facial Bones in all others except simple nasal fracture


Please instruct patient to bring films & diagnostic results to the Specialist Clinic appointment.

Urgent


Most facial fractures require up to 8 weeks of follow up in clinic on a 2-4 week basis (resulting in approximately 2-3 appointments).
Orbital fractures will require longer term (up to a year) follow up to look for enophthalmos which needs specialist assessment (4-5 appointments)

2-5 appointments

Condition / Symptom

GP Management

Investigations Required Prior to Referral

Expected Triage Outcome

Expected Specialist Intervention Outcome

Expected number of Specialist Appointments

Oral Cancer
Oral Ulceration


When to refer:

Any lesion, ulcer or white patch in the oral cavity, tongue, floor of mouth, lip, or alveolus.


Patients requiring second opinion.

To be included in referral:

Clinical history and examination


Imaging will be arranged at Austin
Diagnostics
Please instruct patient to bring films & diagnostic results to the Specialist Clinic appointment.



Urgent

Biopsy as necessary
Presentation at Multidisciplinary Meeting
Surgery and adjunctive therapy


Long term follow up for 5 years if confirmed oral cancer case.

First two years: three monthly.

Third to fifth year: six monthly

Mandible / Maxillary Cysts and Tumours



When to refer:

Expansile swelling of the mandible or maxilla, infection, mobile teeth,



To be included in referral:

Clinical history and examination


Imaging

OPG


CT Facial Bones
Diagnostics
Please instruct patient to bring films & diagnostic results to the Specialist Clinic appointment.



Urgent

Biospy and diagnosis
Most need excision or resection with complex reconstruction

Clear margins and good reconstruction can be discharged after one year

Head and Neck Infections
Odontogenic Infections






CT will be arranged at Austin

Urgent

Drainage of infection removal of teeth


1-2 appointments

Condition / Symptom

GP Management

Investigations Required Prior to Referral

Expected Triage Outcome

Expected Specialist Intervention Outcome

Expected number of Specialist Appointments

Dentofacial Deformity / OSA Orthognathic surgery
Mandibular Hypoplasia, Hyperplasia
Maxillary hypoplasia, hyperplasia
Open bite cases





To be included in referral:

Clinical history and examination


Imaging

OPG and Lateral Ceph


Diagnostics

Study models of teeth (if available)


Please instruct patient to bring films & diagnostic results to the Specialist Clinic appointment.


Routine


Assessment
Orthognathic Surgery


1 year follow up with about 4-6 appointments

Benign conditions of the oral cavity, face and maxillofacial complex


When to refer:

If concerned with any area e.g. polyp, lump, osteoma etc







Routine


Excision of the lesion


1-2 appointments then discharge


Salivary gland pathology
E.g. calculi, masses, sialadenitis of submandibular, parotid, sublingual gland and lip





To be included in referral:

Sialogram, US or CT if relevant





Routine



Surgical treatment of the lesion or gland


Most discharge in first 2 months



Austin Health Template Referral Guidelines | Created:[Insert Date]By: [Insert author] Last Reviewed: [Insert Authorising Clinician & Date] Review & Update By: [Insert 2 years]




The database is protected by copyright ©dentisty.org 2016
send message

    Main page