Dealing with a 'Snake Nest' of Nerves and Venous Structures

There are so many different surgical approaches for oral surgeries. Today on Everyday Oral Surgery, Dr. Andrew Jenzer joins us once again to discuss submandibular and retromandibular approaches. Tuning in, you’ll hear all about the best resources to use when learning about these surgeries, what the submandibular approach does and when it’s used, the instruments you need to use, anesthetic versus epinephrine solution, and so much more! We delve into incision design and nerve testing before discussing what the retromandibular approach does and when it’s used. Dr. Andrew goes on to explain the three different carotid methods used for this surgery, the incisions used, potential issues with the carotid, healing traction problems, and more! Finally, our guest tells us about what’s keeping him busy at work. Thank you for listening! 

Key Points From This Episode:

• Welcoming Dr. Andrew Jenzer back to the show. 
• Dr. Jenzer talks us through some resources to use. 
• What the submandibular approach does and when it’s used. 
• How the House Brackmann skill is used. 
• The kinds of instruments you want during this surgery. 
• Local anesthetic versus pure epinephrine solution. 
• Dr. Jenzer breaks down the incision design of this procedure. 
• Why Dr. Jenzer is so aggressive about nerve testing. 
• The node of Stahr and what you need to know about it. 
• What the retromandibular approach does and when it’s used. 
• The three kinds of approaches for carotid incisions in this surgery. 
• A breakdown of the incisions used in this approach. 
• Potential issues that come with cutting through the carotid. 
• How to try to repair traction issues and nerve weakness if something goes wrong. 
• Dr. Jenzer tells us about his new book, papers, and course.

Links Mentioned in Today’s Episode:

Dr. Andrew Jenzer — https://surgery.duke.edu/profile/andrew-clark-jenzer
Dr. Andrew Jenzer Email Address — andrew.jenzer@gmail.com 

Submandibular Approach — https://surgeryreference.aofoundation.org/cmf/trauma/mandible/approach/submandibular-approach 

Retromandibular Approaches —  https://surgeryreference.aofoundation.org/cmf/sequela/approach/retromandibular-approaches 

‘Surgical Anatomy of the Mandibular Ramus of the Facial Nerve Based on the Dissection of 100 Facial Halves’ —  https://journals.lww.com/plasreconsurg/citation/1962/03000/surgical_anatomy_of_the_mandibular_ramus_of_the.5.aspx 

‘Virtual Subcondylar Osteotomy’ — https://pubmed.ncbi.nlm.nih.gov/5230341/ 

Essentialism — https://www.amazon.com/Essentialism-Disciplined-Pursuit-Greg-McKeown/dp/0804137382 

Wheel of Time — https://www.amazon.com/dp/B07F7MLR2R?binding=hardcover&ref=dbs_m_mng_rwt_sft_thcv_tkin 

Everyday Oral Surgery Website — https://www.everydayoralsurgery.com/ 

Everyday Oral Surgery on Instagram — https://www.instagram.com/everydayoralsurgery/ 

Everyday Oral Surgery