Search

Microvascular free flaps are considered the gold standard in head and neck reconstructive surgery. Myofascial flaps, in particular, are useful in certain oral and maxillofacial reconstruction cases, where mucosal regeneration over the transplanted tissue is planned. Despite high success rates, 1–6% of free flaps fail. A plethora of methods are available to assess transplanted tissue viability after reconstruction, including clinical observational monitoring, surface Doppler, implantable Doppler probe, colour Doppler sonography, laser Doppler flowmeter, surface temperature and indocyanine green angiography. However, no method has demonstrated adequate reliability or has proven to be cost-effective. The authors tested a technique called real-time optical vascular imaging to evaluate the microvascular circulation of myofascial free flaps. This technique was develop at Guy's Hospital, London to observe the microvascular anatomy of the oral cavity in vivo, non-invasively and without the need for patient preparation, with the aim of detecting and monitoring oral diseases. This technology detects the red blood cells flowing inside the microvasculature at a depth of approximately 2 mm, allowing the microvascular architecture and blood flow to be determined. This study showed that RTOVI may prove to be beneficial for the early detection of vascular compromise due to its immediacy and the feasibility of assessing multiple graft tissue regions. [ABSTRACT FROM AUTHOR]

The article focuses on a study related to the development of a follow-up surveillance protocol in head and neck oncological surgery. It mentions preventing recurrence and identifying patients presenting with recurrent or synchronous disease for improving mortality. It also mentions patients engaged in enhanced follow-up having higher attendance rate with no loss to follow-up and symptomatic patients requesting early follow-up led to the detection of the only recurrence in the cohort.

Sodium hypochlorite (NaOCl) is the most common irrigant used in modern endodontics. It is highly effective at dissolving organic debris and disinfecting the root canal system due to the high pH. Extravasation of NaOCl into intra-oral and extra-oral tissues can lead to devastating outcomes leading to long-term functional and aesthetic deficits. Currently no clear guidelines are available which has caused confusion among the dental and oral and maxillofacial (OMFS) surgical community how best to manage these patients. Following a literature review and considering our own experience we have formulated clear and precise guidelines to manage patients with NaOCl injury. [ABSTRACT FROM AUTHOR]

Abstract: Technical notes form an important part of the British Journal of Oral and Maxillofacial Surgery (BJOMS). Many ideas are novel and some change practice. During 2009–2010, 39 technical notes were published in the journal, and they covered the whole remit of the specialty. In this article we briefly review and summarise these articles, and highlight the salient points. [Copyright &y& Elsevier]

Abstract: Serum testosterone levels are known to have diurnal variation and to decrease by up to 2% per year after the age of 40. They can also be affected by stress and aggressive behaviour as well as various medical conditions. Although studies have investigated the role of mood and stress, none has specifically evaluated the effect of operative procedures on surgeons testosterone levels, particularly those in our own specialty, one that has historically been associated with perceived ‘high testosterone’ levels. We devised a suppositional study, particularly pertinent for publication at the beginning of April. This was a prospective randomised study of five male consultant maxillofacial surgeons (including two with male pattern baldness) and assayed serum testosterone levels at rest, during, and after a series of major ablative and reconstructive procedures. The resting testosterone levels were found to be similar in all surgeons (220±120.9mcg/ml). During major head and neck procedures, a statistically significant increase in serum testosterone was found (up to a maximum concentration of 1062.50mcg/ml). Multivariate analysis revealed that the likely predictors of increasing serum testosterone were: size and extent of tumour and complexity, and type of microvascular reconstruction (all P <0.001). The long-term effects of chronically raised serum testosterone warrant further investigation but recent evidence has found that it may be cerebro-protective against conditions including Alzheimer''s syndrome. [Copyright &y& Elsevier]

Abstract: This paper provides a review of articles relating to deformity, orthognathic surgery, and distraction osteogenesis published in the British Journal of Oral and Maxillofacial Surgery during 2008 and 2009. A total of 42 papers (26 full length articles, 5 technical notes, and 11 short communications or letters to the editor) were published. It was pleasing that 62% were full length articles; this is encouraging as such papers have a high educational value and are likely to be cited in future publications. [Copyright &y& Elsevier]

Abstract: The British Journal of Oral and Maxillofacial Surgery (BJOMS) accepts many types of papers that include leading articles, reviews, full length articles, and short communications. Many of the latter are isolated case reports of rare or interesting pathology, or personal experience of a difficult or unexpected complication. Case reports are considered to have a relatively low value in the advancement of medical knowledge, and with increasing pressure for space in paper publications, many journals now limit them to online publication only. We evaluated all 142 short communications published in BJOMS during 2008/2009. Most (87%) were single case reports, and they covered virtually the whole remit of the specialty. There were also 14 formal studies that included two laboratory-based research projects; these were excluded from the analysis. We used established criteria to assess the possible educational value of each publication, and found that 61/128 papers (48%), while interesting and informative, probably added little to existing knowledge. The remaining papers described new or unreported cases, rare or unexpected outcomes, and adverse effects or complications of treatment. We discuss the possible implications of this study for readers of BJOMS and for the journal itself. [Copyright &y& Elsevier]

Abstract: This paper provides a summary of the 95 papers related to oncology that were published in the British Journal of Oral and Maxillofacial Surgery (BJOMS) during 2007–2008. They include full length articles on clinical studies, radiology, basic science, and reconstruction in oral, and head and neck cancer. The journal also publishes technical notes and short communications. It encompasses the whole remit of the specialty and it is encouraging that authors choose to submit their work to BJOMS, but to improve the quality and status of the journal, we need to increase the ratio of full length articles to other submissions. Reviews of other subspecialties will be published in due course. [Copyright &y& Elsevier]

Aim: To report a new intraoral manifestation of sarcoid disease and review the literature. Methods: We present a case of oronasal fistulation as a previously unreported complication of sarcoid disease. A review of the literature was carried out to find documented cases of the oral manifestations of sarcoid disease. The types of intraoral lesions identified were recorded. Results: Seventy-two documented cases of oral sarcoid disease were identified. Soft tissue lesions were the most common, described as nodular or ulcerative and having a predilection for the buccal mucosa. Bony lesions presented as asymptomatic swellings, non-healing tooth sockets or mobile teeth. As far as we are aware, there are no reported cases of an oronasal fistula occurring as a complication of sarcoid disease. Conclusion: Sarcoidosis is a multisystem non-caseating, granulomatous condition of unknown aetiology, most commonly presenting in young adults. Pulmonary and lymph node involvement are common and although oral lesions can occur, these are rare. This is a case report of a man in his 40s who presented with symptoms associated with an oronasal fistula through the hard palate, secondary to sarcoid disease. To our knowledge, this has not been reported previously in the literature. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 58-year-old Iraqi woman who visited a maxillofacial department for the routine extraction of her tooth under local anaesthetic in which the extraction was accomplished without incident. It mentions that the patient collapsed in the hospital's stairs and showed bizarre asynchronous movements. Moreover, the patient's vital signs remained normal as she waned between periods of lucid normality and paroxysmal seizures.

Our vocabulary grows as undergraduates, and continues to develop as we continue to grow as dental professionals. For many of us not learned in Latin or Greek, we are too busy learning what words mean rather than appreciating why a word means what it does. This article aims to clarify where words relating to the maxilla are derived from, why they are used and how they are related to other similar words in everyday use. [ABSTRACT FROM AUTHOR]

This article describes a useful technique of periosteal release to allow free movement of the trocar during fixation of mandibular fractures via the transbuccal approach. [ABSTRACT FROM AUTHOR]

A response by L. Cascarini and A. Kumar to a letter to the editor about their article on the use of long-chain superglue with newer cyanoacrylates in treating wounds is presented.

Many of us can remember how much our vocabulary grew as undergraduates and indeed has continued to grow as dental professionals. For many of us not trained in Latin and Greek we have often been too busy learning what the word means to understand why it means what it does. This article aims to clarify things a little. It explains where words relating to the mandible come from, why we use them now and also shows how they are related to other similar words in everyday use. [ABSTRACT FROM AUTHOR]

A case of a father who treated his child's facial laceration with the home supply of 'superglue' having been previously misinformed that superglue is used to treat lacerations is presented. The differences between tissue adhesive and superglue are described and suggest that emergency staff should be careful to avoid using the term 'superglue' when using tissue adhesives. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the article by L.W. McArdie on Oral and Maxillofacial Surgery training in the 2006 issue.