Audit of oral and maxillofacial surgical conditions seen at Port Harcourt, Nigeria

Benign Orofacial Vascular Anomalies: Review of 47 Cases in Enugu, Nigeria

BACKGROUND

A study of oral vascular anomalies has not been conducted in Nigeria to provide baseline data for comparison with reports in the literature.

AIMS

To study the prevalence and distribution of benign orofacial vascular anomalies at a tertiary hospital in Enugu.

MATERIALS AND METHODS

This is a 10-year retrospective observational study of consecutive patients with orofacial vascular anomalies, diagnosed by histology. The clinic-pathologic information was obtained from records archived in the department, and descriptive analysis was used to determine the frequency, tables for categorical variables, and a Chi-square test to determine the statistical significance.

RESULT

There were 47 cases of benign vascular anomalies out of 897 orofacial lesions giving a prevalence of 5.2%. There were 35.4% (17) male and 64.6% (31) female patients. The mean age in this series was 37.4 ± 19.8 (range: 1 to 76 years). Pyogenic granuloma was the most common vascular lesion 78.7% (37), followed by hemangioma 14.9% (7) and lymphangioma 6.4% (3). The gingiva was the most frequent site of oral occurrence 65.9% (31), especially maxillary gingivae 48.9% (23). The type of orofacial vascular anomalies was significantly associated with the anatomical site of occurrence, P = 0.00. The mean ages for the occurrence of pyogenic granuloma, hemangioma, and lymphangioma were 37.7 ± 18.3, 50.7 ± 16.9 years, and 3.3 ± 3.2 years, respectively. Pain was a frequent occurrence in 36.2% (17) of anomalies.

CONCLUSION

Oral vascular anomalies predominantly presented as pyogenic granuloma on the gingivae, while oral hemangioma was observed in adults, and lymphangioma was infrequent.

Referral pattern of oral and maxillofacial surgery cases in Sudan: A retrospective age-and sex-specific analysis of 3,478 patients over four years

Oral and maxillofacial surgery (OMFS) is a specialty widening in its scope. An objective analysis of the referral pattern can provide essential information to improve healthcare. This four-year retrospective study was implemented in Khartoum Teaching Dental Hospital. Data (age, sex, diagnosis, and type of treatment) were collected from patient records. Disease frequency, as well as the effect of sex and age, were analyzed for each group. The frequency of treatment types was also assessed. Data were collected from a total of 3,478 patients over the four-year study period. There was a male predominance with the third decade of life being the most common age group. Pathological diseases were the most common (37%) reason for referral, followed by trauma (31%). Temporomandibular joint (TMJ) disorders and dentoalveolar extraction were the least frequently observed. Open reduction and internal fixation (ORIF) was the most commonly performed procedure (28%). These data represent the epidemiology of oral and maxillofacial diseases in Sudan. Given that the third decade of life is the most represented age group, it is beneficial to learn the long-term consequences of these diseases in these young patients and to use modern surgical techniques to improve their lives.

A 5-year audit of major maxillofacial surgeries at Usmanu Danfodiyo university teaching hospital, Nigeria

Background

There is a paucity of data on the pattern of oral and maxillofacial surgeries done in Nigeria. Despite the rising prominence of oral and maxillofacial surgery as a specialty in our immediate environment, no published audit of the surgeries performed exist. This study aims to present the pattern and types of major surgeries done by oral and maxillofacial surgeons in our hospital as well as the indications for such surgeries. It is hoped that the findings will assist in formulating informed policies and improving healthcare delivery.

Methods

A review of hospital records of all patients who had major oral and maxillofacial surgeries at Usmanu Danfodiyo University Teaching Hospital from January, 2013 to August, 2017 was done. Descriptive statistics such biodata, indication for surgery and type of surgery were recorded and analyzed using the IBM SPSS statistics for windows version 20 (Armonk, NY: IBM Corp) software.

Results

One hundred and forty six individuals who underwent 158 major surgeries under general anaesthesia were included. There were 82 males and 64 females, giving a male/female ratio of 1.3: 1. The ages ranged from 3 months to 81 years [median of 33 years]. Tumours and tumour-like lesions were the major indications for surgery [85 (58.2%)]. The most commonly performed surgery was mandibulectomy [31 (19.6%)], followed by Open Reduction and Internal Fixation (ORIF) [29 (18.4%)].

Conclusion

Major oral and maxillofacial surgeries are common in our environment. The frequencies of these surgeries can increase with better healthcare financing and universal availability of health insurance schemes. Efforts aimed at reducing the incidence of tumours should be instituted.

One Year Audit of In Patient Department of Oral and Maxillofacial Surgery, Dhaka Dental College Hospital

BACKGROUND

The world wide pattern of oral and maxillofacial surgical conditions has rarely been reported despite its significance in ensuring quality of care. A large number of patients are managed surgically in Oral and Maxillofacial Surgery department of Dhaka Dental College Hospital but there has been no surgical audit to identify the potential problems in patient care.

OBJECTIVES

The aim of this study was to identify the pattern of oral and maxillofacial conditions in patients of maxillofacial surgery of Dhaka Dental College Hospital, which would provide valuable information to build up the focus of attention, to develop a future strategy plan, to improve its clinical care and extend the academic and research field.

PATIENTS AND METHODS

A retrospective survey of oral and maxillofacial surgical cases managed at the inpatient Department of Oral and Maxillofacial Surgery, Dhaka Dental College Hospital. All admitted patients from 1st January, 2012 to 31st December, 2012 were included in this study. The patients' data were retrieved from the wards registers and patient records. The data were recorded as age, sex, occupation, geographic distribution, diagnosis, treatment done and operation name. These were studied to assess the prevalence of age, sex, diseases and the name of the treatment offered. Analysis of major groups of diagnosis on the basis of age and sex was also studied. Mortality was also recorded.

RESULTS

Between 1st January, 2012 and 31st December, 2012 a total of 768 patients were treated. Among them 494 patients were male while 274 were female, male female ratio was 1.80:1. The majority of the patients were from Dhaka division. The mean age of the patients was 33.20 years; peak age group was 15-30 years. The most common diagnosis was maxillofacial injuries (35 %), followed by oral squamous cell carcinoma (22 %) and odontogenic tumours and hamartomas (11 %). Maxillo-mandibular fixation or wiring was the main modality of treatment. The mortality rate was 0.26 % of total patients.

CONCLUSIONS

The department of Oral and Maxillofacial Surgery, Dhaka Dental College Hospital is a busy centre for specialized maxillofacial services in Bangladesh. A good number of patients with a wide range of oral and maxillofacial surgical conditions are managed here. Maxillofacial injury and oral cancer are the two most common conditions encountered here.

Analysis of 46 cases of malignant jaw tumours in Calabar, Nigeria

Background:

The occurrence and distribution of malignant jaw tumours differs across the globe because of differences in geographical, cultural, racial, and socioeconomic factors. The aim of this study was to determine the types and pattern of malignant jaw tumours in Calabar, located in South-South Nigeria.

Materials and Methods:

The histopathologic results, as well as demographic and clinical information of all consecutive patients diagnosed of having a malignant jaw tumour at the Oral and Maxillofacial Unit of University of Calabar Teaching Hospital, Calabar, Nigeria from January 2000 to December 2013 was retrospectively collected and analyzed.

Results:

A total of 46 (25.1%) out of the 180 cases of jaw neoplasms seen over the 14 year period were malignant. There was a slight male predominance with a ratio of 1.7:1 and the age ranged from 4 to 70 years, mean (standard deviation) 34.6 (4.56) years. The most common malignant lesion was squamous cell carcinoma (SCC) (n = 20; 43.5%), followed by Burkitt lymphoma (n = 8; 17.4%). The gender distributions of the lesions were significant, with more SCC seen in females in a ratio of 1.5:1 in relation to males. Osteosarcoma (n = 6; 13%) and rhabdomyosarcoma (n = 4; 8.7%) were observed only in males and females, respectively. About half of the lesions occurred in the mandible (47.8%). The age distribution of lesions was significant (P < 0.001), with SCC frequently seen in the sixth and seventh decades while Burkitt's lymphoma and rhabdomyosarcoma were seen around the first decade. Clinical presentations ranged from swelling (n = 31), pain (n = 26), loosed teeth (n = 15), toothache (n = 11) to missing teeth (n = 9) among others and occurring either singly or in two or more combinations. The duration of symptoms on presentation ranged from 1 to 46 months, mean 21.7 (13.12) months and this was not different for male or female (P > 0.05).

Conclusion:

Oral cancer awareness campaign and advocacy is necessary to steer the awareness of the population on the need for regular dental visits, early recognition, and the dangers associated with late presentation of orofacial malignancy.

Maxillofacial tumors and tumor-like lesions in a Nigerian teaching hospital: an eleven year retrospective analysis

BACKGROUND

This paper reviews the types, prevalence and demographic distribution of maxillofacial tumors, cysts and tumor-like lesions in a Nigerian population.

METHODS

A retrospective analysis of the medical records and histological reports of patients with oral and maxillofacial tumors and cystic lesions who presented to the Maxillofacial Unit of our institution over an eleven year period was undertaken. Information on demographics, histological diagnosis and clinical presentation were obtained and analyzed. A p value of less than 0.05 was considered significant.

RESULTS

A total o:f 146 patients, aged 5-70 years (mean 30.5± 12.9) were seen over the period of study. There were 96 males (65.8%) and 50 females (34.2%) giving a male to female ratio of almost 2:1. Benign tumors accounted for 124, 86.3% and malignant tumors (22, 13.7%). Ameloblastoma was the most prevalent benign tumor observed (53, 36.3%) while squamous cell carcinoma was the most common malignant tumor. The peak age of ameloblastoma was the fourth decade and squamous cell carcinomas the sixth and seventh decades of life. Jaw swellings were the most common presentation (98, 67.1%), followed by pain (23, 15.9). The duration of symptoms on presentation ranged from 1 to 96 months (mean 23.32 ±15.72) and this was not different for malignant or benign tumors (P=0.886).

CONCLUSION

Late presentation still remains the main challenging factor in the early detection and management of maxillofacial tumors in our environment. More awareness campaign is necessary, especially at the primary health care level, to educate the populace on the need for early presentation at treatment centers.

Ambulatory oral surgery: 1-year experience with 11680 patients from Zagreb district, Croatia

AIM

To examine the types and frequencies of oral surgery diagnoses and ambulatory oral surgical treatments during one year period at the Department of Oral Surgery, University Hospital Dubrava in Zagreb, Croatia.

METHODS

Sociodemographic and clinical data on 11680 ambulatory patients, treated between January 1 and of December 31, 2011 were retrieved from the hospital database using a specific protocol. The obtained data were subsequently analyzed in order to assess the frequency of diagnoses and differences in sex and age.

RESULTS

The most common ambulatory procedure was tooth extraction (37.67%) and the most common procedure in ambulatory operating room was alveolectomy (57.25%). The test of proportions showed that significantly more extractions (P<0.001) and intraoral incisions (P<0.001) were performed among male patients, whereas significantly more alveolectomies and apicoectomies were performed among female patients (P<0.001). A greater prevalence of periodontal disease was found in patients residing in Zagreb than in patients residing in rural areas.

CONCLUSION

The data from this study may be useful for planning of ambulatory oral surgery services, budgeting, and sustaining quality improvement, enhancing oral surgical curricula, training and education of primary health care doctors and oral surgery specialists, and promoting patients' awareness of the importance of oral health.