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Colin E, Paasche A, Destrez A, Devauchelle B, Bettoni J, Bouquet J, Dakpé S, Testelin S. Impact of the COVID-19 Pandemic on Head and Neck Cancer Management: The Experience of the Maxillo-Facial Surgery Department of a French Regional Referral Center in a High-Incidence Area. J Clin Med 2024; 13:2439. [PMID: 38673711 PMCID: PMC11050808 DOI: 10.3390/jcm13082439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 03/15/2024] [Accepted: 04/19/2024] [Indexed: 04/28/2024] Open
Abstract
Background: Cancer patients are at a high risk of complications in cases of infection, and head and neck cancers (HNC) are no exception. Since late 2019, SARS-CoV-2 has caused a global health crisis, with high rates and severe forms of the disease in cancer patients. Hospitalization, surgery and radiotherapy were rapidly described as increasing the risk of infection. Since March 2020, the Amiens University Hospital (France) has been taking care of COVID-19 patients while its maxillofacial surgery department managed HNC patients without interruption, even during lockdown periods. However, many questions concerning the impact on patient care were still pending. The aim of this study is to describe HNC management in our center during the first epidemic peak and to evaluate the impact of containment measures on patient treatment. Methods: We retrospectively included 44 HNC patients treated in our department between 1 March and 31 August 2020. Two groups were defined according to the period of care: lockdown (March to May) and lighter restrictions (June to August). Results: The results show typical epidemiological characteristics, maintained management times and non-downgraded procedures. Conclusions: Thus, during the first epidemic peak, continuity of care and patients' safety could be ensured thanks to adequate means, adapted procedures and an experienced surgical team.
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Affiliation(s)
- Emilien Colin
- Maxillofacial Surgery Department, Amiens University Hospital, Rond-Point du Pr Christian Cabrol, 80054 Amiens, France; (A.P.); (A.D.); (B.D.); (J.B.); (J.B.); (S.D.); (S.T.)
- UR 7516 CHIMERE, University of Picardie Jules Verne, Chemin du Thil, CS 52501, 80025 Amiens, France
- Institut Faire Faces, Rond-Point du Pr Christian Cabrol, 80054 Amiens, France
| | - Agnès Paasche
- Maxillofacial Surgery Department, Amiens University Hospital, Rond-Point du Pr Christian Cabrol, 80054 Amiens, France; (A.P.); (A.D.); (B.D.); (J.B.); (J.B.); (S.D.); (S.T.)
- UR 7516 CHIMERE, University of Picardie Jules Verne, Chemin du Thil, CS 52501, 80025 Amiens, France
- Institut Faire Faces, Rond-Point du Pr Christian Cabrol, 80054 Amiens, France
| | - Alban Destrez
- Maxillofacial Surgery Department, Amiens University Hospital, Rond-Point du Pr Christian Cabrol, 80054 Amiens, France; (A.P.); (A.D.); (B.D.); (J.B.); (J.B.); (S.D.); (S.T.)
- UR 7516 CHIMERE, University of Picardie Jules Verne, Chemin du Thil, CS 52501, 80025 Amiens, France
- Institut Faire Faces, Rond-Point du Pr Christian Cabrol, 80054 Amiens, France
| | - Bernard Devauchelle
- Maxillofacial Surgery Department, Amiens University Hospital, Rond-Point du Pr Christian Cabrol, 80054 Amiens, France; (A.P.); (A.D.); (B.D.); (J.B.); (J.B.); (S.D.); (S.T.)
- UR 7516 CHIMERE, University of Picardie Jules Verne, Chemin du Thil, CS 52501, 80025 Amiens, France
- Institut Faire Faces, Rond-Point du Pr Christian Cabrol, 80054 Amiens, France
| | - Jérémie Bettoni
- Maxillofacial Surgery Department, Amiens University Hospital, Rond-Point du Pr Christian Cabrol, 80054 Amiens, France; (A.P.); (A.D.); (B.D.); (J.B.); (J.B.); (S.D.); (S.T.)
- UR 7516 CHIMERE, University of Picardie Jules Verne, Chemin du Thil, CS 52501, 80025 Amiens, France
- Institut Faire Faces, Rond-Point du Pr Christian Cabrol, 80054 Amiens, France
| | - Julien Bouquet
- Maxillofacial Surgery Department, Amiens University Hospital, Rond-Point du Pr Christian Cabrol, 80054 Amiens, France; (A.P.); (A.D.); (B.D.); (J.B.); (J.B.); (S.D.); (S.T.)
- UR 7516 CHIMERE, University of Picardie Jules Verne, Chemin du Thil, CS 52501, 80025 Amiens, France
- Institut Faire Faces, Rond-Point du Pr Christian Cabrol, 80054 Amiens, France
| | - Stéphanie Dakpé
- Maxillofacial Surgery Department, Amiens University Hospital, Rond-Point du Pr Christian Cabrol, 80054 Amiens, France; (A.P.); (A.D.); (B.D.); (J.B.); (J.B.); (S.D.); (S.T.)
- UR 7516 CHIMERE, University of Picardie Jules Verne, Chemin du Thil, CS 52501, 80025 Amiens, France
- Institut Faire Faces, Rond-Point du Pr Christian Cabrol, 80054 Amiens, France
| | - Sylvie Testelin
- Maxillofacial Surgery Department, Amiens University Hospital, Rond-Point du Pr Christian Cabrol, 80054 Amiens, France; (A.P.); (A.D.); (B.D.); (J.B.); (J.B.); (S.D.); (S.T.)
- UR 7516 CHIMERE, University of Picardie Jules Verne, Chemin du Thil, CS 52501, 80025 Amiens, France
- Institut Faire Faces, Rond-Point du Pr Christian Cabrol, 80054 Amiens, France
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Frosolini A, Catarzi L, Benedetti S, Latini L, Chisci G, Franz L, Gennaro P, Gabriele G. The Role of Large Language Models (LLMs) in Providing Triage for Maxillofacial Trauma Cases: A Preliminary Study. Diagnostics (Basel) 2024; 14:839. [PMID: 38667484 PMCID: PMC11048758 DOI: 10.3390/diagnostics14080839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Revised: 04/10/2024] [Accepted: 04/16/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND In the evolving field of maxillofacial surgery, integrating advanced technologies like Large Language Models (LLMs) into medical practices, especially for trauma triage, presents a promising yet largely unexplored potential. This study aimed to evaluate the feasibility of using LLMs for triaging complex maxillofacial trauma cases by comparing their performance against the expertise of a tertiary referral center. METHODS Utilizing a comprehensive review of patient records in a tertiary referral center over a year-long period, standardized prompts detailing patient demographics, injury characteristics, and medical histories were created. These prompts were used to assess the triage suggestions of ChatGPT 4.0 and Google GEMINI against the center's recommendations, supplemented by evaluating the AI's performance using the QAMAI and AIPI questionnaires. RESULTS The results in 10 cases of major maxillofacial trauma indicated moderate agreement rates between LLM recommendations and the referral center, with some variances in the suggestion of appropriate examinations (70% ChatGPT and 50% GEMINI) and treatment plans (60% ChatGPT and 45% GEMINI). Notably, the study found no statistically significant differences in several areas of the questionnaires, except in the diagnosis accuracy (GEMINI: 3.30, ChatGPT: 2.30; p = 0.032) and relevance of the recommendations (GEMINI: 2.90, ChatGPT: 3.50; p = 0.021). A Spearman correlation analysis highlighted significant correlations within the two questionnaires, specifically between the QAMAI total score and AIPI treatment scores (rho = 0.767, p = 0.010). CONCLUSIONS This exploratory investigation underscores the potential of LLMs in enhancing clinical decision making for maxillofacial trauma cases, indicating a need for further research to refine their application in healthcare settings.
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Affiliation(s)
- Andrea Frosolini
- Maxillofacial Surgery Unit, Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy; (L.C.); (S.B.); (L.L.); (G.C.); (P.G.); (G.G.)
| | - Lisa Catarzi
- Maxillofacial Surgery Unit, Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy; (L.C.); (S.B.); (L.L.); (G.C.); (P.G.); (G.G.)
| | - Simone Benedetti
- Maxillofacial Surgery Unit, Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy; (L.C.); (S.B.); (L.L.); (G.C.); (P.G.); (G.G.)
| | - Linda Latini
- Maxillofacial Surgery Unit, Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy; (L.C.); (S.B.); (L.L.); (G.C.); (P.G.); (G.G.)
| | - Glauco Chisci
- Maxillofacial Surgery Unit, Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy; (L.C.); (S.B.); (L.L.); (G.C.); (P.G.); (G.G.)
| | - Leonardo Franz
- Phoniatris and Audiology Unit, Department of Neuroscience DNS, University of Padova, 35122 Treviso, Italy;
- Artificial Intelligence in Medicine and Innovation in Clinical Research and Methodology (PhD Program), Department of Clinical and Experimental Sciences, University of Brescia, 25121 Brescia, Italy
| | - Paolo Gennaro
- Maxillofacial Surgery Unit, Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy; (L.C.); (S.B.); (L.L.); (G.C.); (P.G.); (G.G.)
| | - Guido Gabriele
- Maxillofacial Surgery Unit, Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy; (L.C.); (S.B.); (L.L.); (G.C.); (P.G.); (G.G.)
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Tan KH, Yong CW, Wong RCW. Kern's six-step approach allows for meaningful implementation of an orthognathic surgery training course. J Dent Educ 2024. [PMID: 38562106 DOI: 10.1002/jdd.13517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 12/21/2023] [Accepted: 03/03/2024] [Indexed: 04/04/2024]
Abstract
OBJECTIVES This study investigated the effectiveness of simulation training in improving the confidence and competency of oral and maxillofacial surgery (OMS) residents in performing orthognathic surgery (OGS). METHODS Kern's six-step approach was applied when designing the simulation training for OMS residents. The difficulties encountered by the residents when learning OGS were considered when designing the training program. A training course consisting of didactic sessions, hands-on training on three-dimensional training models, and an assessment tool was implemented for OMS residents. Improvement in the confidence and competence of OMS residents in performing OGS, fidelity of the three-dimensional models, and satisfaction with the course was evaluated. RESULTS All OMS residents (10/10) completed the course. The perceived difficulty in learning OGS was mainly related to the manipulation of the jawbones. While there were improvements in the median confidence and competence scores (3/5 to 4/5), only the differences in competence were found to be statistically significant (p < 0.01, Wilcoxon signed-rank test). Improvements in confidence and competence did not correlate. The mean fidelity scores of both the maxillary and mandibular models were adequate at 3.2 out of 5. Overall, satisfaction with the course was high (5/5). CONCLUSIONS The six-step approach provides a guided process for educators to formulate a training course directed toward the perceived needs of students. Targeted training can significantly enhance the students' competence. Greater efforts should also be put in place to allow simultaneous developments in the students' confidence along with their competence.
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Affiliation(s)
- Kian How Tan
- Faculty of Dentistry, National University of Singapore, Singapore, Singapore
- Dental Branch, Singapore Armed Forces Medical Corps, Singapore, Singapore
| | - Chee Weng Yong
- Faculty of Dentistry, National University of Singapore, Singapore, Singapore
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Corona-Rodarte E, Cano-Aguilar LE, Baldassarri-Ortego LF, Tosti A, Asz-Sigall D. Dermatological perspectives on pressure alopecias: A call for awareness. J Am Acad Dermatol 2024; 90:e133-e134. [PMID: 37778661 DOI: 10.1016/j.jaad.2023.09.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 09/22/2023] [Indexed: 10/03/2023]
Affiliation(s)
- Eduardo Corona-Rodarte
- Department of Dermatology, Instituto Dermatológico de Jalisco Dr. José Barba Rubio, Jalisco, Mexico.
| | | | | | - Antonella Tosti
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida
| | - Daniel Asz-Sigall
- Trichology Clinic, Department of Dermatology, Hospital General Dr. Manuel Gea González, Mexico City, Mexico.
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Zhu G, Ma Z, Cao C, He J, Hong J, Ren R, Xia H, Yan B, Wang X, Li LJ, Li C. Chinese surgical robot-assisted surgery for parotid tumor: a case report. Hua Xi Kou Qiang Yi Xue Za Zhi 2024; 42:262-267. [PMID: 38597087 PMCID: PMC11034414 DOI: 10.7518/hxkq.2024.2023393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 12/22/2023] [Indexed: 04/11/2024]
Abstract
Robotic surgery is known as the "third technological revolution" in the field of surgery, and is an important milestone in the development of modern surgery. However, our country's innovative surgical robot industry is still in its early stages, and it is only being utilized in certain surgical fields. To explore the effectiveness of the application of domestic surgical robot in oral and maxillofacial surgery, the author successfully completed a case of benign parotid tumor resection with the assistance of a domestic autonomous robot. The operation was successful, facial nerve function was preserved, and postoperative wound healing was good.
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Affiliation(s)
- Guiquan Zhu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Dept. of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Zhongkai Ma
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Dept. of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Chang Cao
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Dept. of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Jialu He
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Dept. of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Jiawei Hong
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Dept. of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Ruiting Ren
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Dept. of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Hui Xia
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Dept. of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Bing Yan
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Dept. of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Xiaoyi Wang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Dept. of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Long-Jiang Li
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Dept. of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Chunjie Li
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Dept. of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
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Stoev L, Yankov YG, Nikolaev NI, Stoeva M. A Rare Case of Schwannoma of the Right Greater Palatine Nerve in a 17-Year-Old Female Patient. Cureus 2024; 16:e56836. [PMID: 38654803 PMCID: PMC11037877 DOI: 10.7759/cureus.56836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2024] [Indexed: 04/26/2024] Open
Abstract
Schwannomas are not uncommon in the maxillofacial region; however, those with intraoral localization and, in particular, the hard palate are among the least frequently described. In the current case report, we present a 17-year-old girl with a histologically verified schwannoma of the hard palate on the right, originating from the right greater palatine nerve. In her case, despite the lysis of the palatine bone from the tumor compression, the disease is asymptomatic, causing only a weak sensation of local discomfort. The lesion was removed surgically under general anesthesia and the resulting defect of the palatal mucosa was compensated by plastic reconstruction with a lingual mucosal flap on a posterior feeding base. The recovery period was uneventful.
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Affiliation(s)
- Lyuben Stoev
- General and Clinical Pathology, Forensic Medicine and Deontology, Medical University of Varna, Varna, BGR
| | - Yanko G Yankov
- Maxillofacial Surgery, University Hospital St. Marina, Varna, BGR
- General and Operative Surgery, Medical University of Varna, Varna, BGR
| | | | - Martina Stoeva
- General and Clinical Pathology, Forensic Medicine and Deontology, Medical University of Varna, Varna, BGR
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Abdulaziz MK, Al-Jamali M, Al-Mazidi S, Albuloushi S, Al-Ali AB. Medical Students Understanding of The Scope of Plastic Surgery. Arch Plast Surg 2024; 51:251-257. [PMID: 38596147 PMCID: PMC11001442 DOI: 10.1055/a-2219-2411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 11/24/2023] [Indexed: 04/11/2024] Open
Abstract
Background Plastic surgery has developed to benefit in a variety of challenging areas formerly handled by other disciplines. Medical students do not have a clear picture of plastic surgery as a career due to lacking scope, clinical practice, and understanding of plastic surgery as a clinical area of expertise, including general practitioners, nursing staff, medical trainees, and the general public, and misconceptions about the extent of reconstructive and plastic surgery. Methods A cross-sectional observational study was conducted on Kuwait University Medical students (2nd-7th Years) over a period of 1 month. A questionnaire and a consent form were provided to eligible students. The inclusion criteria were Kuwait University Medical students from 2nd to 7th Years with signed consent form. The response was collected via email sent in coordination with the Vice Dean of Student Affairs in the Faculty of Medicine. Using statistical package for the social sciences, responses were statistically analyzed. Pearson's chi-square test was used to calculate p -values, where p < 0.05 was considered statistically significant. Results A total of 244 eligible medical students, 121 males and 123 females, were included in the study, with a mean age of 21 (±2) years. Similarly, 126 (51.6%) were preclinical students (2nd-4th-year students), while 118 (48.4%) were clinical students (5th-7th-year students). About 79.8% of medical students believed that plastic surgery plays an essential role in trauma management, whereas 9.2% did not consider plastic surgery significant for trauma management. This study found that only 15.5% of medical students were interested in enrolling in plastic surgery residency after graduation, while 47.1% of students did not consider plastic surgery residency after graduation. However, 37.4% were uncertain. The two most driving factors in deciding on plastic surgery residency were expected income (61.8%) and lifestyle (14.3%). Conclusion Improving medical students' education quality can enhance their perception and awareness of plastic surgery. Students should be taught the broader scope of plastic surgery. The inclusion of formal training during undergraduation is the essence of time and should be added to or improved during plastic surgery rotations with more emphasis on reconstructive and hand/peripheral nerve surgery. Student-led interest groups can be a useful tool for educating students about their specialty.
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Affiliation(s)
- Mohammad K.H.B. Abdulaziz
- Department of Plastic Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, Warwickshire, United Kingdom
- Department of Plastic Surgery, University Hospital Coventry, Coventry, United Kingdom
| | - Mohammad Al-Jamali
- Department of Psychiatry, University Hospitals Birmingham NHS Foundation Trust, Birmingham, Birmingham, United Kingdom
| | - Sundus Al-Mazidi
- Department of Plastic Surgery, Al-Babtain Center for Plastic and Burn Surgery, Kuwait City, Kuwait
| | - Sarah Albuloushi
- Department of Opthalmology, Al-Bahar Center for Opthalmology, Kuwait City, Kuwait
| | - Ahmad B. Al-Ali
- Department of Plastic Surgery, Al-Babtain Center for Plastic and Burn Surgery, Kuwait City, Kuwait
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Wang J, Gao Q, Feng X, Chen Y. Role of hydrocolloid dressing in preventing face pressure ulcers from non-invasive ventilation and facilitating postoperative wound healing in maxillofacial surgery: A meta-analysis. Int Wound J 2024; 21:e14780. [PMID: 38385780 PMCID: PMC10883250 DOI: 10.1111/iwj.14780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 01/28/2024] [Indexed: 02/23/2024] Open
Abstract
Facial pressure ulcers from non-invasive ventilation (NIV) and challenges in wound healing post-maxillofacial surgery are significant concerns in clinical care. This meta-analysis aimed to evaluate the effectiveness of hydrocolloid dressings in these contexts. From a pool of 1135 articles, 8 studies met the inclusion criteria. Hydrocolloid dressings demonstrated a significant reduction in facial pressure ulcers for NIV patients, with lower REEDA scores 1-week postapplication (standardized mean difference [SMD] = -16.7, 95% confidence interval [CI]: -24.26 to -9.15, p < 0.01). In maxillofacial surgery, patients treated with hydrocolloid dressings exhibited improved wound healing and reduced scar formation, evidenced by lower Manchester Scar Scale scores 3 months post-surgery (SMD = -15.46, 95% CI: -20.28 to -10.64, p < 0.01). These findings suggest that hydrocolloid dressings are effective in both preventing NIV-related facial pressure ulcers and enhancing wound healing in maxillofacial surgery.
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Affiliation(s)
- Jingqi Wang
- Postanesthesia Care Unit, Affiliated Xinhua Hospital of Medicine College of Shanghai Jiaotong University, Shanghai, China
| | - Qian Gao
- Center of Word, Affiliated Xinhua Hospital of Medicine College of Shanghai Jiaotong University, Shanghai, China
| | - Xiaolan Feng
- Postanesthesia Care Unit, Affiliated Xinhua Hospital of Medicine College of Shanghai Jiaotong University, Shanghai, China
| | - Yi Chen
- Emergency Intensive Care Unit, Affiliated Xinhua Hospital of Medicine College of Shanghai Jiaotong University, Shanghai, China
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Sharma D, Douglas J, Begley A, Magennis P, Koppel D. UK OMFS consultants and trainees strongly support the recommendations of the 2008 Postgraduate Medical Education and Training Board (PMETB) Review of Training in OMFS. The time for delivering them is now. Br J Oral Maxillofac Surg 2024:S0266-4356(24)00051-2. [PMID: 38692979 DOI: 10.1016/j.bjoms.2024.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 02/24/2024] [Indexed: 05/03/2024]
Abstract
When the Postgraduate Medical Education and Training Board's (PMETB) Review of Oral and Maxillofacial Surgery (OMFS) Training was published in 2008 it contained five recommendations about OMFS training. As yet, none of these recommendations has been delivered. An online survey was designed to assess awareness of the PMETB review and the current views of OMFS trainees and consultants about its recommendations. Replies were invited using email and social media (WhatsApp, Twitter, and Facebook). As a result of using social media no denominator for the response rate was possible. A total of 304 responses were received, eight of which were anonymous. There was strong support for all the OMFS-specific recommendations: 1: the OMFS specialty should remain a dual medical and dental degree specialty (255, 84%); 2: OMFS training should be shortened (283, 93%); 3: OMFS training should start at the beginning of the second degree (203, 67%); 4: there should be a single medical regulator (General Medical Council) for OMFS (258, 85%); and 6: the need for a second Foundation Year should be removed (260, 86%). Other suggestions about improving OMFS training were also made by participants in the survey. There remains strong support within the specialty for the recommendations of the review. This support is present across consultants, specialty trainees, and those aiming for OMFS specialty training. Some of the original legislative obstructions to delivery of the recommendations have been removed by Brexit creating a unique opportunity for them to be delivered.
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Affiliation(s)
| | | | - Anne Begley
- Liverpool University Hospitals NHS Foundation Trust, UK.
| | | | - David Koppel
- Faculty of Medicine and Health Sciences, McGill University, Montreal, Canada.
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Rodríguez-Alcalá L, Valderrama-Penagos JX, O'Connor-Garcia St E, O'Connor-Reina C. Lost needle in the oral cavity: can the nightmare be just a bad dream? J Laryngol Otol 2024:1-4. [PMID: 38314758 DOI: 10.1017/s0022215124000264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2024]
Abstract
OBJECTIVE The loss of a scalpel or a needle during surgery can threaten the health of the patient and lead to additional costs, and radiographical assistance during surgery has been the only recovery method. This study evaluates the efficacy of a metal detector compared with conventional radiology for recovering a needle lost in the oropharynx during surgery. METHOD Different fragment sizes of needles normally used in pharyngoplasty were embedded at different locations and depths in a lamb's head. Three experienced and three junior otolaryngologists searched for the needle fragments using a metal detector and conventional radiology. RESULTS All fragments were found with each method, but the mean searching time was 90 per cent shorter with the metal detector. CONCLUSION A metal detector can be a useful tool for locating needles that break during ENT surgery, as it requires less time than conventional radiology and avoids exposing patients to radiation.
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Affiliation(s)
- Laura Rodríguez-Alcalá
- Department of Otorhinolaryngology, Hospital Quiron Salud Marbella and Hospital Quiron Salud Campo de Gibraltar, Spain
| | | | | | - Carlos O'Connor-Reina
- Department of Otorhinolaryngology, Hospital Quiron Salud Marbella and Hospital Quiron Salud Campo de Gibraltar, Spain
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Gelbier S. William Warwick James OBE FRCS MCh FDS FLS (1874 to 1965). J Med Biogr 2024; 32:28-32. [PMID: 34904471 PMCID: PMC10919063 DOI: 10.1177/09677720211064295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
William Warwick James was one of the most inspiring and outstanding dental surgeons of his time, a key researcher in dentistry and zoology and a pioneer in maxillofacial surgery. Most maxillofacial departments hold sets of his dental elevators. He wrote a major wartime work with Benjamin Fickling on the treatment of jaw and facial injuries.
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Affiliation(s)
- Stanley Gelbier
- Unit for the History of Dentistry, King’s College London, London, UK
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12
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Alsalem HZ, Alshahrani M, Fatani B, Alshehri AA, Almutairi RM, Almuqrin RF. Maxillary Odontoma Associated With Noonan Syndrome: A Case Report. Cureus 2024; 16:e52699. [PMID: 38384613 PMCID: PMC10879728 DOI: 10.7759/cureus.52699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2024] [Indexed: 02/23/2024] Open
Abstract
Noonan syndrome (NS) is a common congenital syndrome characterized by multiple anomalies commonly observed in children. In this article, we describe a case of a patient with congenital heart disease, severe mitral regurgitation, and Nonaan syndrome presented with left maxillary swelling and pain, which was treated by complete surgical excision of the left maxillary odontoma. Based on this case, we conclude that numerous oral abnormalities may be related to NS and thus necessitate interdisciplinary treatment planning and prompt therapy. The importance of including oral manifestations as a scoring criterion in diagnosing NS cannot be overstated, as the significance of oral findings in NS has largely been overlooked.
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Affiliation(s)
- Hussam Z Alsalem
- Oral and Maxillofacial Surgery, Prince Sultan Military Medical City, Ministry of Defense and Aviation, Riyadh, SAU
| | | | - Bader Fatani
- Dentistry, King Saud University, College of Dentistry, Riyadh, SAU
| | | | - Rana M Almutairi
- Dentistry, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
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13
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Corona-Rodarte E, Cano-Aguilar LE, Baldassarri-Ortego LF, Tosti A, Asz-Sigall D. Pressure alopecias: A review. J Am Acad Dermatol 2024; 90:125-132. [PMID: 37454698 DOI: 10.1016/j.jaad.2023.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 06/02/2023] [Accepted: 07/06/2023] [Indexed: 07/18/2023]
Abstract
Pressure-induced alopecias (PAs) are an infrequent group of scarring and nonscarring alopecias that occur after ischemic obstruction of capillaries that leads to circumscribed areas of hair loss. Initially described after prolonged surgeries or immobilization, type 1 PA occurs after sustained external pressure to the skin, mainly the scalp prominences. Alopecia induced by cosmetic procedures, referred in this review as type 2 PA, is reported with increased frequency in literature and predominantly emerges from pressure exerted by the volume of injectables. It is important to differentiate type 2 PA from vascular occlusion-induced alopecia because they represent distinct entities. Clinically, PA may present with erythema, swelling, and tenderness; however, alopecia might be the sole manifestation. Crusts and ulceration are associated with a worse outcome and a higher risk of scarring alopecia. Prompt diagnosis is paramount to prevent complications. Trichoscopy, although considered nonspecific, may provide relevant clues for an accurate diagnosis. Hair regrows in most cases, but prognosis depends on ischemia severity and timely treatment with reperfusion therapies or mobilization. Treatment of hair loss is usually not necessary because the disease in most cases is self-limited and reversible. The role of topical minoxidil and corticosteroids remains unknown.
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Affiliation(s)
- Eduardo Corona-Rodarte
- Department of Dermatology, Instituto Dermatológico de Jalisco José Barba Rubio, Zapopan, Mexico.
| | | | | | - Antonella Tosti
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida
| | - Daniel Asz-Sigall
- Trichology Clinic, Department of Dermatology, Hospital General "Dr. Manuel Gea González," Mexico City, Mexico.
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14
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Kulakov AA, Losev FF, Brajlovskaya TV, Bagnenko AS, Kononenko VI, Vedyaeva AP. [Features of medical care provision in the profile « Maxillofacial surgery» in the Southern Federal District of the Russian Federation]. Stomatologiia (Mosk) 2024; 103:23-30. [PMID: 38372603 DOI: 10.17116/stomat202410301123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/20/2024]
Abstract
OBJECTIVE To study the actual state of the organization of medical care for patients with the profile of «maxillofacial surgery» in the Southern Federal District of the Russian Federation in order to develop proposals for its optimization within the framework of a three-level system of medical care. MATERIAL AND METHODS We analyzed accounting and reporting materials characterizing the organization of medical care in the field of «Oral and maxillofacial surgery» to the population in the Southern Federal District of the Russian Federation. RESULTS The population of the Southern Federal District of the Russian Federation is currently provided with accessible round-the-clock medical care in the field of maxillofacial surgery. The forces and means at the disposal of the district government allow this to be implemented. However, the article describes a number of obstacles to the provision of high-quality medical care in the field of maxillofacial surgery and suggests ways to eliminate them. CONCLUSION Preparation of an Order defining the functioning of a three-level system of medical care for adults and children with maxillofacial pathology in the Southern Federal District of the Russian Federation, as well as more effective use of telemedicine consultations will significantly improve the availability and quality of medical care.
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Affiliation(s)
- A A Kulakov
- Central Research Institute of Dentistry and Maxillofacial Surgery of the Ministry of Health of Russia, Moscow, Russia
| | - F F Losev
- Central Research Institute of Dentistry and Maxillofacial Surgery of the Ministry of Health of Russia, Moscow, Russia
| | - T V Brajlovskaya
- Central Research Institute of Dentistry and Maxillofacial Surgery of the Ministry of Health of Russia, Moscow, Russia
| | - A S Bagnenko
- Central Research Institute of Dentistry and Maxillofacial Surgery of the Ministry of Health of Russia, Moscow, Russia
- S.M. Kirov Military Medical Academy of the Ministry of Defense of the Russian Federation, St. Petersburg, Russia
| | - V I Kononenko
- Central Research Institute of Dentistry and Maxillofacial Surgery of the Ministry of Health of Russia, Moscow, Russia
- Rostov State Medical University of the Ministry of Health of Russia, Rostov-on-Don, Russia
| | - A P Vedyaeva
- Central Research Institute of Dentistry and Maxillofacial Surgery of the Ministry of Health of Russia, Moscow, Russia
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15
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Boroojeni HSH, Mohaghegh S, Khojasteh A. Application of CAD-CAM Technologies for Maxillofacial Bone Regeneration: A Narrative Review of the Clinical Studies. Curr Stem Cell Res Ther 2024; 19:461-472. [PMID: 36372914 DOI: 10.2174/1574888x18666221111154057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 07/24/2022] [Accepted: 09/13/2022] [Indexed: 11/13/2022]
Abstract
The application of regenerative methods in treating maxillofacial defects can be categorized as functional bone regeneration in which scaffolds without protection are used and in-situ bone regeneration in which a protected healing space is created to induce bone formation. It has been shown that functional bone regeneration can reduce surgical time and obviate the necessity of autogenous bone grafting. However, studies mainly focused on applying this method to reconstruct minor bone effects, and more investigation concerning the large defects is required. In terms of in situ maxillofacial bone regeneration with the help of CAD-CAM technologies, the present data have suggested feasible mesh rigidity, perseverance of the underlying space, and apt augmentative results with CAD-CAM-based individualized Ti meshes. However, complications, including dehiscence and mesh exposure, coupled with consequent graft loss, infection and impeded regenerative rates have also been reported.
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Affiliation(s)
- Helia Sadat Haeri Boroojeni
- Dental Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sadra Mohaghegh
- Dental Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Arash Khojasteh
- Dental Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Cranio-Maxillofacial Surgery/University Hospital, Faculty of Medicine & Health Sciences, University of Antwerp, Antwerp, Belgium
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16
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Jaxa-Kwiatkowski A, Łysenko L, Gara-Rucińska M, Leszczyszyn A, Gerber H, Kubiak M. Potentially Lethal But Rarely Considered. Risk of Developing Refeeding Syndrome in Primary Oral Squamous Cell Carcinoma. J Stomatol Oral Maxillofac Surg 2023; 125:101742. [PMID: 38141827 DOI: 10.1016/j.jormas.2023.101742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 12/14/2023] [Indexed: 12/25/2023]
Abstract
Presurgical preparation and postoperative care are cornerstones of all surgical procedures. Surgeons should be especially vigilant with malnourished cancer patients. Refeeding syn-drome (RFS) is a serious, potentially fatal complication of initiating appropriate nutrition in malnourished patients or after a period of starvation, although no standard precise definition has been proposed. The rarity of its une-quivocally life-threatening course means that its risk may be underestimated in clinical practice. The study's main goal was to assess the degree of malnutrition and the risk of RFS in the presurgical status of patients with oral cavity cancer and to identify risk factors for the occurrence of RFS. This single-center prospective observational study included patients diagnosed with oral squamous cell carcinoma. We investigated the relationship of RFS with age, BMI, features of the malignant tumor process selected internal medicine comorbidities, inflam-matory markers, renal and hepatic parameters, plasma levels of diverse electrolytes, and microelements were assessed. In the work, we utilized the National Institute for Health and Clinical Excellence (NICE) criteria. The study included 90 patients: 35 women and 55 men, aged 64.2±10.5. A robust statistical correlation at a significance level of p < 0.05 was demonstrated between advanced age, lower BMI, lymph node metastases, and a relatively low LDH as positive predictors of the onset of RFS and confirmed the high predictive value of the NRS-2002 scale. This paper seeks to call attention to RFS and identify critical issues that may be useful for its prevention.
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Affiliation(s)
| | - Lidia Łysenko
- Department of Anesthesiology and Intensive Therapy, Medical University Wroclaw, Poland
| | | | - Anna Leszczyszyn
- Oral Surgery outpatient Clinic, 4th Military Hospital,Weigla 5 Street Wroclaw
| | - Hanna Gerber
- Department of Maxillofacial Surgery, Medical University Wroclaw, Poland
| | - Marcin Kubiak
- Department of Maxillofacial Surgery, Medical University Wroclaw, Poland
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17
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Bulthuis LCM, Ho JPTF, Zuurbier PCM, Koutris M, Nolte JW, de Lange J. Temporomandibular Joint Prosthesis in a Patient with Congenital Infiltrating Lipomatosis of the Face with Bony Ankylosis of the Temporomandibular Joint: A Case Report. J Clin Med 2023; 12:7723. [PMID: 38137792 PMCID: PMC10743689 DOI: 10.3390/jcm12247723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Revised: 12/10/2023] [Accepted: 12/14/2023] [Indexed: 12/24/2023] Open
Abstract
Hemifacial hyperplasia (HFH) is a rare congenital disorder characterized by marked unilateral overgrowth of the facial tissues. A subtype of HFH is congenital infiltrating lipomatosis of the face (CIL-F). This disease is characterized by unilateral diffuse infiltration of mature adipose cells in the facial soft tissue and is associated with skeletal hypertrophy. This work aims to report a case of a CIL-F patient with right facial asymmetry and progressive growth at adolescent age, causing mandibular asymmetry due to signs of concomitant unilateral condylar hyperplasia. At the age of seventeen, a condylectomy was performed to stop the progression of asymmetric mandibular growth. Five years later, the patient developed CIL-F-associated temporomandibular joint ankylosis, manifesting as progressive restricted mouth opening along with temporal facial pain. In this CIL-F patient, a TMJ reconstruction with an alloplastic total joint prosthesis was successfully performed with optimal maximal mouth opening, complete alleviation of temporal facial pain, and stable dental occlusion one year postoperatively. A TMJ reconstruction with a complete alloplastic total joint prosthesis proved to be a predictable, stable, and safe treatment option in a patient with CIL-F-associated TMJ ankylosis who was previously treated with condylectomy due to progressive mandibular asymmetry.
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Affiliation(s)
- Lauren C. M. Bulthuis
- Department of Oral and Maxillofacial Surgery, Amsterdam Universitair Medische Centra, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands; (J.P.T.F.H.); (J.W.N.); (J.d.L.)
| | - Jean Pierre T. F. Ho
- Department of Oral and Maxillofacial Surgery, Amsterdam Universitair Medische Centra, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands; (J.P.T.F.H.); (J.W.N.); (J.d.L.)
- Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, 1081 LA Amsterdam, The Netherlands
- Department of Oral and Maxillofacial Surgery, Northwest Clinics, 1815 JD Alkmaar, The Netherlands
| | - Petra C. M. Zuurbier
- Department of Orthodontics, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, 1081 LA Amsterdam, The Netherlands;
| | - Michail Koutris
- Department of Oral Kinesiology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, 1081 LA Amsterdam, The Netherlands;
| | - Jitske W. Nolte
- Department of Oral and Maxillofacial Surgery, Amsterdam Universitair Medische Centra, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands; (J.P.T.F.H.); (J.W.N.); (J.d.L.)
- Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, 1081 LA Amsterdam, The Netherlands
| | - Jan de Lange
- Department of Oral and Maxillofacial Surgery, Amsterdam Universitair Medische Centra, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands; (J.P.T.F.H.); (J.W.N.); (J.d.L.)
- Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, 1081 LA Amsterdam, The Netherlands
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18
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Vazquez I, Cebotari M, Pereira F, Coelho L, Burnay T. Ectopic Tooth in the Roof of the Left Maxillary Sinus. Cureus 2023; 15:e49765. [PMID: 38164311 PMCID: PMC10758270 DOI: 10.7759/cureus.49765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2023] [Indexed: 01/03/2024] Open
Abstract
The presence of sinonasal ectopic teeth is a rare entity that is usually asymptomatic. In some cases, the presence of foreign bodies in the maxillary sinus, such as ectopic teeth, can lead to chronic maxillary sinusitis. We report a case of chronic sinusitis because of an ectopic tooth in the roof of the left maxillary sinus in a 50-year-old female who presented with complaints of facial pain in the left maxillary region and purulent nasal discharge. The treatment of ectopic teeth usually consists of the removal of the previous, taking into account its location and possible risks. In this case, the close proximity to the orbit could have led to a greater risk of complications involving the infraorbital bundle. CT scan evaluation is frequently required to identify the exact location and is useful for treatment planning. The traditional surgical approaches to maxillary sinus pathology are transoral Caldwell-Luc approaches or transnasal endoscopic surgery. The method used in this case was the Caldwell-Luc approach. Although more invasive, it allows visualization into the maxillary sinus and superior access for instrumentation of the posterolateral region while permitting manipulation and removal of larger objects. Despite maxillary sinus ectopic teeth being uncommon, it is important for clinicians to become aware and to consider this entity to provide early adequate treatment.
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Affiliation(s)
- Isabel Vazquez
- Maxillofacial Surgery Department, Centro Hospitalar Universitário de São João, Porto, PRT
| | - Mariana Cebotari
- Maxillofacial Surgery Department, Centro Hospitalar Universitário de São João, Porto, PRT
| | - Flávia Pereira
- Maxillofacial Surgery Department, Centro Hospitalar Universitário de São João, Porto, PRT
| | - Lígia Coelho
- Maxillofacial Surgery Department, Centro Hospitalar Universitário de São João, Porto, PRT
| | - Teresa Burnay
- Maxillofacial Surgery Department, Centro Hospitalar Universitário de São João, Porto, PRT
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19
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Michelutti L, Tel A, Zeppieri M, Ius T, Sembronio S, Robiony M. The Use of Artificial Intelligence Algorithms in the Prognosis and Detection of Lymph Node Involvement in Head and Neck Cancer and Possible Impact in the Development of Personalized Therapeutic Strategy: A Systematic Review. J Pers Med 2023; 13:1626. [PMID: 38138853 PMCID: PMC10745006 DOI: 10.3390/jpm13121626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 11/17/2023] [Accepted: 11/18/2023] [Indexed: 12/24/2023] Open
Abstract
Given the increasingly important role that the use of artificial intelligence algorithms is taking on in the medical field today (especially in oncology), the purpose of this systematic review is to analyze the main reports on such algorithms applied for the prognostic evaluation of patients with head and neck malignancies. The objective of this paper is to examine the currently available literature in the field of artificial intelligence applied to head and neck oncology, particularly in the prognostic evaluation of the patient with this kind of tumor, by means of a systematic review. The paper exposes an overview of the applications of artificial intelligence in deriving prognostic information related to the prediction of survival and recurrence and how these data may have a potential impact on the choice of therapeutic strategy, making it increasingly personalized. This systematic review was written following the PRISMA 2020 guidelines.
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Affiliation(s)
- Luca Michelutti
- Clinic of Maxillofacial Surgery, Head-Neck and NeuroScience Department, University Hospital of Udine, p.le S. Maria della Misericordia 15, 33100 Udine, Italy (A.T.)
| | - Alessandro Tel
- Clinic of Maxillofacial Surgery, Head-Neck and NeuroScience Department, University Hospital of Udine, p.le S. Maria della Misericordia 15, 33100 Udine, Italy (A.T.)
| | - Marco Zeppieri
- Department of Ophthalmology, University Hospital of Udine, Piazzale S. Maria della Misericordia 15, 33100 Udine, Italy
| | - Tamara Ius
- Neurosurgery Unit, Head-Neck and NeuroScience Department, University Hospital of Udine, p.le S. Maria della Misericordia 15, 33100 Udine, Italy
| | - Salvatore Sembronio
- Clinic of Maxillofacial Surgery, Head-Neck and NeuroScience Department, University Hospital of Udine, p.le S. Maria della Misericordia 15, 33100 Udine, Italy (A.T.)
| | - Massimo Robiony
- Clinic of Maxillofacial Surgery, Head-Neck and NeuroScience Department, University Hospital of Udine, p.le S. Maria della Misericordia 15, 33100 Udine, Italy (A.T.)
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20
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Maurer M, Schlipköter C, Gottsauner M, Waiss W, Meier JK, Fiedler M, Schuderer JG, Taxis J, Reichert TE, Ettl T. Animal Bite Injuries to the Face: A Retrospective Evaluation of 111 Cases. J Clin Med 2023; 12:6942. [PMID: 37959407 PMCID: PMC10649818 DOI: 10.3390/jcm12216942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 10/24/2023] [Accepted: 11/04/2023] [Indexed: 11/15/2023] Open
Abstract
The treatment of bite wounds to the face is discussed controversially in relation to surgery and antibiotics. The aim of this study is a retrospective evaluation of 111 cases of animal bite injuries to the face that presented to our unit of oral and maxillofacial surgery over a 13-year period. Children under 10 years of age were predominantly involved. A total of 94.5% of the assessed injuries were caused by dogs. Wound infections occurred in 8.1%. Lackmann type II was the most common type of injury (36.9%). The perioral area was affected most frequently (40.5%). Primary wound closure was carried out in 74.8% of the cases. In 91.9% of the cases, antibiotic prophylaxis was prescribed. The most often administered type of antibiotic was amoxicillin with clavulanic acid (62.1%). Patients without antibiotics showed an increased infection rate without significance. Wound infections occurred significantly more frequently in wounds to the cheeks (p = 0.003) and when local flap reconstruction was necessary (p = 0.048). Compared to the other surgical treatment options, primary closure showed the lowest infection rates (4.8%, p = 0.029). We recommend antibiotic prophylaxis using amoxicillin with clavulanic acid and wound drains for wounds of Lackmann class II or higher. Primary closure seems to be the treatment of choice whenever possible.
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Affiliation(s)
- Michael Maurer
- Department of Cranio- and Maxillofacial Surgery, Hospital of the University of Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany
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21
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Yankov YG. Socket Preservation and Guided Bone Regeneration: Prerequisites for Successful Implant Dentistry. Cureus 2023; 15:e48785. [PMID: 38098920 PMCID: PMC10720259 DOI: 10.7759/cureus.48785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/14/2023] [Indexed: 12/17/2023] Open
Abstract
Implant success is measured not only by implant survival but also by the long-term aesthetic and functional results. Implant placement should be prosthetically driven, with proper three-dimensional positioning for optimal support and stability of the tissues. Several procedures could be performed to ensure this requirement. While socket preservation (SP) is performed at the stage of tooth extraction, guided bone regeneration (GBR) takes place before or simultaneous to implant placement. The current review aims to summarize and discuss the procedures used for the preparation of the implant site, the preservation of the existing tissues, and their augmentation in cases of deficiency. An electronic search using Google Scholar, PubMed, and Scopus was conducted up to October 2023, in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The review summarizes the current knowledge on SP and GBR as prerequisites for future implant placement. Their indications, advantages, and limitations have been thoroughly evaluated and some recommendations for further research have been suggested. Implant placement in sites with severe bone resorption is extremely challenging. It necessitates the application of different surgical techniques, especially augmentation procedures, including guided bone regeneration. The need for such procedures could be avoided or at least minimized by the execution of SP after tooth extraction or immediate/early implant placement.
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Affiliation(s)
- Yanko G Yankov
- Clinic of Maxillofacial Surgery, University Hospital "St. Marina", Varna, BGR
- Department of General and Operative Surgery, Medical University "Prof. Dr. Paraskev Stoyanov", Varna, BGR
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22
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Yankov YG, Stoev L, Dimanov S, Stoeva M, Stanislavova K. A Rare Case of Papillary Thyroid Carcinoma in the Thyroglossal Duct Cyst of a 14-Year-Old Female Patient With Left Thyroid Hemiagenesis. Cureus 2023; 15:e49712. [PMID: 38161947 PMCID: PMC10757459 DOI: 10.7759/cureus.49712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2023] [Indexed: 01/03/2024] Open
Abstract
Congenital abnormalities in the development of the thyroglossal duct are a common pathology in the pediatric population. The exact frequency of hemiagenesis of the thyroid gland is not known because the condition is rarely manifested clinically and is almost always discovered incidentally. Papillary carcinoma of thyroglossal cysts is relatively uncommon, has a good prognosis if promptly detected and treated and occurs mainly in adults. The case we present here is an extremely rare occurrence: a patient with papillary thyroid carcinoma of the thyroglossal duct cyst and thyroglossal duct cyst carcinoma (TDCa). So far, only two such adult patients (women aged 24 and 35) have been described in the world medical literature. The patient we present is a 14-year-old female and is the first described adolescent with papillary carcinoma of the thyroglossal duct cyst and thyroid hemiagenesis (THA). The disease didn't have any clinical manifestations, and the patient was brought in by her parents to improve her aesthetic appearance. Neither the physical examination nor the radiological evaluation showed any signs of malignancy. The diagnosis was reached by our team only after the patoanatomical examination. In this patient's case, due to its early diagnosis, the spread of the disease was limited only to the borders of the thyroglossal duct cyst and the absence of regional and distant metastasis. Surgical removal led to a complete cure, without any postoperative data suggestive of residual disease. The functions of the thyroid gland in her case were not affected, despite her left-lobe agenesis, to which there are multiple proofs, namely the normal blood concentration of the examined thyroid markers: free triiodothyronine (FT3), free thyroxine (FT4), thyroglobulin (TG), thyroid stimulating hormone (TSH), anti-TG (thyroid antibody test (TAT)), anti-thyroid peroxidase (TPO) (microsomal antibody test (MAT)), and normal physical and psychological development.
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Affiliation(s)
- Yanko G Yankov
- Maxillofacial Surgery, University Hospital St. Marina, Varna, BGR
- General and Operative Surgery, Medical University of Varna, Varna, BGR
| | - Lyuben Stoev
- General and Clinical Pathology, Forensic Medicine and Deontology, Medical University of Varna, Varna, BGR
| | | | - Martina Stoeva
- General and Clinical Pathology, Forensic Medicine and Deontology, Medical University of Varna, Varna, BGR
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23
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Mosea A, Bella MH, Thamer M. Awareness and attitude of ENT surgeons towards various dental implants or oral surgery procedures: a cross-sectional survey in the UK. J Laryngol Otol 2023; 137:1261-1263. [PMID: 37185221 DOI: 10.1017/s0022215123000737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
OBJECTIVE To assess the level of awareness and attitude of ENT surgeons towards dental implants and oral surgery procedures that involve the maxillary sinus. METHODS A cross-sectional survey was conducted using a closed-ended questionnaire on 40 UK-based ENT surgeons. RESULTS Within the study population, 45 per cent of ENT surgeons were not aware of sinus lift augmentation in implant dentistry. Only 25 per cent of respondents were aware of the two subtypes of sinus lift techniques. Thirty per cent of the respondents were aware of or had heard of benign positional paroxysmal vertigo following dental treatment. Fifty-two per cent of respondents came across a dental foreign body, most commonly a tooth that had been displaced into the maxillary sinus. It was also reported that 82.5 per cent of respondents had liaised with an oral surgeon for an oroantral communication problem or a dental infection. CONCLUSION Dental awareness among ENT surgeons needs to be raised for optimum interdisciplinary communication and patient safety.
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Affiliation(s)
- A Mosea
- Colchester Dental Specialist Centre (BUPA Platinum), Colchester, UK
| | - M H Bella
- ENT Department, Princess Alexandra Hospital NHS Trust, Harlow, UK
| | - M Thamer
- ENT Department, Bristol Royal Infirmary, Bristol, UK
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Yankov YG, Bocheva Y. Comparative Characterization of Procalcitonin (Sensitivity, Specificity, Predictability, and Cut-Off Reference Values) as a Marker of Inflammation in Odontogenic Abscesses of the Head and Neck in the Female Population. Cureus 2023; 15:e48207. [PMID: 38050495 PMCID: PMC10693721 DOI: 10.7759/cureus.48207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/03/2023] [Indexed: 12/06/2023] Open
Abstract
Introduction Odontogenic abscesses of the head and neck can lead to serious complications and even end in death. This requires healthcare professionals to have a good knowledge of all the markers of inflammation that can be used in their diagnosis and treatment. Such markers that we use in our daily medical practice are leukocytes (WBC), neutrophils (Neu), and C-reactive protein (CRP). Somehow, in the background is procalcitonin (PCT), which has not been studied in detail in this type of purulent infection. The aim of the present study is to investigate and analyze PCT in odontogenic purulent infections of the head and neck in the female population and to compare it with already proven markers of inflammation such as CRP, WBC, and Neu. For the first time in the literature, as per our knowledge, the sensitivity, specificity, and predictability of PCT were determined when using it as an independent indicator of inflammation, and its cut-off reference values were determined in women with odontogenic abscesses of the head and neck. Materials and methods This is a prospective study, in which the CRP, WBC, Neu, and PCT of 30 women with odontogenic abscesses of the head and neck with a mean age of 47 (18-81) years were examined and analyzed. As a control group, we included 30 healthy women with a mean age of 48 (18-80) years, in whom there was no anamnestic and physical evidence of the presence of any infection in the last three months. The four markers were measured for the control group too. Results In the clinical group of women with odontogenic abscesses of the head and neck, the average values of CRP, WBC, Neu, and PCT were significantly higher (p<0.0001) compared to the same in the control group of healthy women; CRP: 95.46±76.41 mg/l vs. 0.63±0.37 mg/l, WBC: 10.44±2.97x103/L vs. 6.5±1.49x103/L, Neu: 7.92±2.93x103/L vs. 4.03±1.07x103/L, PCT: 0.74±0.69 ng/ml vs. 0.14±0.08 ng/ml. Discussion PCT, as well as CRP, WBC, and Neu, increases its plasma concentration in women with odontogenic abscesses of the head and neck and is extremely well positively correlated with them, with a high correlation with CRP and a significant correlation with WBC and Neu. In addition, PCT has a number of advantages over the other markers; it begins to increase its plasma concentration faster, reaches its maximum plasma concentration faster, normalizes its concentration faster after the infection subsides, and increases its blood level only in bacterial infection genesis. Conclusions PCT as a marker of inflammation not only positively correlates well with CRP, WBC, and Neu but also, with its advantages over them, it appears to be the most accurate indicator in the diagnosis, treatment, and follow-up of odontogenic head and neck abscesses in the near future; not only in women but also in the male and children's population. Its sensitivity, specificity, and predictability as an independent indicator of inflammation are 80%, 76.7%, and 83%, respectively, and its cut-off value of 0.225 ng/ml is lower than the generally accepted 0.5 ng/ml.
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Affiliation(s)
- Yanko G Yankov
- Maxillofacial Surgery, University Hospital St. Marina, Varna, BGR
- General and Operative Surgery, Medical University "Prof. Dr. Paraskev Stoyanov", Varna, BGR
| | - Yana Bocheva
- Cinical Laboratory, Medical University "Prof. Dr. Paraskev Stoyanov", Varna, BGR
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Miragall MF, Knoedler S, Kauke-Navarro M, Saadoun R, Grabenhorst A, Grill FD, Ritschl LM, Fichter AM, Safi AF, Knoedler L. Face the Future-Artificial Intelligence in Oral and Maxillofacial Surgery. J Clin Med 2023; 12:6843. [PMID: 37959310 PMCID: PMC10649053 DOI: 10.3390/jcm12216843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 10/24/2023] [Accepted: 10/28/2023] [Indexed: 11/15/2023] Open
Abstract
Artificial intelligence (AI) has emerged as a versatile health-technology tool revolutionizing medical services through the implementation of predictive, preventative, individualized, and participatory approaches. AI encompasses different computational concepts such as machine learning, deep learning techniques, and neural networks. AI also presents a broad platform for improving preoperative planning, intraoperative workflow, and postoperative patient outcomes in the field of oral and maxillofacial surgery (OMFS). The purpose of this review is to present a comprehensive summary of the existing scientific knowledge. The authors thoroughly reviewed English-language PubMed/MEDLINE and Embase papers from their establishment to 1 December 2022. The search terms were (1) "OMFS" OR "oral and maxillofacial" OR "oral and maxillofacial surgery" OR "oral surgery" AND (2) "AI" OR "artificial intelligence". The search format was tailored to each database's syntax. To find pertinent material, each retrieved article and systematic review's reference list was thoroughly examined. According to the literature, AI is already being used in certain areas of OMFS, such as radiographic image quality improvement, diagnosis of cysts and tumors, and localization of cephalometric landmarks. Through additional research, it may be possible to provide practitioners in numerous disciplines with additional assistance to enhance preoperative planning, intraoperative screening, and postoperative monitoring. Overall, AI carries promising potential to advance the field of OMFS and generate novel solution possibilities for persisting clinical challenges. Herein, this review provides a comprehensive summary of AI in OMFS and sheds light on future research efforts. Further, the advanced analysis of complex medical imaging data can support surgeons in preoperative assessments, virtual surgical simulations, and individualized treatment strategies. AI also assists surgeons during intraoperative decision-making by offering immediate feedback and guidance to enhance surgical accuracy and reduce complication rates, for instance by predicting the risk of bleeding.
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Affiliation(s)
- Maximilian F. Miragall
- Department of Oral and Maxillofacial Surgery, University Hospital Regensburg, 93053 Regensburg, Germany
- Department of Oral and Maxillofacial Surgery, School of Medicine, Technical University of Munich, 81675 Munich, Germany
| | - Samuel Knoedler
- Division of Plastic Surgery, Department of Surgery, Yale New Haven Hospital, Yale School of Medicine, New Haven, CT 06510, USA
| | - Martin Kauke-Navarro
- Division of Plastic Surgery, Department of Surgery, Yale New Haven Hospital, Yale School of Medicine, New Haven, CT 06510, USA
| | - Rakan Saadoun
- Department of Plastic Surgery, University of Pittsburgh, Pittsburgh, PA 15261, USA
| | - Alex Grabenhorst
- Department of Oral and Maxillofacial Surgery, School of Medicine, Technical University of Munich, 81675 Munich, Germany
| | - Florian D. Grill
- Department of Oral and Maxillofacial Surgery, School of Medicine, Technical University of Munich, 81675 Munich, Germany
| | - Lucas M. Ritschl
- Department of Oral and Maxillofacial Surgery, School of Medicine, Technical University of Munich, 81675 Munich, Germany
| | - Andreas M. Fichter
- Department of Oral and Maxillofacial Surgery, School of Medicine, Technical University of Munich, 81675 Munich, Germany
| | - Ali-Farid Safi
- Craniologicum, Center for Cranio-Maxillo-Facial Surgery, 3011 Bern, Switzerland;
- Faculty of Medicine, University of Bern, 3010 Bern, Switzerland
| | - Leonard Knoedler
- Division of Plastic Surgery, Department of Surgery, Yale New Haven Hospital, Yale School of Medicine, New Haven, CT 06510, USA
- Department of Plastic, Hand and Reconstructive Surgery, University Hospital Regensburg, 93053 Regensburg, Germany
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Yankov YG. Delta Neutrophil Index as a New Marker of Purulent Inflammation in Men With Non-odontogenic Abscesses of the Neck. Cureus 2023; 15:e47165. [PMID: 38021868 PMCID: PMC10652030 DOI: 10.7759/cureus.47165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/16/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction If non-odontogenic abscesses and phlegmons (all purulent inflammations where the etiology is not a diseased tooth) of the neck are not promptly treated, they can lead to serious complications and even end in the death of the affected patient. Classical markers of inflammation such as plasma concentration of leukocytes (WBC), neutrophils (Neu), C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) are elevated in inflammatory neck diseases, but none of them has been proven as a definite marker in the prediction of this type of pathology. This necessitates the search and analysis of new indicators that could be used in the diagnosis, follow-up, and prognosis of patients with purulent neck infections. Potentially, such a marker could be the delta neutrophil index (DNI), which is increasingly entering clinical practice as a prognostic indicator in critically ill patients with life-threatening illnesses, including sepsis and systemic inflammatory response syndrome (SIRS). In the world literature, there are no data that have been studied in patients with purulent diseases of the neck of non-odontogenic origin, which is the aim of this original article. Materials and methods This retrospective study included 40 men with an average age of 46 (18-87) years with non-odontogenic abscesses and phlegmons of the neck who were hospitalized and operated on. In all of them, the concentration of leukocytes, eosinophils (Eo), neutrophils, and mature polymorphonuclear neutrophil leukocytes (PMN) was examined on an automatic 5-Diff hematology analyzer, ADVIA 2120i (Siemens Medical Solutions USA, Malvern, PA). Thus, it was calculated according to the formula for calculating DNI (DNI% = (Neu%+Eo%) - PMN%). Retrospectively, 30 healthy men with an average age of 42 (18-81) years were used as a control group, in which the same indicators were examined during a preventive examination. Results and discussion Comparing the mean values of WBC, Neu, and DNI between the studied patients with non-odontogenic purulent neck infections (n=40) and the healthy male controls (n=30) it was found that all three indicators of inflammation are significantly higher in the ill men, and these differences are statistically significant (p<0.05): 10.19 ±2.68x103/L versus 7.37 ±1.93x103/L for leukocytes, 7.68 ±2, 76x103/L versus 4.13 ±1.48x103/L for neutrophils, and 1.11±0.83% versus -1.07±1.22% for DNI. Therefore, the high mean numbers of measured WBC and Neu in men with non-odontogenic purulent neck infections were associated with an increase in their mean calculated DNI. This gives us reason to think that while WBC and Neu alone are not sufficient for definitive diagnosis, treatment follow-up, and prediction of disease outcome, in combination with DNI they become reliable indicators in purulent neck infections. Conclusions The DNI correlates well with other well-known and established indicators of inflammation, such as the concentration of leukocytes and neutrophils in the peripheral blood of patients. Its calculation is fast as an implementation procedure and is economically beneficial. Its independent use in the diagnosis and treatment of these diseases is about to be investigated and analyzed.
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Affiliation(s)
- Yanko G Yankov
- Maxillofacial Surgery, University Hospital St. Marina, Varna, BGR
- General and Operative Surgery, Medical University "Prof. Dr. Paraskev Stoyanov", Varna, BGR
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Yankov YG. The Etiological Bacterial Spectrum of Neck Abscesses of Lymph Node Origin - Gram-Positive and Gram-Negative Bacteria. Cureus 2023; 15:e46940. [PMID: 38021983 PMCID: PMC10640683 DOI: 10.7759/cureus.46940] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/12/2023] [Indexed: 12/01/2023] Open
Abstract
According to our medical practice as maxillofacial and oral surgeons, operated patients with purulent infections of the cervical lymph nodes are not many in number. On the other hand, the presence of a purulent infection requires not only the surgical evacuation of the pus but also the application of antimicrobial preparations. This necessitates good knowledge of the spectrum of the bacterial causative agents of the disease, the determination and analysis of which is the purpose of this original article. The bacteria studied in 181 patients with a mean age of 26.25 years, ranging between 29 days and 82 years, who underwent surgery for suppurating cervical lymph nodes, were retrospectively analyzed over a period of eight years. No bacteria were found in 69 of them. In 83 (74.11%) of the remaining 112 studied patients, the isolated microorganisms were of the gram-positive spectrum - Staphylococcus aureus (n=34), gram-positive resident microflora represented by more than one bacterial species (n=21), Staphylococcus hemolyticus (n=10), Staphylococcus epidermidis (n=9) and beta-hemolytic streptococci (n=9). Gram-negative bacteria were 25.89% (n=29) - Klebsiella pneumoniae (n=8), Bartonella henselae (n=7), Klebsiella oxytoca (n=6), Enterobacter cloacae (n=5) and Flavimonas oryzihabitans (n=3). No anaerobic and fungal microorganisms were isolated. Therefore, antimicrobial therapy in these patients should be directed against both gram-positive and gram-negative bacteria, which in our study were represented in a ratio of approximately three to one in favor of gram-positive microorganisms. Otherwise, we create a prerequisite for the formation of phlegmon on the neck, which hides real chances for the lives of patients.
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Affiliation(s)
- Yanko G Yankov
- Department of General and Operative Surgery, Medical University "Prof. Dr. Paraskev Stoyanov", Varna, BGR
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Ostrowski P, Bonczar M, Wilk J, Michalczak M, Czaja J, Niziolek M, Sienkiewicz J, Szczepanek E, Chmielewski P, Iskra T, Gregorczyk-Maga I, Walocha J, Koziej M. The complete anatomy of the lingual nerve: A meta-analysis with implications for oral and maxillofacial surgery. Clin Anat 2023; 36:905-914. [PMID: 36864652 DOI: 10.1002/ca.24033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 02/15/2023] [Accepted: 02/22/2023] [Indexed: 03/04/2023]
Abstract
Lingual nerve (LN) injury during surgical procedures in the third molar region warrants a detailed study of its common pathway and important variations. Therefore, the objective of this study was to analyze and compile the multiple anatomical variations of the LN for use in oral and maxillofacial surgery. It is anticipated that the results of the present meta-analysis may help to minimize the possible complications when performing procedures associated with this anatomical entity. Major online databases such as PubMed, Web of Science, Scopus, Embase were used to gather all relevant studies regarding the LN anatomy. The results were established based on a total of 1665 LNs. The pooled prevalence of the LN being located below the lingual/ alveolar crest was found to be 77.87% (95% CI: 0.00%-100.00%). The LN was located above the lingual/ alveolar crest in 8.21% (95% CI: 4.63%-12.89%) of examined nerves. The most common shape of the LN was established to be round with a prevalence of 40.96% (95% CI: 23.96%-59.06%), followed by oval at 37.98% (95% CI: 23.98%-53.02%) and flat at 25.16% (95% CI: 12.85%-39.77%). In conclusion, we believe that this is the most accurate and up-to-date study regarding the anatomy of the LN. The LN was found to be located below the lingual/alveolar crest in 77.87% of the cases. Furthermore, the LN was found to enter the tongue under the submandibular duct in 68.39% of the cases. Knowledge about the anatomy of the LN is crucial for numerous oral and maxillofacial procedures such as during the extraction of the third molar.
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Affiliation(s)
- Patryk Ostrowski
- Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
- Youthoria, Youth Research Organization, Kraków, Poland
| | - Michał Bonczar
- Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
- Youthoria, Youth Research Organization, Kraków, Poland
| | - Jakub Wilk
- Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
| | - Mateusz Michalczak
- Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
| | - Julia Czaja
- Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
| | - Martha Niziolek
- Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
| | - Justyna Sienkiewicz
- Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
| | - Elżbieta Szczepanek
- Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
| | | | - Tomasz Iskra
- Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
| | | | - Jerzy Walocha
- Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
- Youthoria, Youth Research Organization, Kraków, Poland
| | - Mateusz Koziej
- Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
- Youthoria, Youth Research Organization, Kraków, Poland
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Yankov YG. Etiological Bacterial Spectrum of Purulent Inflammation of Cervical Lymph Nodes in Children With Unknown Causes of Lymphadenopathy. Cureus 2023; 15:e46276. [PMID: 37908904 PMCID: PMC10615367 DOI: 10.7759/cureus.46276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/30/2023] [Indexed: 11/02/2023] Open
Abstract
In the management of the non-specific purulent inflammation of the cervical lymph nodes in children, not only surgical treatment to evacuate the available pus but also antibacterial therapy is mandatory. Knowledge of the spectrum of the bacterial causative agents of this disease is of fundamental importance for it. This retrospective study included 66 patients with purulent inflammation of the cervical lymph nodes with a mean age of 5.79 years, ranging from 29 days to 17 years, who were hospitalized for the period 2015-2022 in the three pediatric clinics at the St. Marina University Multispecialty Hospital for Active Treatment in Varna, Bulgaria, and operated by an oral or maxillofacial surgeon, in which for microbiological examination material from the suppurated lymph node was taken and analyzed first by direct microscopy for gram-positivity and then on a biochemical machine identifier VITEK (bioMérieux, Marcy-l'Étoile, France). In all of them, the patients and their parents did not provide anamnestic data explaining the etiology of their infectious diseases of the cervical lymph nodes. There was no clear cause that would explain the occurrence of cervical lymphadenopathy - skin infections, dental diseases, diseases of the ears and upper and lower respiratory tracts, onco-hematological diseases, and others. During the medical examination by pediatricians and surgeons, no entrances to the infection were found, but only local signs of inflammation (redness, swelling, and pain), increased levels of blood markers of inflammation (leukocytes, neutrophils, erythrocyte sedimentation rate, and C-reactive protein) and there was imaging evidence (ultrasound, magnetic resonance imaging, and computed tomography) of a purulent collection in the lymph nodes and/or in the soft tissues surrounding them. Exudate without microbial growth was found in 22 of the cases. The main causative agents of purulent lymphadenopathy are gram-positive bacteria (n=32, 72,73%) - Staphylococcus aureus (n=16), Staphylococcus haemolyticus (n=8), Beta-hemolytic streptococcus (n=2), and gram-positive mixed resident microflora (n=6). However, in 27.27% (n=12) of all 44 patients described in this article with isolated pathogens, cultures were gram-negative. These are Bartonella henselae (n=4), Klebsiella pneumoniae (n=4), Klebsiella oxytoca (n=2), and Flavimonas oryzihabitans (n=2).
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Affiliation(s)
- Yanko G Yankov
- Department of General and Operative Surgery, Medical University of Varna "Prof. Dr. Paraskev Stoyanov", Varna, BGR
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Vaira LA, Lechien JR, Abbate V, Allevi F, Audino G, Beltramini GA, Bergonzani M, Bolzoni A, Committeri U, Crimi S, Gabriele G, Lonardi F, Maglitto F, Petrocelli M, Pucci R, Saponaro G, Tel A, Vellone V, Chiesa-Estomba CM, Boscolo-Rizzo P, Salzano G, De Riu G. Accuracy of ChatGPT-Generated Information on Head and Neck and Oro maxillofacial Surgery: A Multicenter Collaborative Analysis. Otolaryngol Head Neck Surg 2023. [PMID: 37595113 DOI: 10.1002/ohn.489] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 06/16/2023] [Accepted: 07/14/2023] [Indexed: 08/20/2023]
Abstract
OBJECTIVE To investigate the accuracy of Chat-Based Generative Pre-trained Transformer (ChatGPT) in answering questions and solving clinical scenarios of head and neck surgery. STUDY DESIGN Observational and valuative study. SETTING Eighteen surgeons from 14 Italian head and neck surgery units. METHODS A total of 144 clinical questions encompassing different subspecialities of head and neck surgery and 15 comprehensive clinical scenarios were developed. Questions and scenarios were inputted into ChatGPT4, and the resulting answers were evaluated by the researchers using accuracy (range 1-6), completeness (range 1-3), and references' quality Likert scales. RESULTS The overall median score of open-ended questions was 6 (interquartile range[IQR]: 5-6) for accuracy and 3 (IQR: 2-3) for completeness. Overall, the reviewers rated the answer as entirely or nearly entirely correct in 87.2% of cases and as comprehensive and covering all aspects of the question in 73% of cases. The artificial intelligence (AI) model achieved a correct response in 84.7% of the closed-ended questions (11 wrong answers). As for the clinical scenarios, ChatGPT provided a fully or nearly fully correct diagnosis in 81.7% of cases. The proposed diagnostic or therapeutic procedure was judged to be complete in 56.7% of cases. The overall quality of the bibliographic references was poor, and sources were nonexistent in 46.4% of the cases. CONCLUSION The results generally demonstrate a good level of accuracy in the AI's answers. The AI's ability to resolve complex clinical scenarios is promising, but it still falls short of being considered a reliable support for the decision-making process of specialists in head-neck surgery.
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Affiliation(s)
- Luigi Angelo Vaira
- Maxillofacial Surgery Operative Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari, Sassari, Italy
- Biomedical Sciences Department, PhD School of Biomedical Science, University of Sassari, Sassari, Italy
| | - Jerome R Lechien
- Department of Anatomy and Experimental Oncology, Mons School of Medicine, UMONS, Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium
- Department of Otolaryngology-Head Neck Surgery, Elsan Polyclinic of Poitiers, Poitiers, France
| | - Vincenzo Abbate
- Head and Neck Section, Department of Neurosciences, Reproductive and Odontostomatological Science, Federico II University of Naples, Naples, Italy
| | - Fabiana Allevi
- Maxillofacial Surgery Department, ASSt Santi Paolo e Carlo, University of Milan, Milan, Italy
| | - Giovanni Audino
- Head and Neck Section, Department of Neurosciences, Reproductive and Odontostomatological Science, Federico II University of Naples, Naples, Italy
| | - Giada Anna Beltramini
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
- Maxillofacial and Dental Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Michela Bergonzani
- Maxillo-Facial Surgery Division, Head and Neck Department, University Hospital of Parma, Parma, Italy
| | - Alessandro Bolzoni
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Umberto Committeri
- Head and Neck Section, Department of Neurosciences, Reproductive and Odontostomatological Science, Federico II University of Naples, Naples, Italy
| | - Salvatore Crimi
- Operative Unit of Maxillofacial Surgery, Policlinico San Marco, University of Catania, Catania, Italy
| | - Guido Gabriele
- Department of Maxillofacial Surgery, University of Siena, Siena, Italy
| | - Fabio Lonardi
- Department of Maxillofacial Surgery, University of Verona, Verona, Italy
| | - Fabio Maglitto
- Maxillo-Facial Surgery Unit, University of Bari "Aldo Moro", Bari, Italy
| | - Marzia Petrocelli
- Maxillofacial Surgery Operative Unit, Bellaria and Maggiore Hospital, Bologna, Italy
| | - Resi Pucci
- Maxillofacial Surgery Unit, San Camillo-Forlanini Hospital, Rome, Italy
| | - Gianmarco Saponaro
- Maxillo-Facial Surgery Unit, IRCSS "A. Gemelli" Foundation-Catholic, University of the Sacred Heart, Rome, Italy
| | - Alessandro Tel
- Department of Head and Neck Surgery and Neuroscience, Clinic of Maxillofacial Surgery, University Hospital of Udine, Udine, Italy
| | | | | | - Paolo Boscolo-Rizzo
- Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, Trieste, Italy
| | - Giovanni Salzano
- Head and Neck Section, Department of Neurosciences, Reproductive and Odontostomatological Science, Federico II University of Naples, Naples, Italy
| | - Giacomo De Riu
- Maxillofacial Surgery Operative Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari, Sassari, Italy
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Dowsett PA, Khan SA, Khan AA, D'Souza RL, Reebye UN. An Alternative Airway Intervention to Preserve the Surgical Field in Oral and Maxillofacial Surgery. Surg Innov 2023; 30:529-532. [PMID: 36416642 DOI: 10.1177/15533506221141493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/06/2023]
Abstract
Background/need. Office-based sedation has become increasingly commonplace in dental offices in recent years, allowing for practitioners to provide broader scope of care for their patients. Maintaining high standards of safety is of utmost importance when sedation is utilized in the office-based setting, especially for patients deemed at a higher-risk for intraoperative airway obstruction. This demographic includes but is not limited to individuals with a medical history significant for obstructive sleep apnea, chronic obstructive pulmonary disease, and morbid obesity. Presently, a wide variety of airway devices exist for use in the event of airway obstruction. However, in the context of oral and maxillofacial surgery, placement of these devices can encroach upon the surgical field, extending the perioperative period and putting the patient at greater long-term risk for maintaining adequate oxygenation. Methodology. The authors describe a preliminary technique trialed in our offices which utilizes a size 5.0 endotracheal tube (5OET) as an adjunct supraglottic airway to help mitigate the issue of oxygen saturation maintenance, as well as unimpeded access to the oral cavity. Implementation of the device requires identifying appropriate candidates during preoperative screening and placing the device through the nare and securing it above the glottis. Device Description. The 'tube kit' is comprised of a standard size straight 5.0 cuffed oral ETT, a 5-mL syringe for inflation of the cuff post insertion, lubricant, flex extension tubing, end tidal sampling line for capnography, tape for securement of the 5OET, and an anesthesia breathing circuit. Optional equipment pieces include an elbow connecter and a foam piece for comfort. Results/Current Status. Preliminary results have demonstrated oxygen saturations maintained above 98% when the 5OET is placed preoperatively. Continued use of the trial device will inform the development of a tube by our clinicians, and its efficacy will be studied in our offices. The next steps will be to start developing a pilot cuff that will be submitted for patent approval after its use in IRB-approved clinical studies.
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Affiliation(s)
| | - Saad A Khan
- Creighton University School of Medicine, Omaha, NE, USA
| | - Amina A Khan
- Creighton University School of Medicine(Phoenix Regional Campus), Phoenix, AZ, USA
| | | | - Uday N Reebye
- Triangle Implant Center, Durham, NC, USA
- Boston University Henry M. Goldman School of Dental Medicine, Boston, MA, USA
- Duke Regional Hospital, Durham, NC, USA
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Deep M, Baroudi I, Assad M. Assessment of the efficacy of auricular conchal cartilage graft in repairing orbital floor fractures and its effect on diplopia: a nonrandomized clinical trial. Ann Med Surg (Lond) 2023; 85:3538-3544. [PMID: 37427204 PMCID: PMC10328706 DOI: 10.1097/ms9.0000000000000980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 06/10/2023] [Indexed: 07/11/2023] Open
Abstract
Orbital fractures are a common sequela of maxillofacial zone trauma. Rapid assessment and management are essential for successful reconstruction. The selected treatment method depends on fracture types, accompanied injuries, and intervention time. Implantable grafts used to be from autologous materials. The study aimed to evaluate the effectiveness of using the auricular conchal cartilage taken from the ear to repair orbital floor fractures in cases of minimal bone loss, less than (2×2) cm. Material and Methods A prospective single-arm, nonrandomised clinical trial was conducted during the past 4 years (from 2018 to 2022). A total of 15 cases, who had visited the department of oral and maxillofacial surgery department with orbital floor fractures, were enrolled. The participants underwent conchal cartilage grafting for orbital floor fracture reconstruction. The time factor to perform the surgery after trauma had been considered. Patients were closely monitored for the development of double vision (diplopia) at 15 days, 1 month, and 3 months postsurgery. Results The results showed statistically significant differences during the follow-up period following the surgical procedure. They appeared to have complete restoration of eye movements, restoration of the normal positioning of the eyeball affected by the orbital floor fracture compared to the healthy eyeball, and regression of double vision (diplopia) throughout the follow-up period. Conclusion Using the auricular conchal cartilage graft in repairing fractures of the orbital floor resulted in the improvement of the functional aspect of the eyeball and the restoration of the esthetic aspect.
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Affiliation(s)
- Mohammad Deep
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Tishreen University, Lattakia
| | - Ihsan Baroudi
- Faculty of Medicine, University of Hama, Hama, Syria
| | - Mounzer Assad
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Tishreen University, Lattakia
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Tao Y, Qiu X, Ye F, Liao Z, Wu P. Amyloidosis of the tongue: a rare case report. Braz J Otorhinolaryngol 2023; 89:101286. [PMID: 37418852 PMCID: PMC10344665 DOI: 10.1016/j.bjorl.2023.101286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 06/13/2023] [Accepted: 06/21/2023] [Indexed: 07/09/2023] Open
Abstract
•This patient presented with clinical symptoms of tongue enlargement and stiffness. •AL amyloidosis requires a pathological biopsy for diagnosis. •Treatment involves chemotherapy and local surgical interventions. •Misdiagnosis or delayed diagnosis of AL amyloidosis is common.
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Affiliation(s)
- Ying Tao
- The University of Hong Kong-Shenzhen Hospital, Department of Surgery, Division of Otolaryngology, Head and Neck Surgery, Shenzhen City, China
| | - Xiaoling Qiu
- The University of Hong Kong-Shenzhen Hospital, Department of Hematology, Shenzhen City, China
| | - Fan Ye
- The University of Hong Kong-Shenzhen Hospital, Department of Surgery, Division of Otolaryngology, Head and Neck Surgery, Shenzhen City, China
| | - Zhencheng Liao
- The University of Hong Kong-Shenzhen Hospital, Department of Surgery, Division of Otolaryngology, Head and Neck Surgery, Shenzhen City, China
| | - Pingan Wu
- The University of Hong Kong-Shenzhen Hospital, Department of Surgery, Division of Otolaryngology, Head and Neck Surgery, Shenzhen City, China.
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Roi CI, Roi A, Nicoară A, Nica D, Rusu LC, Soancă A, Motofelea AC, Riviș M. Impact of Treatment on Systemic Immune-Inflammatory Index and Other Inflammatory Markers in Odontogenic Cervicofacial Phlegmon Cases: A Retrospective Study. Biomedicines 2023; 11:1710. [PMID: 37371805 DOI: 10.3390/biomedicines11061710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 06/07/2023] [Accepted: 06/13/2023] [Indexed: 06/29/2023] Open
Abstract
Cervicofacial odontogenic infections can have an aggressive evolution with life-threatening complications. Management in many cases can be a challenge for clinicians, implying an extra focus on individual inflammatory parameters. The aim of this study is to evaluate the evolution of inflammatory markers for the included diagnosed odontogenic cervicofacial phlegmon cases at the moment of hospitalization and after receiving surgical and pharmaceutical treatment. MATERIALS AND METHODS A total of 39 patients diagnosed with odontogenic cervicofacial phlegmons that were admitted to the Maxillofacial Surgery Department of the Emergency Hospital from Timisoara were included in the study. The main focus was the parameters represented by the systemic immune-inflammatory index (SII) based on neutrophil, platelet, and lymphocytes count; the neutrophil-lymphocyte ratio (NLR); C-reactive protein level (CRP); and white blood cell count (WBC) before and after the treatment as potential prognosis factors. RESULTS The results of the study after analyzing the included parameters revealed a significant difference between the calculated values of the SII, NLR, CRP, and WBC at admission and at time of discharge, being directly influenced by the treatment. CONCLUSIONS SII, NLR, CRP, and WBC dynamic changes in severe cervicofacial odontogenic infections can be influenced by receiving accurate surgical and pharmacological treatment, with the potential to become future severity prognosis indexes.
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Affiliation(s)
- Ciprian Ioan Roi
- Department of Anesthesiology and Oral Surgery, "Victor Babeș" University of Medicine and Pharmacy, Eftimie Murgu Sq. No. 2, 30041 Timișoara, Romania
- Multidisciplinary Center for Research, Evaluation, Diagnosis and Therapies in Oral Medicine, "Victor Babeș" University of Medicine and Pharmacy, Eftimie Murgu Sq. No. 2, 30041 Timișoara, Romania
| | - Alexandra Roi
- Multidisciplinary Center for Research, Evaluation, Diagnosis and Therapies in Oral Medicine, "Victor Babeș" University of Medicine and Pharmacy, Eftimie Murgu Sq. No. 2, 30041 Timișoara, Romania
- Department of Oral Pathology, "Victor Babeș" University of Medicine and Pharmacy, Eftimie Murgu Sq. No. 2, 30041 Timișoara, Romania
| | - Adrian Nicoară
- Department of Anesthesiology and Oral Surgery, "Victor Babeș" University of Medicine and Pharmacy, Eftimie Murgu Sq. No. 2, 30041 Timișoara, Romania
| | - Diana Nica
- Department of Anesthesiology and Oral Surgery, "Victor Babeș" University of Medicine and Pharmacy, Eftimie Murgu Sq. No. 2, 30041 Timișoara, Romania
| | - Laura Cristina Rusu
- Multidisciplinary Center for Research, Evaluation, Diagnosis and Therapies in Oral Medicine, "Victor Babeș" University of Medicine and Pharmacy, Eftimie Murgu Sq. No. 2, 30041 Timișoara, Romania
- Department of Oral Pathology, "Victor Babeș" University of Medicine and Pharmacy, Eftimie Murgu Sq. No. 2, 30041 Timișoara, Romania
| | - Andrada Soancă
- Department of Periodontology, Faculty of Dental Medicine, Iuliu Hațieganu University of Medicine and Pharmacy, Victor Babes Street, No. 15, 40012 Cluj-Napoca, Romania
| | - Alexandru Cătălin Motofelea
- Department of Internal Medicine, Faculty of Medicine, "Victor Babeș" University of Medicine and Pharmacy, 30041 Timișoara, Romania
| | - Mircea Riviș
- Department of Anesthesiology and Oral Surgery, "Victor Babeș" University of Medicine and Pharmacy, Eftimie Murgu Sq. No. 2, 30041 Timișoara, Romania
- Multidisciplinary Center for Research, Evaluation, Diagnosis and Therapies in Oral Medicine, "Victor Babeș" University of Medicine and Pharmacy, Eftimie Murgu Sq. No. 2, 30041 Timișoara, Romania
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Salloum MG, Ganji KK, Aldajani AM, Sonune S. Colour Stability of Two Commercially Available Maxillofacial Prosthetic Elastomers after Outdoor Weathering in Al Jouf Province. Materials (Basel) 2023; 16:4331. [PMID: 37374515 DOI: 10.3390/ma16124331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 05/25/2023] [Accepted: 05/26/2023] [Indexed: 06/29/2023]
Abstract
Facial prostheses are created from special elastomers modified for their specific physical and mechanical properties; however, they also show two common major clinical problems: gradual discolouration of the prosthesis over time in service environment and deterioration of static, dynamic, and physical properties. As a result of external environmental factors, facial prostheses may become discoloured and discolour by changing colour from intrinsic and extrinsic colouring, and this is associated with the intrinsic colour stability of elastomers and colourants. Thus, in this in vitro study, a comparative evaluation of the effect of outdoor weathering on the colour stability of A-103 and A-2000 room-temperature vulcanised silicones used for maxillofacial prosthesis was conducted. To accomplish this study, a total of 80 samples were fabricated, 40 samples of each material were grouped as clear (20) and pigmented (20). These samples were mounted on wooden board and the assembly was placed on the roof of the dental school from October 2021 to March 2022. To maximise the amount of sunlight on the specimens, the exposure rack was set on five 68° angles from horizontal and also to prevent standing water. The specimens were left uncovered during exposure. The testing of samples was conducted with the help of a spectrophotometer. The colour values were recorded in the CIELAB colour system. It describes the three colour coordinates (colour values) x, y, and z in three new reference values of L, a, and b, aiding in numerically classifying colour differences. After 2, 4, and 6 months of weathering, testing was conducted using a spectrophotometer and the colour change (ΔE) was calculated. The A-103 RTV silicone group with pigmentation showed the maximum change in colour after six months of environmental conditioning. The data for colour difference within groups were analysed using a one-way ANOVA test. Tukey's post hoc test assessed the pairwise mean comparison's contribution to the overall significant difference. The nonpigmented A-2000 RTV silicone group showed the maximum change in colour after six months of environmental conditioning. After 2, 4, and 6 months of environmental conditioning, pigmented A-2000 RTV silicone showed better colour stability than A-103 RTV silicone. The patients requiring facial prosthesis do need to work on outdoor fields, and thus weathering will have deleterious effects on such prosthesis. Hence, the selection of appropriate silicone material with respect to the Al Jouf province region is crucial, which includes economic, durable, and colour stability.
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Affiliation(s)
- Mahmoud Gamal Salloum
- Department of Substitutive Dental Sciences, College of Dentistry & Pharmacy, Buraydah Private College, Buraydah 51418, Saudi Arabia
| | - Kiran Kumar Ganji
- Department of Preventive Dentistry, College of Dentistry, Jouf University, Sakaka 72345, Saudi Arabia
- Department of Periodontics & Implantology, Sharad Pawar Dental College & Hospital, Datta Meghe Institute of Higher Education & Research, Sawangi (Meghe), Wardha 442107, India
| | - Ali Mohammed Aldajani
- Department of Prosthetic Dental Sciences, College of Dentistry, Jouf University, Sakaka 72345, Saudi Arabia
| | - Shital Sonune
- Department of Prosthetic Dental Sciences, College of Dentistry, Jouf University, Sakaka 72345, Saudi Arabia
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Rostamzad P, Pleumeekers MM, Versnel SL, Loudon SE. Effect of Midface Surgery on Ocular Outcomes in Patients with Orbital and Midface Malformations. J Clin Med 2023; 12:jcm12113862. [PMID: 37298056 DOI: 10.3390/jcm12113862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 05/26/2023] [Accepted: 05/31/2023] [Indexed: 06/12/2023] Open
Abstract
(1) Background: Orbital and midface malformations occur in multiple craniofacial disorders. Depending on the deformity, surgical corrections include orbital box osteotomy (OBO), Le Fort III (LFIII), monobloc (MB), and facial bipartition (FB). The aim of this study was to determine the effect of these procedures on ocular outcomes. (2) Methods: A retrospective analysis was performed. All patients with craniofacial disorders who had previously undergone midface surgery were included. The Wilcoxon signed ranks test was used for statistical analysis. (3) Results: In total, 63 patients were included: two patients were treated by OBO, 20 by LFIII, 26 by MB, and 15 by FB. Pre-operatively, strabismus was present in 39 patients (61.9%), in whom exotropia was most common (n = 27; 42.9%), followed by esotropia (n = 11; 17.5%). Postoperatively, strabismus significantly worsened (p = 0.035) in the overall population (n = 63). Pre-operative binocular vision (n = 33) was absent in nine patients (27.3%), poor in eight (24.2%), moderate in 15 (45.5%), and good in one (3.0%). Postoperatively, binocular vision significantly improved (p < 0.001). Before surgery, the mean visual acuity (VA) in the better eye was 0.16 LogMAR (Logarithm of the Minimum Angle of Resolution), and 0.31 LogMAR in the worse eye. Furthermore, pre-operative astigmatism was present in 46 patients (73.0%) and hypermetropia in 37 patients (58.7%). No statistical difference was found for VA (n = 51; p = 0.058) postoperatively. (4) Conclusions: Midface surgery has a direct and indirect substantial effect on several ocular outcomes. This study emphasizes the importance of appropriate ophthalmological evaluation in patients with craniofacial disorders undergoing midface surgery.
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Affiliation(s)
- Parinaz Rostamzad
- Department of Plastic and Reconstructive Surgery, Erasmus Medical Center, 3000 CA Rotterdam, The Netherlands
| | - Mieke M Pleumeekers
- Department of Plastic and Reconstructive Surgery, Erasmus Medical Center, 3000 CA Rotterdam, The Netherlands
| | - Sarah L Versnel
- Department of Plastic and Reconstructive Surgery, Erasmus Medical Center, 3000 CA Rotterdam, The Netherlands
| | - Sjoukje E Loudon
- Department of Ophthalmology, Erasmus Medical Center, 3000 CA Rotterdam, The Netherlands
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Kumar S, Parashar P, Mallick S, Abhishek D, L. Mane S, Girija A. SCPNB is an adjuvant to local anaesthesia for maxillofacial surgical practice. Bioinformation 2023; 19:605-610. [PMID: 37886162 PMCID: PMC10599667 DOI: 10.6026/97320630019605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 05/31/2023] [Accepted: 05/31/2023] [Indexed: 10/28/2023] Open
Abstract
The superficial cervical plexus nerve block [SCPNB] procedure is frequently used throughout head and neck surgery because it is simple to learn and has a low rate of complications. The investigation of this method might produce superior outcomes in treating frequent maxillofacial disorders including mandibular fractures and infections of the odontogenic region. The SCPNB is known to play a part in the medical evacuation of head and neck abscesses, the excision of superficial diseases in the perimandibular region, and the therapy of mandibular fracture, despite the dearth of research in this area. Considering this background, it was expected that the SCPNB might be helpful as an adjuvant to regional anaesthesia in maxillofacial surgery. The purpose of this study was to assess the effectiveness of the SCPNB in the treatment of mandibular fractures and infectious diseases in the perimandibular area. 48 patients with either submandibular space infections or mandibular injuries who were anticipated for surgical procedure under regional anaesthesia participated in a prospective randomized clinical study (eg, inferior alveolar nerve block, long buccal nerve block). Administering a combination of a local infiltration and regional anaesthesia was used as the control group. Regional anaesthesia and a SCPNB were administered to the intervention class. The following factors were examined: pain, anaesthesia's duration and onset, waiting period before initial analgesic demand, pulse rate, and blood pressure. The unpaired t-test was used to compare groups. Multiple variables ANOVA (for more than two observations) was used for intragroup analysis, accompanied by a post-hoc analysis of variance. In aspects of intra - operative pain at thirty minutes, time required of anaesthesia, intraoperative anesthetic necessity, duration until first analgesic recommendation, and intra - operative diastolic arterial blood pressure at ten minutes, the SCPNB group demonstrated a substantial (P ≤.01) improved performance. It can be concluded that the use of a regional anaesthetic approach in conjunction with a SCPNB is a good substitute to localized infiltration for patients having surgery for fracture of mandible and perimandibular area infections.
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Affiliation(s)
- Sachin Kumar
- Department of Oral and Maxillofacial Surgery School of Dental Sciences, Sharda University, Greater Noida, UP, India
| | - Pranav Parashar
- Department of Dentistry, N.S.C.B. Medical College & Hospital, Jabalpur, M.P, India
| | - Saurabh Mallick
- Department of Oral & Maxillofacial Surgery, Mallick Dental & Maxillofacial Centre, Ranchi, Jharkhand, India
| | - Dr. Abhishek
- Department of Oral and Maxillofacial Surgery Oro Care Facial Trauma Centre, Patna, Bihar, India
| | - Sanjivani L. Mane
- Department of General Pathology and Microbiology, MA Rangoonwala College of Dental Sciences & Research Centre, Pune, Maharashtra, India
| | - Adsure Girija
- Department of Orthodontics & Dentofacial Orthopaedics, MA Rangoonwala College of Dental Sciences & Research Centre, Pune, Maharashtra, India
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Massarelli O, Vaira LA, Crimi S, Salzano G, Latini L, Bianchi A, Gennaro P, De Riu G. Tongue Reconstruction with Buccinator Myomucosal Island Flaps: Technical Considerations, Oncologic Safety, Functional Outcomes and QoL Assessment-A Retrospective Observational Study. J Pers Med 2023; 13:879. [PMID: 37373868 DOI: 10.3390/jpm13060879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 05/17/2023] [Accepted: 05/21/2023] [Indexed: 06/29/2023] Open
Abstract
The objective of this study was to investigate the effectiveness of buccinator myomucosal island flaps for tongue reconstruction following malignant tumor resections. A retrospective study was performed on 52 patients who underwent tongue reconstructions with buccinator myomucosal island flaps between 2012 and 2020. We reviewed the flap type and size, harvesting time, recipient- and donor-site complications, postoperative oncologic outcomes, functional recovery and QoL assessment. All of the flaps were transposed successfully without any total flap loss. Neither in the primary site nor in the neck were cancer relapses observed. An evaluation of the sensitivity revealed that 96.1% of patients experienced a recovery of touch, two-point and pain sensations. There were significant differences between the flap and the native mucosa in terms of the tactile (p < 0.001), pain (p < 0.001) and two-point (p < 0.001) thresholds. The average swallowing score recorded was 6.1 out of 7, with only minor complaints. The quality of life assessments demonstrated high scores across physical (24.5 out of 28), social (25.8 out of 28), emotional (20.3 out of 24) and functional (25 out of 28) aspects. The present study showed how buccinator myomucosal island flaps represent an effective and functional tongue reconstructive option, requiring a short operative time with a low rate of donor site morbidity, and with evidence of long-term oncologic safety and high quality of life.
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Affiliation(s)
- Olindo Massarelli
- Maxillofacial Surgery Operative Unit, Department of Mental Health and Sense Organs, Santa Maria Le Scotte, University Hospital of Siena, 53100 Siena, Italy
| | - Luigi Angelo Vaira
- Maxillofacial Surgery Operative Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
- Biomedical Science Department, PhD School of Biomedical Science, University of Sassari, 07100 Sassari, Italy
| | - Salvatore Crimi
- Maxillofacial Surgery Unit, University Hospital "Policlinico San Marco" of Catania, 95124 Catania, Italy
| | - Giovanni Salzano
- Maxillofacial Surgery Operative Unit, University Hospital of Naples "Federico II", 80131 Naples, Italy
| | - Linda Latini
- Maxillofacial Surgery Operative Unit, Department of Mental Health and Sense Organs, Santa Maria Le Scotte, University Hospital of Siena, 53100 Siena, Italy
| | - Alberto Bianchi
- Maxillofacial Surgery Unit, University Hospital "Policlinico San Marco" of Catania, 95124 Catania, Italy
| | - Paolo Gennaro
- Maxillofacial Surgery Operative Unit, Department of Mental Health and Sense Organs, Santa Maria Le Scotte, University Hospital of Siena, 53100 Siena, Italy
| | - Giacomo De Riu
- Maxillofacial Surgery Operative Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
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Singh AK, Khanal N, Chaulagain R, Sharma N, Thieringer FM. Is the Pre-Shaping of an Orbital Implant on a Patient-Specific 3D-Printed Model Advantageous Compared to Conventional Free-Hand Shaping? A Systematic Review and Meta-Analysis. J Clin Med 2023; 12:jcm12103426. [PMID: 37240532 DOI: 10.3390/jcm12103426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 05/01/2023] [Accepted: 05/05/2023] [Indexed: 05/28/2023] Open
Abstract
This study aimed to perform a systematic review and meta-analysis to compare pre-shaped implants on a patient-specific 3D-printed (3DP) model to manual free-hand shaping (MFS) for orbital wall reconstruction. The PRISMA protocol was followed in this study, and the review was registered in the PROSPERO database (CRD42021261594). A search was conducted in MEDLINE (PubMed), Embase, Cochrane Library, Clinicaltrials.gov, Google Scholar, and the grey literature. Ten articles were included, and six outcomes were analyzed. In total, 281 patients were in the 3DP group and 283 were in the MFS group. The studies had an overall high risk of bias. 3DP models resulted in a better accuracy of fit, anatomical angle reproduction, and defect area coverage. The correction of orbital volume was also superior with statistical significance. There was a higher percentage of the correction of enophthalmos and diplopia in the 3DP group. Intraoperative bleeding and hospital stay were reduced in the 3DP group. The meta-analysis of operative time showed a reduction in the average operative time by 23.58 min (95% CI: -43.98 to -3.19), which was statistically significant (t(6) = -2.8299, p = 0.0300). The 3DP models appear advantageous for an accurate orbital wall reconstruction, with fewer complications than those for conventional free-hand-shaped implants.
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Affiliation(s)
- Ashutosh Kumar Singh
- Department of Oral and Maxillofacial Surgery, Tribhuvan University Teaching Hospital, Institute of Medicine, Kathmandu 44600, Nepal
| | - Nikita Khanal
- Department of Population Health Sciences, University of Bristol, Bristol BS8 1QU, UK
| | - Rajib Chaulagain
- Department of Oral Biology, Chitwan Medical College, Bharatpur 44200, Nepal
| | - Neha Sharma
- Clinic of Oral and Cranio-Maxillofacial Surgery, University Hospital Basel, CH-4031 Basel, Switzerland
- Medical Additive Manufacturing Research Group (Swiss MAM), Department of Biomedical Engineering, University of Basel, Hegenheimermattweg 167C, CH-4123 Allschwil, Switzerland
| | - Florian M Thieringer
- Clinic of Oral and Cranio-Maxillofacial Surgery, University Hospital Basel, CH-4031 Basel, Switzerland
- Medical Additive Manufacturing Research Group (Swiss MAM), Department of Biomedical Engineering, University of Basel, Hegenheimermattweg 167C, CH-4123 Allschwil, Switzerland
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Abstract
Benign fibro-osseous lesions are a group of pathological conditions characterized by the replacement of normal bone with cellular fibrous connective tissue that undergoes mineralization. The most common types of benign fibro-osseous lesions include fibrous dysplasia, ossifying fibroma, and osseous dysplasia. However, diagnosing these lesions can be challenging due to their overlapping clinical, radiological, and histological features, which can cause a diagnostic dilemma for surgeons, radiologists, and pathologists. One rare type of benign fibro-osseous lesion is the cemento-ossifying fibroma (COF), which is a definitive form of a benign fibro-osseous tumor that affects the craniofacial region, particularly the jaws (70%). Here, we present a case of COF in a 61-year-old female patient in the maxillary anterior region. Due to a clear distinction between the lesion and healthy bone, the lesion was treated with conservative surgical excision followed by curettage and primary closure. However, differential diagnosis of COF can be highly challenging for clinicians due to its overlapping features with other fibro-osseous lesions like Paget's disease and fibrous dysplasia. Ossifying fibroma and fibrous dysplasia often present a histopathological, clinical, and radiological overlap. The post-operative follow-up after eight months was unpredictable, with a radiological picture showing the increased thickness of the frontal bone, parietal bone, and maxilla with obliteration of marrow spaces, alteration of the trabecular pattern with a cotton wool/ground glass appearance, and reduced maxillary sinus space. Proper evaluation and diagnosis of fibro-osseous lesions are necessary before arriving at a final conclusion. Cemento-ossifying fibroma in the maxillofacial skeleton is uncommon, and after eight months, the recurrence rate is rare. This case highlights the importance of considering COF as a differential diagnosis for fibro-osseous lesions in the maxillofacial region and the necessity for proper evaluation and diagnosis to determine the appropriate treatment plan and prognosis. In summary, the diagnosis of benign fibro-osseous lesions can be challenging due to their overlapping features, but early diagnosis and proper evaluation are essential for successful treatment outcomes. COF is a rare type of benign fibro-osseous lesion where other fibro-osseous lesions in the maxillofacial region should be considered as a differential diagnosis, and the necessary steps should be taken to confirm the diagnosis before arriving at a final conclusion.
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Affiliation(s)
- Vedha Aravindan
- Oral and Maxillofacial Surgery, Saveetha Institute of Medical and Technical Sciences, Chennai, IND
| | - Santhosh P Kumar
- Oral and Maxillofacial Surgery, Saveetha Institute of Medical and Technical Sciences, Chennai, IND
| | - Senthil Murugan P
- Oral and Maxillofacial Surgery, Saveetha Institute of Medical and Technical Sciences, Chennai, IND
| | - Murugesan Krishnan
- Oral and Maxillofacial Surgery, Saveetha Institute of Medical and Technical Sciences, Chennai, IND
| | - Alladi Sneha
- Oral and Maxillofacial Surgery, Saveetha Institute of Medical and Technical Sciences, Chennai, IND
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Vaira LA, De Riu G, Boscolo-Rizzo P, Hopkins C, Lechien JR. In reference to Intranasal Corticosteroid Treatment on Recovery of Long-Term Olfactory Dysfunction Due to COVID-19. Laryngoscope 2023; 133:E29-E30. [PMID: 36495301 PMCID: PMC9877991 DOI: 10.1002/lary.30505] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 09/06/2022] [Indexed: 12/14/2022]
Abstract
This is a commentary on the article by Hosseinpoor et al. Laryngoscope, 2022
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Affiliation(s)
- Luigi Angelo Vaira
- Maxillofacial Surgery Operative Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy.,Biomedical Science Department, PhD School of Biomedical Science, University of Sassari, Sassari, Italy
| | - Giacomo De Riu
- Maxillofacial Surgery Operative Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Paolo Boscolo-Rizzo
- Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, Trieste, Italy
| | - Claire Hopkins
- Department of otorhinolaryngology, King's College, London, UK.,British Rhinological Society, London, UK
| | - Jerome R Lechien
- Department of Anatomy and Experimental Oncology, Mons School of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons, Mons, Belgium.,Department of Otolaryngology-Head Neck Surgery, Elsan Polyclinic of Poitiers, Poitiers, France
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42
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Luo QF. Application of Intratissue Laser Ablation in Facial Morphological Modification. Photobiomodul Photomed Laser Surg 2023; 41:182-188. [PMID: 36976829 DOI: 10.1089/photob.2022.0145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023] Open
Abstract
Objective: To conduct a retrospective analysis of the therapeutic effects of laser ablation in maxillofacial applications. Methods: Laser ablation was performed in 97 patients, 27 cases of facial fat accumulation, 40 cases of sagging caused by facial aging, 16 cases of soft tissue asymmetry, and 14 cases of facial hyperplasia. Laser parameters were as follows: lipolysis 8 W, 90-120 J/cm2, and the ablation of hyperplastic tissue 9-10 W, 150-200 J/cm2. The subcutaneous thickness, facial morphology, patient's self-evaluation, and satisfaction were evaluated. Results: Laser ablation reduced the subcutaneous thickness, and tightened loose skin. The patient's appearance looked younger and more beautiful. The curves of the facial contours were more of Oriental beauty. The hyperplasia site became thinner, and the facial asymmetry was corrected or significantly improved. Most of the patients were satisfied with the outcome. There were no serious complications besides swelling. Conclusions: Laser ablation can effectively treat thickening and relaxation of maxillofacial soft tissues. With low risk, few complications, and quick recovery, it can be used as a first-line treatment for maxillofacial soft tissue plastic surgery.
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Affiliation(s)
- Quan-Feng Luo
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China
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Barca I, Ferragina F, Kallaverja E, Arrotta A, Cristofaro MG. Electrochemotherapy as an Effective Alternative in the Treatment of Local Advanced Oral Squamous Cell Carcinoma: A Retrospective Analysis of Treated Cases. Int J Environ Res Public Health 2023; 20:5170. [PMID: 36982078 PMCID: PMC10049161 DOI: 10.3390/ijerph20065170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 03/07/2023] [Accepted: 03/14/2023] [Indexed: 06/18/2023]
Abstract
Advanced oral squamous cell carcinomas represent a major challenge for maxillofacial surgeons, oncologists and radiation therapists. They also account for a large share of healthcare costs. They respond little and/or poorly to conventional therapies (surgery, radiotherapy and chemotherapy). Electrochemotherapy is a new method used as a palliative treatment in patients with advanced cancer of the neck/head region who are not eligible for standard therapies. It combines the use of cytotoxic drugs with the physical principle of electroporation; it effectively controls the tumour locally and preserves organ function. To date, ECT has been little used for oral mucosal tumours, as this is difficult to access for electrodes. We report six cases of advanced oral squamous cell carcinoma treated with electrochemotherapy. This study aims to assess the debulking effect of cancer via ECT in patients with advanced oral squamous cell carcinoma. It also aims to assess the safety and tolerability of this treatment.
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Affiliation(s)
- Ida Barca
- Unit of Maxillofacial Surgery, Department of Experimental and Clinical Medicine, “Magna Graecia” University, Viale Europa, 88100 Catanzaro, Italy
| | - Francesco Ferragina
- Unit of Maxillofacial Surgery, Department of Experimental and Clinical Medicine, “Magna Graecia” University, Viale Europa, 88100 Catanzaro, Italy
| | - Elvis Kallaverja
- Unit of Maxillofacial Surgery, Department of Experimental and Clinical Medicine, “Magna Graecia” University, Viale Europa, 88100 Catanzaro, Italy
| | - Antonella Arrotta
- Department of Medical and Surgical Sciences, “Magna Graecia” University, Viale Europa, 88100 Catanzaro, Italy
| | - Maria Giulia Cristofaro
- Unit of Maxillofacial Surgery, Department of Experimental and Clinical Medicine, “Magna Graecia” University, Viale Europa, 88100 Catanzaro, Italy
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Materni A, Pasquale C, Signore A, Benedicenti S, Amaroli A. Comparison between the Flapless Surgical Approach and a Novel Single Incision Access in Terms of Recovery Time and Comfort after Extraction of Impacted Inferior Third Molars: A Randomised, Blinded, Split-Mouth Controlled Clinical Trial. J Clin Med 2023; 12:jcm12051995. [PMID: 36902781 PMCID: PMC10004479 DOI: 10.3390/jcm12051995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 02/28/2023] [Accepted: 03/01/2023] [Indexed: 03/06/2023] Open
Abstract
The recent attention to quality of life and oral health care procedures reflects a renewed 'patient-based' approach to dealing with non-life-threatening conditions. In the current study, we proposed a novel surgical approach to the extraction of impacted inferior third molars (iMs3) through a randomised, blinded, split-mouth controlled clinical trial following the CONSORT guidelines. The novel surgical procedure, hereinafter referred to as single incision access (SIA), will be compared with our previously described flapless surgical approach (FSA). The predictor variable was the novel SIA approach, involving access through a single incision without removal of soft tissue, on the impacted iMs3. The primary endpoint was the acceleration of the iMs3 extraction healing time. The secondary endpoints were the incidences of pain and oedema as well as gum health (pocket probing depth and attached gingiva). The study was carried out on 84 teeth of 42 patients with both iMs3 impacted. The cohort was composed of 42% Caucasian males and 58% Caucasian females, aged 23.8 ± 7.9 (17-49) years. We observed faster recovery/wound-healing on the SIA side (33.6 ± 4.3 days) than at the FSA side (42.1 ± 5.4 days; p < 0.05). The FSA approach confirmed the evidence previously detected concerning early post-surgery improvement in terms of attached gingiva and reduced oedema and pain, with respect to the traditional envelope flap. The novel SIA approach follows the early positive post-surgery FSA results.
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Affiliation(s)
- Alberto Materni
- Department of Surgical and Diagnostic Sciences (DISC), University of Genoa, 16132 Genoa, Italy
| | - Claudio Pasquale
- Department of Surgical and Diagnostic Sciences (DISC), University of Genoa, 16132 Genoa, Italy
- Department of Civil, Chemical and Environmental Engineering (DICCA), University of Genoa, 16100 Genoa, Italy
| | - Antonio Signore
- Department of Surgical and Diagnostic Sciences (DISC), University of Genoa, 16132 Genoa, Italy
- Therapeutic Dentistry Department, Institute of Dentistry, First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia
| | - Stefano Benedicenti
- Department of Surgical and Diagnostic Sciences (DISC), University of Genoa, 16132 Genoa, Italy
| | - Andrea Amaroli
- Department of Earth, Environmental and Life Sciences (DISTAV) University of Genoa, 16132 Genoa, Italy
- Correspondence:
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Sorribes De Ramón LA, Ferrández Martínez AF, García Carricondo AR, Espín Gálvez F, Alarcón Rodríguez R. Effect of virtual reality and music therapy on anxiety and perioperative pain in surgical extraction of impacted third molars. J Am Dent Assoc 2023; 154:206-214. [PMID: 36707274 DOI: 10.1016/j.adaj.2022.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 11/11/2022] [Accepted: 11/12/2022] [Indexed: 01/27/2023]
Abstract
BACKGROUND The objective of this study was to evaluate the effect of virtual reality (VR) and music therapy on anxiety and perioperative pain in patients undergoing extraction of impacted third molars. METHODS A total of 275 patients who had to undergo surgery for third-molar extraction participated in a randomized controlled trial and were divided into 3 parallel groups: music therapy intervention (n = 91), VR intervention (n = 93), and control (n = 91). The Spielberger State-Trait Anxiety Inventory and the visual analog scale of pain intensity were used as measurements in this study. RESULTS Patients in the music therapy and VR groups showed a greater reduction in anxiety level scores after third-molar extraction surgery (reduction in total anxiety in music group: 15.12; 95% CI, 13.16 to 17.08; Rosenthal r, 1.61; P < .001; reduction in total anxiety in VR group: 9.80; 95% CI, 7.66 to 11.95; Rosenthal r, 0.97; P < .001; reduction in total anxiety in control group: 9.80; 95% CI, 7.66 to 11.95; Rosenthal r, 0.97; P < .001). The intensity of pain after the intervention was lower in patients in the music therapy group than patients in the control group (P = .04). After the intervention, the music therapy and VR groups presented a significant decrease in systolic blood pressure (P < .05), diastolic blood pressure (P < .05), and heart rate (P < .05) compared with the control group. CONCLUSIONS These findings suggest that the use of music therapy and VR during third-molar extraction surgery reduces anxiety and improves the patient's physiological parameters. PRACTICAL IMPLICATIONS Implementation of these interventions (noninvasive, nonpharmacologic, economic) in the field of oral and maxillofacial surgery and dentistry could improve procedures performed under local anesthesia, improving the clinical experience of patients. This clinical trial was registered with the Australian New Zealand Clinical Trials Registry. The registration number is ACTRN12622000384752.
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Vaira LA, Sergnese S, Salzano G, Maglitto F, Arena A, Carraturo E, Abbate V, Committeri U, Vellone V, Biglio A, Lechien JR, De Riu G. Are YouTube Videos a Useful and Reliable Source of Information for Patients with Temporomandibular Joint Disorders? J Clin Med 2023; 12:jcm12030817. [PMID: 36769466 PMCID: PMC9918192 DOI: 10.3390/jcm12030817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 01/16/2023] [Accepted: 01/17/2023] [Indexed: 01/22/2023] Open
Abstract
Counseling is considered a first-line conservative therapy with respect to temporomandibular joint disorders (TMJD). Nowadays, 50 to 80% of patients acquire health information from the internet before turning to professionals. The purpose of this study has been to investigate the quality of information about TMJD that patients can obtain from YouTube. A YouTube.com search was conducted using the terms "temporomandibular joint disorder"; "limited movement of the mandible"; and "mandibular joint pain". The videos identified were assessed independently by two panels of three professional and lay reviewers with HONcode, modified DISCERN (MD) and the global quality scale (GQS). A total of 106 videos were included. The professional reviewers reported a mean HONcode score of 4.148 ± 1.314 and a mean MD score of 2.519 ± 1.267, testifying to a modest general quality of the videos. The mean GQS score was 2.987 ± 1.012 for the professional and 3.469 ± 0.891 for the lay reviewers (p < 0.001). The correlations between the ratings were significant between the reviewers within the same group but not between the two groups. The presence of animations significantly influenced the GQS score expressed by the lay reviewers (p = 0.011) but not that of the professionals (p = 0.640). The quality of the information on TMJD on YouTube is generally of poor quality. Healthcare systems and professionals should be prepared to correct misinformation and build trusting relationships with patients which are based on quality counseling. Similarly, academic institutions should produce quality content that leads patients with TMJD toward a correct diagnostic-therapeutic process.
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Affiliation(s)
- Luigi Angelo Vaira
- Maxillofacial Surgery Operative Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
- Biomedical Science Department, PhD School of Biomedical Science, University of Sassari, 07100 Sassari, Italy
- Correspondence: ; Tel.: +39-340-1846168
| | - Silvia Sergnese
- Maxillofacial Surgery Operative Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
| | - Giovanni Salzano
- Maxillofacial Surgery Operative Unit, University Hospital of Naples “Federico II”, 80131 Naples, Italy
| | - Fabio Maglitto
- Maxillofacial Surgery Operative Unit, University Hospital of Naples “Federico II”, 80131 Naples, Italy
| | - Antonio Arena
- Maxillofacial Surgery Operative Unit, University Hospital of Naples “Federico II”, 80131 Naples, Italy
| | - Emanuele Carraturo
- Maxillofacial Surgery Operative Unit, University Hospital of Naples “Federico II”, 80131 Naples, Italy
| | - Vincenzo Abbate
- Maxillofacial Surgery Operative Unit, University Hospital of Naples “Federico II”, 80131 Naples, Italy
| | - Umberto Committeri
- Maxillofacial Surgery Operative Unit, University Hospital of Naples “Federico II”, 80131 Naples, Italy
| | - Valentino Vellone
- Department of Maxillofacial Surgery, Santa Maria Hospital, 05100 Terni, Italy
| | - Andrea Biglio
- Maxillofacial Surgery Operative Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
| | - Jérome R. Lechien
- Department of Anatomy and Experimental Oncology, Mons School of Medicine, UMONS, Research Institute for Health Sciences and Technology, University of Mons (UMons), 7000 Mons, Belgium
- Department of Otolaryngology-Head Neck Surgery, Elsan Polyclinic of Poitiers, 86000 Poitiers, France
| | - Giacomo De Riu
- Maxillofacial Surgery Operative Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
- Biomedical Science Department, PhD School of Biomedical Science, University of Sassari, 07100 Sassari, Italy
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Rais MA, Naouri Y, Awad AK. A rare case of left parapharyngeal space large schwannoma of unknown origin. J Surg Case Rep 2023; 2023:rjac578. [PMID: 36685115 PMCID: PMC9844957 DOI: 10.1093/jscr/rjac578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 11/19/2022] [Indexed: 01/20/2023] Open
Abstract
Schwannoma, also called neurilemmoma, is a rare neurogenic tumor exclusively benign that develops from a variety of glial nerve cells called Schwann cells. We present a 26-year-old female patient who was admitted with a history of dysphagia, headache and swelling going from the lower limit of the ear to the floor of the neck on the left side, which has been slowly progressing for 5 years. Upon local clinical examination, a well-defined mass was revealed, 6 × 5 cm in size, non-painful spontaneously, painful on direct palpation of the left neck. Computed tomography scan has shown a well-circumscribed large mass with heterogenous areas of enhancement in the left parapharyngeal space displacing the submandibular gland superiorly and the carotid sheath anterolaterally and compressing the oropharyngeal airway. Excision of the tumor was done by a combined route without post-operative complications noted. Histopathological examination revealed a benign schwannoma without the identification of the nerve of origin.
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Affiliation(s)
- Mohammed Amir Rais
- Correspondence address. Faculty of Medicine of Algiers, University of Algiers, Algeria. E-mail:
| | - Yahia Naouri
- Mustapha Pacha University Hospital, Algiers 16014, Algeria
| | - Ahmed K Awad
- Faculty of Medicine, Ain Shams University, Cairo 11528, Egypt
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Mayo-Yáñez M, Díaz-Díaz A, Calvo-Henríquez C, Lechien JR, Vaira LA, Figueroa A. Diamine Oxidase Activity Deficit and Idiopathic Rhinitis: A New Subgroup of Non-Allergic Rhinitis? Life (Basel) 2023; 13. [PMID: 36676189 DOI: 10.3390/life13010240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 12/15/2022] [Accepted: 01/12/2023] [Indexed: 01/18/2023] Open
Abstract
Idiopathic rhinitis represents more than 50% of non-allergic rhinitis, a heterogeneous group that involves the symptomatic inflammation of the nasal mucosa. The TRPV1 receptor of unmyelinated C-type neurons appears to be involved in its pathophysiology. Histamine, whose main catabolic enzyme is DAO, is one of the mediators that can activate this receptor. The failure of DAO causes an increase in the level of histamine in the body and, consequently, the activation of TRPV1. The objective was to investigate the existence of a DAO enzyme activity deficit in idiopathic rhinitis and its correlation with symptoms. A cross-sectional study was conducted in 116 idiopathic rhinitis patients, and DAO activity, nasal peak inspiratory flow, and rhinitis severity were recorded. The prevalence of a DAO activity deficit was 41.38% (95%CI 0.33−0.50; p = 0.05). The DAO activity in patients with mild rhinitis was 52.93 ± 8.72 HDU/mL, in those with moderate rhinitis it was 120.33 ± 71.63 HDU/mL, and in those with severe rhinitis it was 92.58 ± 27.75 HDU/mL (p = 0.006). The NPIF in patients with a DAO activity deficit was 107.92 ± 34.05 L/min, compared to 72.35 ± 27.16 L/min in patients with normal enzymatic activity (p < 0.001), demonstrating a linear correlation between activity levels and nasal obstruction (−0.45; p < 0.001). Therefore, patients with a DAO deficiency and idiopathic rhinitis could present a milder disease course, because the repeated and continuous activation of TRPV1 led to a partial or total decrease in their response (desensitization). This new theory represents a different perspective for the study of idiopathic rhinitis and its relationship with TRPV1, with the regulation or modulation of the desensitization of TRPV1 being an important therapeutic target for patients with idiopathic rhinitis in the future.
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Hashemi SJ, Shetabi H, Talakoub R, Aminizad A. Comparison of Success Rate and Safety of Nasotracheal Intubation by Conventional and Finger-Guided Method in Patients Undergoing Maxillofacial Surgery. Adv Biomed Res 2023; 12:35. [PMID: 37057229 PMCID: PMC10086639 DOI: 10.4103/abr.abr_255_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 12/29/2021] [Accepted: 01/31/2022] [Indexed: 04/15/2023] Open
Abstract
Background Different techniques have been introduced to reduce the complications of nasotracheal intubation. The aim of this study was to compare the incidence of nasotracheal intubation complications in finger-guided and conventional methods. Materials and Methods In this double-blind randomized trial study, 70 patients who were candidates for oral and maxillofacial surgery who required nasal intubation were included in the study finally of which 33 patients with conventional method and 35 patients with finger-guided tubes in the nasopharynx were analyzed at the end of the study. Variables such as success rate, hemodynamic response, and complications of intubation were compared between the two groups. Results There was no significant difference between the two groups in terms of hemodynamic response to intubation (P > 0.05). There was a significant difference between the two groups in terms of success in tracheal intubation (P < 0.05). There was a significant difference between the two groups in terms of epistaxis immediately after intubation (P < 0.05). There was no significant difference between the two groups in terms of nasal turbine fractures (P > 0.05). However, the frequency of submucosal intubation in the conventional method was significantly higher than the other group (P = 0.02). Conclusion Nasotracheal intubation using the finger guiding technique in the nasopharynx is associated with a higher success rate and less complications after intubation such as epistaxis and submucosal intubation compared to the conventional method.
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Affiliation(s)
- Seyed Jalal Hashemi
- Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hamidreza Shetabi
- Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
- Address for correspondence: Dr. Hamidreza Shetabi, Alzahra Hospital, Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran. E-mail:
| | - Reihanak Talakoub
- Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Avishan Aminizad
- Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
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Ceccariglia F, Cercenelli L, Badiali G, Marcelli E, Tarsitano A. Application of Augmented Reality to Maxillary Resections: A Three-Dimensional Approach to Maxillofacial Oncologic Surgery. J Pers Med 2022; 12:jpm12122047. [PMID: 36556268 PMCID: PMC9785494 DOI: 10.3390/jpm12122047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 12/03/2022] [Accepted: 12/07/2022] [Indexed: 12/14/2022] Open
Abstract
In the relevant global context, although virtual reality, augmented reality, and mixed reality have been emerging methodologies for several years, only now have technological and scientific advances made them suitable for revolutionizing clinical care and medical settings through the provision of advanced features and improved healthcare services. Over the past fifteen years, tools and applications using augmented reality (AR) have been designed and tested in the context of various surgical and medical disciplines, including maxillofacial surgery. The purpose of this paper is to show how a marker-less AR guidance system using the Microsoft® HoloLens 2 can be applied in mandible and maxillary demolition surgery to guide maxillary osteotomies. We describe three mandibular and maxillary oncologic resections performed during 2021 using AR support. In these three patients, we applied a marker-less tracking method based on recognition of the patient's facial profile. The surgeon, using HoloLens 2 smart glasses, could see the virtual surgical planning superimposed on the patient's anatomy. We showed that performing osteotomies under AR guidance is feasible and viable, as demonstrated by comparison with osteotomies performed using CAD-CAM cutting guides. This technology has advantages and disadvantages. However, further research is needed to improve the stability and robustness of the marker-less tracking method applied to patient face recognition.
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Affiliation(s)
- Francesco Ceccariglia
- Oral and Maxillo-Facial Surgery Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni 15, 40138 Bologna, Italy
- Maxillofacial Surgery Unit, Department of Biomedical and Neuromotor Science, University of Bologna, 40138 Bologna, Italy
- Correspondence: ; Tel.: +39-051-2144197
| | - Laura Cercenelli
- eDimes Lab-Laboratory of Bioengineering, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, 40138 Bologna, Italy
| | - Giovanni Badiali
- Oral and Maxillo-Facial Surgery Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni 15, 40138 Bologna, Italy
- Maxillofacial Surgery Unit, Department of Biomedical and Neuromotor Science, University of Bologna, 40138 Bologna, Italy
| | - Emanuela Marcelli
- eDimes Lab-Laboratory of Bioengineering, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, 40138 Bologna, Italy
| | - Achille Tarsitano
- Oral and Maxillo-Facial Surgery Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Albertoni 15, 40138 Bologna, Italy
- Maxillofacial Surgery Unit, Department of Biomedical and Neuromotor Science, University of Bologna, 40138 Bologna, Italy
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