The British journal of oral & maxillofacial surgery
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Br J Oral Maxillofac Surg · Feb 2014
Analysis of time taken to discuss new patients with head and neck cancer in multidisciplinary team meetings.
Multidisciplinary team (MDT) meetings have an important role in the management of head and neck cancer. Increasing incidence of the disease and a drive towards centralised meetings on large numbers of patients mean that effective discussions are pertinent. We aimed to evaluate new cases within a single high volume head and neck cancer MDT and to explore the relation between the time taken to discuss each case, the number of discussants, and type of case. ⋯ Most discussions on patients with early stage tumours were short (T1: 58% less than 60s, mean 90) and fewer people contributed. Many patients, particularly those with early stage disease, require little discussion, and their treatment might reasonably be planned according to an agreed protocol, which would leave more time and resources for those that require greater multidisciplinary input. Further studies may highlight extended discussions on patients with head and neck cancer, which may prompt a review of protocols and current evidence.
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Br J Oral Maxillofac Surg · Feb 2014
Patients' expectations and online presence of Oral and Maxillofacial Surgery in the United Kingdom.
In patient-centred medical practice, consideration of the patients' expectations is vital to the planning and delivery of service. Modern medicine must use the continuing advances in information technology to disseminate knowledge and raise awareness among patients and the public. People increasingly use the Internet to search for information on health, and the online presence of an organisation or a profession is known to bring a wide range of benefits. ⋯ There were none in Wales and Northern Ireland. Only half of the websites contained information that related to patients' expectations. Strategies to improve the content of websites for OMFS units and to improve their online presence are urgently needed.
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Br J Oral Maxillofac Surg · Feb 2014
Equine-associated maxillofacial injuries: retrospective 5-year analysis.
We explored the relation between the causes of facial injuries in equestrians and the presence or absence of associated injuries. Over a 5-year period we retrospectively reviewed all patients who presented to the John Hunter Hospital, New South Wales, with facial injuries that had resulted from activity with horses. We analysed the rates of hard and soft tissue injuries, and of associated injuries by sex and mechanism. ⋯ Women who had been kicked by a horse were more likely to sustain bony injuries than men (p<0.05). Our data confirm the association between kicks and facial fracture, and this may provide an impetus for the development of appropriate protective equipment. Patients who sustain facial injuries when falling from a horse often present with associated injuries and this has practical implications for clinicians involved in their management.
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Br J Oral Maxillofac Surg · Dec 2013
Comparative StudyA novel method of computer aided orthognathic surgery using individual CAD/CAM templates: a combination of osteotomy and repositioning guides.
The maxilla is usually positioned during orthognathic surgery using surgical splints, which has many limitations. In this preliminary study we present a new computer-aided design and manufacture (CAD/CAM) template to guide the osteotomy and the repositioning, and illustrate its feasibility and validity. Six patients with dental maxillofacial deformities were studied. ⋯ All patients were satisfied with the aesthetic results. Our CAD/CAM templates provide a reliable method for transfer of maxillary surgical planning, which may be a useful alternative to the intermediate splint technique. Our technique does not require traditional model surgery, scanning of dental casts, or recording of the CAD/CAM splint.
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Br J Oral Maxillofac Surg · Dec 2013
ReviewElective surgical cricothyroidotomy in oral and maxillofacial surgery.
Surgical Cricothyroidotomy is regarded as an emergency procedure today even though it has a good evidential record as an elective surgical airway. A misunderstanding of Jackson's landmark paper in 1921 has made the simple and safe procedure unpopular because of the fear of subglottic stenosis. We present the incidence of subglottic stenosis after surgical cricothyroidotomy, discuss evidence for elective surgical cricothyroidotomy, and suggest potential applications in oral and maxillofacial surgery.