Pub Date : 2025-01-16DOI: 10.1016/j.adoms.2025.100515
Alice Cameron , Simon Haworth , Jerry N. Farrier
In our previous service evaluation, we reported improvement in patients’ pain scores for masseteric pain and spasm, following injection of 50 units of botulinum toxin A (BtA), measured using visual analogue scales (VAS). We have recently introduced a lower dose BtA protocol, for appropriately selected patients, aimed to evaluate whether this is also effective at relieving symptoms of masseteric pain and spasm. The rationale was to reduce side-effects and costs.
VAS scores were measured before and after treatment for 48 patients who received treatment with the original BtA protocol (“Protocol A” - the historical cohort who received 50 units) and for 46 patients who receieved a modified BtA protocol (“Protocol B” - the current cohort who received 25 units).
Patients in both treatment groups reported severe symptoms prior to treatment. Patients who received protocol B reported, on average, a 5 unit improvement in VAS following treatment (95 % confidence interval 4.3 to 5.7 improvement in VAS). There was no evidence that protocol B was less effective, despite the lower dose.
We recommend a reduced dose of BtA, of 25 units, for injection for appropriately selected patients with masseteric pain and spasm. A lower dose of BtA reduces wastage, particularly for single muscles injection and may reduce the incidence of unwanted side-effects. Reducing the standard dose of BtA will reduce costs for healthcare providers and may therefore facilitate funding for provision of intramuscular injection of BtA, where justified.
{"title":"Patient-centred evaluation of a reduced dose of botulinum toxin A in the management of myofascial pain","authors":"Alice Cameron , Simon Haworth , Jerry N. Farrier","doi":"10.1016/j.adoms.2025.100515","DOIUrl":"10.1016/j.adoms.2025.100515","url":null,"abstract":"<div><div>In our previous service evaluation, we reported improvement in patients’ pain scores for masseteric pain and spasm, following injection of 50 units of botulinum toxin A (BtA), measured using visual analogue scales (VAS). We have recently introduced a lower dose BtA protocol, for appropriately selected patients, aimed to evaluate whether this is also effective at relieving symptoms of masseteric pain and spasm. The rationale was to reduce side-effects and costs.</div><div>VAS scores were measured before and after treatment for 48 patients who received treatment with the original BtA protocol (“Protocol A” - the historical cohort who received 50 units) and for 46 patients who receieved a modified BtA protocol (“Protocol B” - the current cohort who received 25 units).</div><div>Patients in both treatment groups reported severe symptoms prior to treatment. Patients who received protocol B reported, on average, a 5 unit improvement in VAS following treatment (95 % confidence interval 4.3 to 5.7 improvement in VAS). There was no evidence that protocol B was less effective, despite the lower dose.</div><div>We recommend a reduced dose of BtA, of 25 units, for injection for appropriately selected patients with masseteric pain and spasm. A lower dose of BtA reduces wastage, particularly for single muscles injection and may reduce the incidence of unwanted side-effects. Reducing the standard dose of BtA will reduce costs for healthcare providers and may therefore facilitate funding for provision of intramuscular injection of BtA, where justified.</div></div>","PeriodicalId":100051,"journal":{"name":"Advances in Oral and Maxillofacial Surgery","volume":"17 ","pages":"Article 100515"},"PeriodicalIF":0.0,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143095719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-06DOI: 10.1016/j.adoms.2024.100513
Rebecca T. Bernstein, Aphra Garner-Purkis, Jennifer E. Gallagher, Sasha Scambler
The objective was to examine the social impacts of treatment and rehabilitation on patients with head and neck cancer (HNC). Following a comprehensive search of OVID (Embase, Medline, Pubmed, PsycINFO) and Web of Science, the Mixed Methods Appraisal Tool (MMAT) was used to assess the methodological quality of all included studies. The findings were reported using Preferred Reporting Items of Systematic review and Meta-Analyses (PRISMA) checklist. From 14,661 papers identified, 46 were eligible for inclusion of which 25 were quantitative, 14 qualitative and 7 mixed methods. Most papers focussed on the theme of eating and swallowing impacts (n = 16), with the next most frequent group using general quality-of-life measures (n = 11). Methodological inadequacy concerned small sample sizes and relatively short follow-up times. Qualitative studies revealed a wide range of social impacts which affect patients relating to the cancer, therapeutic education, and the negative impact of treatment side effects over time. The literature suggests that HNC patients experience a range of social impacts linked to identity, relationships, activities undertaken, and cultural issues. This review concludes that more in-depth larger scale prospective research as well as qualitative research is urgently needed to ascertain how to optimize care for HNC patients.
{"title":"A systematic review of social impacts of treatment and rehabilitation of head and neck cancer patients","authors":"Rebecca T. Bernstein, Aphra Garner-Purkis, Jennifer E. Gallagher, Sasha Scambler","doi":"10.1016/j.adoms.2024.100513","DOIUrl":"10.1016/j.adoms.2024.100513","url":null,"abstract":"<div><div>The objective was to examine the social impacts of treatment and rehabilitation on patients with head and neck cancer (HNC). Following a comprehensive search of OVID (Embase, Medline, Pubmed, PsycINFO) and Web of Science, the Mixed Methods Appraisal Tool (MMAT) was used to assess the methodological quality of all included studies. The findings were reported using Preferred Reporting Items of Systematic review and Meta-Analyses (PRISMA) checklist. From 14,661 papers identified, 46 were eligible for inclusion of which 25 were quantitative, 14 qualitative and 7 mixed methods. Most papers focussed on the theme of eating and swallowing impacts (n = 16), with the next most frequent group using general quality-of-life measures (n = 11). Methodological inadequacy concerned small sample sizes and relatively short follow-up times. Qualitative studies revealed a wide range of social impacts which affect patients relating to the cancer, therapeutic education, and the negative impact of treatment side effects over time. The literature suggests that HNC patients experience a range of social impacts linked to identity, relationships, activities undertaken, and cultural issues. This review concludes that more in-depth larger scale prospective research as well as qualitative research is urgently needed to ascertain how to optimize care for HNC patients.</div></div>","PeriodicalId":100051,"journal":{"name":"Advances in Oral and Maxillofacial Surgery","volume":"17 ","pages":"Article 100513"},"PeriodicalIF":0.0,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143095346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-04DOI: 10.1016/j.adoms.2025.100514
Jaymit Patel, Mehmet Sen
Head and neck cancer is the fastest accelerating cancer. Radiotherapy is commonly used to treat head and neck cancer. Whilst radiotherapy is an effective treatment modality for head and neck cancer, it is associated with significant early and late side effects which impact on the quality of life of patients. The late side effects of radiotherapy (depending on the volume and dose) may cause irreversible problems such as dysphagia, xerostomia, dental decay, and osteoradionecrosis.
We performed a retrospective analysis of head and neck cancer cases treated with radiotherapy at Leeds Teaching Hospitals Trust, UK. The aim of this process was to perform an exploratory analysis into the potential risk factors for osteoradionecrosis, focussing on risk factors that would be identifiable at a pre-radiotherapy dental screening appointments. This methodology was not utilised to determine statistically significant correlations, but to inform future studies which may involve regression analysis, and subsequent risk prediction.
Our study confirms findings from previous studies suggesting that variables such as the timing of pre-radiotherapy extractions, the number of pre-radiotherapy extractions, and the smoking status of the patient may increase the risk of osteoradionecrosis. We found new potential risk factors which require further investigation, including the presence of dental pathology on the pre-treatment PET-CT. This novel finding may provide further indication of the patient specific risk for osteoradionecrosis.
{"title":"The association between head and neck radiotherapy, and osteoradionecrosis: A retrospective analysis of risk factors","authors":"Jaymit Patel, Mehmet Sen","doi":"10.1016/j.adoms.2025.100514","DOIUrl":"10.1016/j.adoms.2025.100514","url":null,"abstract":"<div><div>Head and neck cancer is the fastest accelerating cancer. Radiotherapy is commonly used to treat head and neck cancer. Whilst radiotherapy is an effective treatment modality for head and neck cancer, it is associated with significant early and late side effects which impact on the quality of life of patients. The late side effects of radiotherapy (depending on the volume and dose) may cause irreversible problems such as dysphagia, xerostomia, dental decay, and osteoradionecrosis.</div><div>We performed a retrospective analysis of head and neck cancer cases treated with radiotherapy at Leeds Teaching Hospitals Trust, UK. The aim of this process was to perform an exploratory analysis into the potential risk factors for osteoradionecrosis, focussing on risk factors that would be identifiable at a pre-radiotherapy dental screening appointments. This methodology was not utilised to determine statistically significant correlations, but to inform future studies which may involve regression analysis, and subsequent risk prediction.</div><div>Our study confirms findings from previous studies suggesting that variables such as the timing of pre-radiotherapy extractions, the number of pre-radiotherapy extractions, and the smoking status of the patient may increase the risk of osteoradionecrosis. We found new potential risk factors which require further investigation, including the presence of dental pathology on the pre-treatment PET-CT. This novel finding may provide further indication of the patient specific risk for osteoradionecrosis.</div></div>","PeriodicalId":100051,"journal":{"name":"Advances in Oral and Maxillofacial Surgery","volume":"17 ","pages":"Article 100514"},"PeriodicalIF":0.0,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143095720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-03DOI: 10.1016/j.adoms.2024.100512
Marshall F. Newman, Elizabeth Floodeen, Zachary Gardner
Background
Temporomandibular joint (TMJ) ankylosis is a challenging clinical entity and management is primarily surgical. Patients with neurological conditions such as epilepsy may be prone to frequent joint dislocations or trauma over their lifetimes. They may also undergo surgeries to prevent recurrent joint dislocation that may increase the risk of TMJ ankylosis. Epileptic patients represent a population in which treatment of TMJ ankylosis, particularly bilateral ankylosis, can be complicated by difficult airway or medical management in the postoperative period. Tracheostomy is not often required for airway management in patients undergoing total joint replacement for bilateral TMJ ankylosis but may be a useful surgical adjunct to increase treatment safety in certain patient populations. A multi-disciplinary approach to anti-epileptic medication management is also beneficial given potential difficulties with oral intake in patients with TMJ ankylosis.
Methods
A systematic review of the literature was undertaken for evaluation of available literature using the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). A representative case example was provided for consideration.
Results
Review of the available literature resulted in no articles addressing the potential utilization of tracheostomy in patients with TMJ ankylosis. A variety of literature is available for patients with craniofacial anomalies who may require tracheostomy and who may develop TMJ ankylosis from a young age, but no literature is available to provide evidenced-based treatment guidelines for adult patients with ankylosis who may be at increased risk for airway compromise. Medical management of patients with refractory seizure activity can be difficult to optimize, and treatment regimens may require alterations during the perioperative period for patients undergoing TMJ total joint replacement.
Conclusions
Patients undergoing surgical treatment for bilateral TMJ ankylosis who also have neurological conditions such as epilepsy may be at increased risk for airway compromise during the postoperative period. Patients with difficult to control seizure activity may also be at increased risk for joint dislocation during the postoperative period of TMJ total joint replacement. Temporary tracheostomy represents a surgical option to improve patient safety in the immediate postoperative period along with appropriate medical management, and its consideration has not previously been reported for this patient population.
{"title":"Tracheostomy in temporomandibular joint ankylosis – A review of the literature and case report","authors":"Marshall F. Newman, Elizabeth Floodeen, Zachary Gardner","doi":"10.1016/j.adoms.2024.100512","DOIUrl":"10.1016/j.adoms.2024.100512","url":null,"abstract":"<div><h3>Background</h3><div>Temporomandibular joint (TMJ) ankylosis is a challenging clinical entity and management is primarily surgical. Patients with neurological conditions such as epilepsy may be prone to frequent joint dislocations or trauma over their lifetimes. They may also undergo surgeries to prevent recurrent joint dislocation that may increase the risk of TMJ ankylosis. Epileptic patients represent a population in which treatment of TMJ ankylosis, particularly bilateral ankylosis, can be complicated by difficult airway or medical management in the postoperative period. Tracheostomy is not often required for airway management in patients undergoing total joint replacement for bilateral TMJ ankylosis but may be a useful surgical adjunct to increase treatment safety in certain patient populations. A multi-disciplinary approach to anti-epileptic medication management is also beneficial given potential difficulties with oral intake in patients with TMJ ankylosis.</div></div><div><h3>Methods</h3><div>A systematic review of the literature was undertaken for evaluation of available literature using the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). A representative case example was provided for consideration.</div></div><div><h3>Results</h3><div>Review of the available literature resulted in no articles addressing the potential utilization of tracheostomy in patients with TMJ ankylosis. A variety of literature is available for patients with craniofacial anomalies who may require tracheostomy and who may develop TMJ ankylosis from a young age, but no literature is available to provide evidenced-based treatment guidelines for adult patients with ankylosis who may be at increased risk for airway compromise. Medical management of patients with refractory seizure activity can be difficult to optimize, and treatment regimens may require alterations during the perioperative period for patients undergoing TMJ total joint replacement.</div></div><div><h3>Conclusions</h3><div>Patients undergoing surgical treatment for bilateral TMJ ankylosis who also have neurological conditions such as epilepsy may be at increased risk for airway compromise during the postoperative period. Patients with difficult to control seizure activity may also be at increased risk for joint dislocation during the postoperative period of TMJ total joint replacement. Temporary tracheostomy represents a surgical option to improve patient safety in the immediate postoperative period along with appropriate medical management, and its consideration has not previously been reported for this patient population.</div></div>","PeriodicalId":100051,"journal":{"name":"Advances in Oral and Maxillofacial Surgery","volume":"17 ","pages":"Article 100512"},"PeriodicalIF":0.0,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143095408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-28DOI: 10.1016/j.adoms.2024.100500
Bianca Pulino , Jéssica Freitas de Andrade , Thiago Felippe Oliveira de Macedo , Geraldo Prestes de Camargo Filho , Andreas Neff , Raphael Capelli Guerra
Since the beginning of the 20th century, surgical techniques have greatly improved to provide more effective surgical treatment, minimise transoperative time, and restore function. When it comes to facial fractures, it is extremely important to minimise complications, such as facial nerve damage and scarring. The aim of this article was to address the main analyses of the types of condylar fractures and surgical approaches, providing the reader with existing possibilities to help them choose an approach which is effective and reduces the risk of complications.
{"title":"Surgical approaches for condylar fractures: An analysis of the advantages of transmeatal retroauricular access","authors":"Bianca Pulino , Jéssica Freitas de Andrade , Thiago Felippe Oliveira de Macedo , Geraldo Prestes de Camargo Filho , Andreas Neff , Raphael Capelli Guerra","doi":"10.1016/j.adoms.2024.100500","DOIUrl":"10.1016/j.adoms.2024.100500","url":null,"abstract":"<div><div>Since the beginning of the 20th century, surgical techniques have greatly improved to provide more effective surgical treatment, minimise transoperative time, and restore function. When it comes to facial fractures, it is extremely important to minimise complications, such as facial nerve damage and scarring. The aim of this article was to address the main analyses of the types of condylar fractures and surgical approaches, providing the reader with existing possibilities to help them choose an approach which is effective and reduces the risk of complications.</div></div>","PeriodicalId":100051,"journal":{"name":"Advances in Oral and Maxillofacial Surgery","volume":"17 ","pages":"Article 100500"},"PeriodicalIF":0.0,"publicationDate":"2024-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143095714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-16DOI: 10.1016/j.adoms.2024.100511
Nelson J. León , Stefanía Requejo , Ronar Gudiño , Henry García , Steven Rodríguez
Minimally invasive orthognathic surgery (MIOS) represents a significant paradigm shift in oral and maxillofacial surgery. The impact of MIOS on the temporomandibular joint (TMJ) remains a topic of debate. This case report aims to evaluate changes in mandibular condylar volume in the TMJ following MIOS and establish a foundation for further research in this area.
{"title":"Condylar volume changes following minimally invasive orthognathic surgery: A case report","authors":"Nelson J. León , Stefanía Requejo , Ronar Gudiño , Henry García , Steven Rodríguez","doi":"10.1016/j.adoms.2024.100511","DOIUrl":"10.1016/j.adoms.2024.100511","url":null,"abstract":"<div><div>Minimally invasive orthognathic surgery (MIOS) represents a significant paradigm shift in oral and maxillofacial surgery. The impact of MIOS on the temporomandibular joint (TMJ) remains a topic of debate. This case report aims to evaluate changes in mandibular condylar volume in the TMJ following MIOS and establish a foundation for further research in this area.</div></div>","PeriodicalId":100051,"journal":{"name":"Advances in Oral and Maxillofacial Surgery","volume":"17 ","pages":"Article 100511"},"PeriodicalIF":0.0,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143095852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-12DOI: 10.1016/j.adoms.2024.100510
Pascal Grün , Sepideh Hatamikia , Ruva Jadadic , Arb Gjergjindreaj , Lars Jansen , Florian Pfaffeneder-Mantai , Sebastian Fitzek , Margit Mostegel , Kyung-Eun Anna Choi , Dritan Turhani
Introduction
The Dental Apical Inflammation Score (DAIS) is a semi-quantitative histopathological score used to categorise apical inflammatory lesions. This score has shown clinical potential for assessment of wound-healing and infection risk in post-apical lesions.
Objective
This retrospective study aimed to investigate whether periapical lesion volume measurements obtained using manual segmentation on cone-beam computed tomography (CBCT) scans were related to the DAIS categorisation. In addition, the correlations of periapical lesion volume with treatment, anatomical sites, and histological diagnosis criteria were explored.
Lesions with a DAIS of 4 showed a significantly larger mean volume than those with a DAIS of 2 (p-value of 0.0377). Lesion volumes also showed a significant difference (p-value of 0.0157) in relation to the histological diagnosis types, with diagnosis based on the presence of radicular cysts being associated with a larger mean lesion volume than that based on the proportion of radicular cysts.
Discussion/conclusions
The volume of the preoperative periapical lesion correlates with both the DAIS category and histological diagnosis and can be used to assess inflammatory infiltrations, facilitating clinical decision-making and treatment-plan optimisation.
Pub Date : 2024-12-04DOI: 10.1016/j.adoms.2024.100509
Federico Stolbizer , María Luisa Paparella , María Magdalena Andrada , Diego Vázquez , María Elina Itoiz , Krissya María Villegas
{"title":"A Method to evaluate the efficacy of conservative treatment of intraosseous mandibular ameloblastoma","authors":"Federico Stolbizer , María Luisa Paparella , María Magdalena Andrada , Diego Vázquez , María Elina Itoiz , Krissya María Villegas","doi":"10.1016/j.adoms.2024.100509","DOIUrl":"10.1016/j.adoms.2024.100509","url":null,"abstract":"","PeriodicalId":100051,"journal":{"name":"Advances in Oral and Maxillofacial Surgery","volume":"17 ","pages":"Article 100509"},"PeriodicalIF":0.0,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143095483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-30DOI: 10.1016/j.adoms.2024.100507
Atanwo Nita Lise Dongmo, Edouma Bohimbo Jacques, Kwedi Karl, Mboya Marius, Nkollo Francis, Bengondo Messanga Charles
Introduction and general objective
Benign tumours develop locally and remain confined to the tissue in which they originate. They grow slowly. However, they can grow to significant size and weight. They rarely reoccur after surgical removal. Their evolution is generally favourable. In some cases, however, they can cause serious or even morbid complications, due to their location or metabolic disorders.There are two types of management for these tumours: conservative surgery, which consists of removing the tumour with a margin of healthy surrounding tissue, while preserving the role and appearance of the organ in question; and radical surgery, which is the removal of a diseased organ and all surrounding tissues likely to be affected by the disease. These treatments can lead to loss of substance, resulting in both functional and aesthetic sequelae.
The general objective of our study was to: Determine the aesthetic and functional sequelae of patients operated on for benign jaw tumours at the Yaoundé Central Hospital.
Methodology
We conducted a descriptive cross-sectional from January 1, 2013 to January 1, 2023 with prospective data collection in the ENT and Cervico Maxillofacial Surgery Department of the Yaoundé Central Hospital. Patient recruitment was consecutive and non-exhaustive. Epidemiological, clinical and anatomopathological data were collected, as well as the various aesthetic and functional sequelae.
This study concerned all patients operated on for benign tumours presenting anatomopathological evidence and having given their informed consent at the Yaoundé Central Hospital. Patients who were lost to follow-up, deceased or who had not given consent were excluded.
Results
39 patients were recruited; 16 men and 23 women, giving a sex ratio of 0.69. The mean age was 36.18 ± 15.38 years, a minimum of 14 years and a maximum of 71 years. Ameloblastoma was the most common tumour (38.5 %). The most common method of treatment was radical surgery, and the most common material used for reconstruction was the screw-plate (86.9 %). Sequelae were found in 35 patients (89.74 %), the most common functional sequelae being impaired mastication (92.5 %). Aesthetic sequelae were mainly marked by facial asymmetry (66.7 %).
Conclusion
The fourth decade of female gender was the most represented population among patients operated on for benign tumours of the jaws. Radical surgery was more commonly used in our work. Among the aesthetic sequelae in our study, we noted facial asymmetries, scars and their location were predominantly mandibular. The most common functional sequelae were impaired mastication, nerve damage and impaired speech.
{"title":"Aesthetic and functional sequelae of patients operated upon for benign jaw tumours at a tertiary hospital in Cameroon","authors":"Atanwo Nita Lise Dongmo, Edouma Bohimbo Jacques, Kwedi Karl, Mboya Marius, Nkollo Francis, Bengondo Messanga Charles","doi":"10.1016/j.adoms.2024.100507","DOIUrl":"10.1016/j.adoms.2024.100507","url":null,"abstract":"<div><h3>Introduction and general objective</h3><div>Benign tumours develop locally and remain confined to the tissue in which they originate. They grow slowly. However, they can grow to significant size and weight. They rarely reoccur after surgical removal. Their evolution is generally favourable. In some cases, however, they can cause serious or even morbid complications, due to their location or metabolic disorders.There are two types of management for these tumours: conservative surgery, which consists of removing the tumour with a margin of healthy surrounding tissue, while preserving the role and appearance of the organ in question; and radical surgery, which is the removal of a diseased organ and all surrounding tissues likely to be affected by the disease. These treatments can lead to loss of substance, resulting in both functional and aesthetic sequelae.</div><div>The general objective of our study was to: Determine the aesthetic and functional sequelae of patients operated on for benign jaw tumours at the Yaoundé Central Hospital.</div></div><div><h3>Methodology</h3><div>We conducted a descriptive cross-sectional from January 1, 2013 to January 1, 2023 with prospective data collection in the ENT and Cervico Maxillofacial Surgery Department of the Yaoundé Central Hospital. Patient recruitment was consecutive and non-exhaustive. Epidemiological, clinical and anatomopathological data were collected, as well as the various aesthetic and functional sequelae.</div><div>This study concerned all patients operated on for benign tumours presenting anatomopathological evidence and having given their informed consent at the Yaoundé Central Hospital. Patients who were lost to follow-up, deceased or who had not given consent were excluded.</div></div><div><h3>Results</h3><div>39 patients were recruited; 16 men and 23 women, giving a sex ratio of 0.69. The mean age was 36.18 ± 15.38 years, a minimum of 14 years and a maximum of 71 years. Ameloblastoma was the most common tumour (38.5 %). The most common method of treatment was radical surgery, and the most common material used for reconstruction was the screw-plate (86.9 %). Sequelae were found in 35 patients (89.74 %), the most common functional sequelae being impaired mastication (92.5 %). Aesthetic sequelae were mainly marked by facial asymmetry (66.7 %).</div></div><div><h3>Conclusion</h3><div>The fourth decade of female gender was the most represented population among patients operated on for benign tumours of the jaws. Radical surgery was more commonly used in our work. Among the aesthetic sequelae in our study, we noted facial asymmetries, scars and their location were predominantly mandibular. The most common functional sequelae were impaired mastication, nerve damage and impaired speech.</div></div>","PeriodicalId":100051,"journal":{"name":"Advances in Oral and Maxillofacial Surgery","volume":"17 ","pages":"Article 100507"},"PeriodicalIF":0.0,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143095484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-29DOI: 10.1016/j.adoms.2024.100508
Xue-gang Niu
We describe one case of the rehabilitation for large mandibular defect by the combined application of internal curvilinear and linear distraction osteogenesis. In the first operation, the transport discs were produced on both sides of the defect. The internal curvilinear and linear distraction were then performed Three months later, the defect was reduced by half, then in the second operation, the internal linear distraction osteogenesis bilateral to the residual defect was started. Another three months later, the newly-formed bone was evident in the distraction gaps, then in the third operation, the distracted transport bony discs were connected by a small local bone graft. By the steps, the 70 mm defect was reconstructed. This might be a practical way for the synchronous reconstruction of bony and soft tissue for large mandibular defects that do not require bone grafts from other anatomic areas.
{"title":"The reconstruction of large mandibular defect with combined distraction osteogenesis","authors":"Xue-gang Niu","doi":"10.1016/j.adoms.2024.100508","DOIUrl":"10.1016/j.adoms.2024.100508","url":null,"abstract":"<div><div>We describe one case of the rehabilitation for large mandibular defect by the combined application of internal curvilinear and linear distraction osteogenesis. In the first operation, the transport discs were produced on both sides of the defect. The internal curvilinear and linear distraction were then performed Three months later, the defect was reduced by half, then in the second operation, the internal linear distraction osteogenesis bilateral to the residual defect was started. Another three months later, the newly-formed bone was evident in the distraction gaps, then in the third operation, the distracted transport bony discs were connected by a small local bone graft. By the steps, the 70 mm defect was reconstructed. This might be a practical way for the synchronous reconstruction of bony and soft tissue for large mandibular defects that do not require bone grafts from other anatomic areas.</div></div>","PeriodicalId":100051,"journal":{"name":"Advances in Oral and Maxillofacial Surgery","volume":"17 ","pages":"Article 100508"},"PeriodicalIF":0.0,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143095715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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