Advances in Oral and Maxillofacial Surgery最新文献

Enhanced experience in performing percutaneous tracheostomies during the COVID-19 pandemic resulted in changes to airway management protocol for patients undergoing major head and neck reconstructive surgery within our department. Most patients now receive a percutaneous tracheostomy over the previously favoured surgical tracheostomy. The aim of this study was to review our experience in performing percutaneous tracheostomies, whilst comparing complication rates with surgical tracheostomies performed in similar settings. All consecutive patients undergoing free flap reconstructive surgery for head and neck cancer between June 2020 and November 2021 were included, with 56 patients receiving a percutaneous tracheostomy. Data across a range of variables including age, BMI, comorbidities and complications was compared with 56 surgical tracheostomies performed for the same group of patients before the COVID-19 pandemic and resultant protocol changes. In the percutaneous group, a marginally lower complication rate was observed over the surgical tracheostomy group; 28.57% and 30.35% respectively. Analysis of the 16 patients who experienced complications in the percutaneous group led to development of selection criteria to identify appropriate patients to receive a percutaneous tracheostomy in future, based on factors such as BMI, bleeding risk and positioning deformities. The COVID-19 pandemic has offered a multitude of learning experiences for healthcare professionals to change our practice. In our unit, this has involved modifying the routine tracheostomy procedure used for airway management intra- and post-operatively in major head and neck reconstruction surgery.

Still in today's advanced era to reconstruct surgical abnormalities following removal of upper airway and proximal esophageal malignancies is regarded a herculean task which does require tremendous surgical experience and expertise and multidisciplinary team work. In this short communication we are presenting a case of advanced carcinoma hypopharynx which was surgically managed with laryngopharyngoesophagectomy with Robotic assistance.

Objective

To investigate the effect of “X"-shaped cross-compression dressing of nasal root in rhytidectomy surgery.

Methods

From 2019.01 to 2022.02, 60 patients with high SMAS facelift in our department were selected to undergo “X"-shaped cross compression bandaging of the nasal root, and the incidence of postoperative hematoma and skin necrosis were counted.

Results

There were two small-scale hematomas, and no flap infection and skin necrosis were observed postoperatively.

Conclusion

Nasal “X"-shaped cross-compression bandaging method is reliable. It can effectively prevent the occurrence of postoperative hematoma and other complications and significantly improve patients' comfort.

Evidence based medicine(ebm) level

IV.

Objective

Understanding the extent of social reintegration is crucial in providing social support to patients. The incidence and treatment of oral cancer can result in functional and aesthetic impairments that significantly affect the daily lives of patients. Therefore, we aimed to determine the social adaptation status of patients after oral cancer surgery.

Methods

Patients who had undergone resection and reconstructive surgery with free flaps for oral cancer between February 2017 and October 2020 and agreed to participate in this study were included. The social adaptation status of patients was assessed using the Japanese version of the Social Adaptation Self-evaluation Scale (SASS-J; higher scores denote better social adaptation) preoperatively and at 3- and 6-months postoperatively.

Results

Thirty-four patients completed the SASS-J questionnaire. The median preoperative and 3- and 6-month postoperative SASS-J scores were 34 (26.5–39.25), 33.5 (25–38), and 33.5 (30–40), respectively, and did not differ significantly between these three categories. Analysis of covariance (ANCOVA) of 6-month postoperative SASS-J scores revealed significant differences for both the primary site of cancer (F = 6.6024, p = 0.0007) and marital status (F = 11.6866, p = 0.0019). Furthermore, multiple comparisons for the primary site of cancer indicated that the SASS-J scores of patients with tongue cancer were significantly lower than those of patients with mandibular cancer (p = 0.0178).

Conclusions

These results indicate that the postoperative social adaptation status among patients who underwent oral cancer resection with reconstruction is worse in patients with tongue cancer and in those who are unmarried.

In late years, combination of Cisplatin and Docetaxel, S-1 (as follows: a TPS therapy) show a high effect in induction chemotherapy in the oral carcinoma, we are said to be it, and it is used. We receive TPS therapy for carcinoma in the oral floor (T2N2bM0) this time and report our experience with the case that had a complete response. 61-years-old men, with squamous cell carcinoma in the Left oral floor (T2N2bM0) was diagnosed than a clinical examination and image findings, an examination of histopathology. Because it was local progressive carcinoma, perform induction chemotherapy in a TPS therapy preoperative tumor reduction. The primary tumor, the cervical metastasis lymph nodes reduced after 1 course end remarkably. We performed floor of mouth part tumor resection and all left neck dissection. The histologic effect of treatment judgment were Grade3 for histopathology. Resist evaluation was CR. We follow it up, but it is primary and the cervical lymph nodes recurrence does not show it now either.

We conducted a survey for the application of Carnoy's solution in oral surgeons of China. The results showed that few oral surgeons use Carnoy's solution for the treatment of the odontogenic keratocyst and the reason for not using Carnoy's solution was the accession difficulty. It should be aware that Carnoy's solution is an effective complementary therapy for treating odontogenic keratocyst but omitted by most oral surgeons.

Aim and objectives

Facial suspension threads have been used in the last decades for the reposition of facial soft tissue. Nonetheless, it remains unclear which technique and/or material has the greatest lifting effect for the middle and lower face. To evaluate non-surgical thread lifts we used a novel “1 Point, 2 Targets, 12 Threads” Vectors technique, verified by 3D imaging of horizontal skin displacement, volume changes at the nasolabial sulcus, jawline, and repositioning of fat compartments in the middle third and lower face.

Material and methods

Thirty-six Caucasian patients (35 females and 1 male), with a mean age of 42 ± 4 years and a mean body mass index of 22.72 ± 0.72 kg/m², were analyzed. Polydioxanone bidirectional cog-barbed facial threads were introduced using a 21-gauge, 90-mm cannula, and the “1 Point, 2 Targets, 12 Threads” Vectors technique aimed towards the nasolabial fold and the jawline. Vectra H2 software was used to calculate horizontal lift skin displacement changes, volume reduction in the nasolabial fold and jawline and volume reposition of the middle third.

Results

Mean horizontal skin displacement (left side, 2.75 ± 1.17 mm vs right side, 2.84 ± 1.40 mm) was 2.80 ± 1.06 mm, with no statistical significance (p = 0.8349). The mean volume change of the nasolabial fold was −0.09 ± 0.47 cc (left, −0.02 ± 0.45 cc vs right, −0.16 ± 0.58 cc), with no statistically significant difference (p = 0.1991). The mean volume change of jawline was −0.36 ± 0.43 cc (left, −0.36 ± 0.43 cc vs right, −0.37 ± 0.54 cc) with no statistically significant difference (p = 0.4561). Mean volume repositioning of the middle superficial fat compartments was 1.34 ± 0.79 cc (left 1.24 ± 0.84 vs right 1.43 ± 1.01 cc), with no statistically significant difference (p = 0.1897).

Conclusion

This is the first study to generate evidence of an objective measurement of non-surgical anatomical lifting with threads. More clinical studies utilising digital soft tissue facial anthropometry will be essential in clinical practice to verify this non-surgical lifting treatment.

Introduction

Mucous Retention cyst is a mass of fluid containing serous or mucous. Nasal septum deviation (NSD) is a condition that may cause sinusitis in severe cases. In addition, the frequency of maxillary sinus retention cysts is higher in patients with sinusitis than in patients without sinusitis. This study aimed to evaluate the retention cyst in the paranasal sinuses in patients with septum deviation compared with those without NSD.

Materials and methods

This observational study was performed by simple random sampling from CBCT scans of patients over 18 years’ old those referred to the radiology department of Isfahan Dental School (Khorasgan) 100 patients with NSD and 100 patients with no NSD. Data were analyzed by independent samples t-test, Mann-Whitney U test, Chi-square, and Fisher exact tests.

Results

Mucous retention cysts were observed in 5% of patients without NSD and 19% of patients with NSD (p = 0.002). Also, the number of cyst retention was significantly higher in patients with NSD (p = 0.002) but there was no significant relationship between cyst side and nasal deviation in patients with NSD (p = 1.00).

Conclusion

There was a significant relationship between the occurrence of mucous retention cysts and NSD and the number of cysts in the group with greater deviation.