Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons
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J. Oral Maxillofac. Surg. · Jul 2019
Frequency of Cervical Spine Injuries in Pediatric Craniomaxillofacial Trauma.
In pediatric patients with craniomaxillofacial (CMF) trauma, evaluation for cervical spine injury (CSI) is critical, but there are no studies investigating CSI in this unique population. The aim of this study was to measure the frequency of CSI in the pediatric CMF fracture population. ⋯ CSIs in pediatric patients with CMF fracture are rare (frequency, 0.169%); this is considerably lower than the reported ranges in adults (3.69 to 24%). No child with deciduous dentition was found to have a CSI. The lack of CSI in deciduous patients with CMF fracture could be explained by the anatomic differences between pediatric and adult cervical spines and supports conservative imaging for children in this age group (level of evidence, III).
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J. Oral Maxillofac. Surg. · Jun 2019
Preoperative Assessment of Obstructive Sleep Apnea in the Ambulatory Anesthesia Patient: A Survey of Oral and Maxillofacial Surgery Providers.
Oral and maxillofacial surgeons often treat patients with both diagnosed and undiagnosed obstructive sleep apnea (OSA). Patients with OSA are at substantial risk of perioperative and postoperative complications after receiving intravenous sedation, general anesthesia, or postoperative opiate analgesia. The purpose of this study was to determine whether oral and maxillofacial surgery (OMS) providers are screening patients for perioperative and postoperative risks related to OSA before office-based ambulatory anesthesia. ⋯ Most of the surveyed OMS providers are not screening pre-anesthesia patients for OSA with a quantifiable method such as the STOP-Bang questionnaire. These findings identify a need to investigate the rate of undiagnosed OSA syndrome in the OMS office-based ambulatory anesthesia patient population. The STOP-Bang questionnaire may be a useful tool to better assess for anesthesia risk and modify management accordingly.
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J. Oral Maxillofac. Surg. · Jun 2019
Randomized Controlled TrialThe Effects of Music Listening During Extraction of the Impacted Mandibular Third Molar on the Autonomic Nervous System and Psychological State.
Pain, anxiety, and nervousness related to dental procedures can cause acute changes in the autonomic nervous system. Music is widely accepted as a relaxation method during dental treatment; however, its effects during dental treatment are unclear. The authors explored the effects of listening to music during extraction of the impacted mandibular third molar on the autonomic nervous system and the psychological state and hypothesized that listening to music would suppress sympathetic nervous activity and decrease anxiety. ⋯ This study suggested that listening to music while undergoing extraction of the impacted mandibular third molar suppresses activity of the sympathetic nerves during incision, flap reflection, bone removal, and separation of the tooth crown and relieves anxiety after treatment. Future studies will focus on the mechanisms involved and methods to prevent the onset of systemic incidents.
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J. Oral Maxillofac. Surg. · May 2019
Rate of Submandibular Gland Involvement in Oral Squamous Cell Carcinoma.
Whether the submandibular gland (SMG) can be preserved during neck dissection in the surgical treatment of oral squamous cell carcinoma (OSCC) is controversial. This study investigated the SMG involvement rate and provides a basis for preserving the SMG during neck dissection in appropriate cases of OSCC. ⋯ The rate of SMG involvement in OSCC is very low, and the most common mode of involvement is by direct spread. The SMG might be preserved during neck dissection in OSCC when it is unlikely to be involved through direct spread.