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. · Mar 2008
ReviewTemporal bone fractures: a review for the oral and maxillofacial surgeon.
Fracture of the temporal bone is, by definition, a fracture of the skull base. Even though the oral and maxillofacial surgeon (OMS) may not provide definitive management of temporal bone fractures or their sequelae, a working knowledge of this area is important for any surgeon participating in the care of patients with craniomaxillofacial trauma, because temporal bone fractures are often associated with injuries to other areas of the craniomaxillofacial skeleton and because these fractures are relatively frequent. In many centers, particularly community hospitals, the OMS may be the primary provider of care for facial trauma and will treat patients with clinical or radiographic evidence of temporal bone fractures. ⋯ This article briefly reviews the epidemiology of temporal bone injuries, as well as the pertinent anatomy, radiographic imaging findings, and ancillary testing maneuvers. It then presents a more detailed description of the various clinical findings and the associated management strategies. It concludes with a discussion of the subset of temporal bone fractures involving the temporomandibular joint.
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J. Oral Maxillofac. Surg. · Mar 2008
Comparative StudyOral squamous cell carcinoma margin discrepancy after resection and pathologic processing.
Resecting oral squamous cell carcinoma (SCC) with an appropriate margin of uninvolved tissue is critical in preventing local recurrence and making the decision regarding postoperative radiation therapy. This task can be difficult due to the discrepancy between margins measured intraoperatively and those measured microscopically by the pathologist after specimen processing. The goal of this study is to quantify and compare the amount of margin discrepancy observed based on tumor location and staging. ⋯ Oral SCC margin discrepancies after resection and specimen processing are highly significant. Tumors located in the buccal mucosa, retromolar trigone, and mandibular alveolar ridge show significantly greater discrepancies than tumors of the maxilla or oral tongue. Late stage tumors also show significantly greater margin discrepancies. These findings suggest that it might be prudent to consider oral site and staging when outlining margins to ensure adequacy of resection.
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J. Oral Maxillofac. Surg. · Mar 2008
Noma (cancrum oris) in human immunodeficiency virus infection and acquired immunodeficiency syndrome (HIV and AIDS): clinical experience in Zimbabwe.
This retrospective study describes the clinical features and management of noma (cancrum oris) in patients with HIV and AIDS. ⋯ Noma cases are on the increase in line with the current HIV and AIDS epidemic. Female children appear to be more commonly affected than their male counterparts. Reconstructive surgery is possible in patients with low CD4/CD8 ratios because of HIV infection.
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J. Oral Maxillofac. Surg. · Feb 2008
Randomized Controlled TrialHyaluronidase increases the duration of mepivacaine in inferior alveolar nerve blocks.
To evaluate the duration of the effect of mepivacaine when hyaluronidase is injected immediately prior to the end of pulpal anesthesia. ⋯ Hyaluronidase increases the duration of mepivacaine in inferior alveolar nerve blocks.