The British journal of oral & maxillofacial surgery
-
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.
-
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.
-
Br J Oral Maxillofac Surg · Dec 2013
Case ReportsManagement of airway and feeding difficulties in a neonate with Pierre Robin sequence: a case report.
Pierre Robin sequence is a congenital disorder that affects neonates, and is characterised by the classic triad of micrognathia, glossoptosis, and cleft of the secondary palate. We present the case of a child with Pierre Robin sequence who had severe respiratory distress and feeding problems, and describe a simple technique for forward traction of the mandible to relieve the respiratory distress and activate the tongue.
-
Br J Oral Maxillofac Surg · Dec 2013
Observational StudyComputer-assisted orthognathic surgery: waferless maxillary positioning, versatility, and accuracy of an image-guided visualisation display.
There may well be a shift towards 3-dimensional orthognathic surgery when virtual surgical planning can be applied clinically. We present a computer-assisted protocol that uses surgical navigation supplemented by an interactive image-guided visualisation display (IGVD) to transfer virtual maxillary planning precisely. The aim of this study was to analyse its accuracy and versatility in vivo. ⋯ Seven hard tissue variables were chosen to compare (ΔT1-T0) the virtual maxillary planning (T0) with the postoperative result (T1) using 3-dimensional cephalometry. Clinically acceptable precision for the surgical planning transfer of the maxilla (<0.35 mm) was seen in the anteroposterior and mediolateral angles, and in relation to the skull base (<0.35°), and marginal precision was seen in the orthogonal dimension (<0.64 mm). An interactive IGV display complemented surgical navigation, augmented virtual and real-time reality, and provided a precise technique of waferless stereotactic maxillary positioning, which may offer an alternative approach to the use of arbitrary splints and 2-dimensional orthognathic planning.