The British journal of oral & maxillofacial surgery
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Br J Oral Maxillofac Surg · Feb 2014
Analysis of time taken to discuss new patients with head and neck cancer in multidisciplinary team meetings.
Multidisciplinary team (MDT) meetings have an important role in the management of head and neck cancer. Increasing incidence of the disease and a drive towards centralised meetings on large numbers of patients mean that effective discussions are pertinent. We aimed to evaluate new cases within a single high volume head and neck cancer MDT and to explore the relation between the time taken to discuss each case, the number of discussants, and type of case. ⋯ Most discussions on patients with early stage tumours were short (T1: 58% less than 60s, mean 90) and fewer people contributed. Many patients, particularly those with early stage disease, require little discussion, and their treatment might reasonably be planned according to an agreed protocol, which would leave more time and resources for those that require greater multidisciplinary input. Further studies may highlight extended discussions on patients with head and neck cancer, which may prompt a review of protocols and current evidence.
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Br J Oral Maxillofac Surg · Feb 2014
Patients' expectations and online presence of Oral and Maxillofacial Surgery in the United Kingdom.
In patient-centred medical practice, consideration of the patients' expectations is vital to the planning and delivery of service. Modern medicine must use the continuing advances in information technology to disseminate knowledge and raise awareness among patients and the public. People increasingly use the Internet to search for information on health, and the online presence of an organisation or a profession is known to bring a wide range of benefits. ⋯ There were none in Wales and Northern Ireland. Only half of the websites contained information that related to patients' expectations. Strategies to improve the content of websites for OMFS units and to improve their online presence are urgently needed.
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Br J Oral Maxillofac Surg · Feb 2014
Equine-associated maxillofacial injuries: retrospective 5-year analysis.
We explored the relation between the causes of facial injuries in equestrians and the presence or absence of associated injuries. Over a 5-year period we retrospectively reviewed all patients who presented to the John Hunter Hospital, New South Wales, with facial injuries that had resulted from activity with horses. We analysed the rates of hard and soft tissue injuries, and of associated injuries by sex and mechanism. ⋯ Women who had been kicked by a horse were more likely to sustain bony injuries than men (p<0.05). Our data confirm the association between kicks and facial fracture, and this may provide an impetus for the development of appropriate protective equipment. Patients who sustain facial injuries when falling from a horse often present with associated injuries and this has practical implications for clinicians involved in their management.
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Br J Oral Maxillofac Surg · Feb 2014
Randomized Controlled Trial Comparative StudyThe effect of endotracheal tube cuff pressure control on postextubation throat pain in orthognathic surgeries: a randomized double-blind controlled clinical trial.
Pain in the throat after extubation is one of the most common complaints after maxillofacial operations under general anaesthesia. We have evaluated the amount of pain after extubation when we controlled the pressure in the endotracheal cuff during operation by analysing the records of 43 patients who had maxillofacial operations under general anaesthesia. In the study group (n=20) the cuff pressure of the endotracheal tube was adjusted using a pressure gauge at the beginning of intubation and every hour during operation. ⋯ Throat pain was evaluated 1, 6, and 24h postoperatively on a visual analogue scale (VAS), and the pain scores in the control and study groups postoperatively was 5.3 (1.1) compared with 3.9 (1.5) (p=0.002); 4.5 (1.3) compared with 3.1 (1.5) (p=0.002); and 1.9 (1.1) compared with 1.6 (1.2) (p=0.4), respectively. The differences between the two groups at 1h and 6h postoperatively were significant, but that at 24h was not. Control of the cuff pressure of the endotracheal tube with a gauge at the beginning of the operation, and adjustment of the pressure during operation, can reduce postoperative complications such as throat pain.