The British journal of oral & maxillofacial surgery
-
Br J Oral Maxillofac Surg · Jul 2013
Marking the skin for oral surgical procedures: improving the WHO checklist.
We present a system for marking the skin during oral surgical operations. This system identifies teeth to be extracted or exposed under general anaesthesia. Removal of the wrong tooth can cause appreciable morbidity and leaves the surgeon and organisation liable for litigation and scrutiny by regulatory bodies. ⋯ In 2010/2011 the National Reporting and Learning System (NRLS) of the National Patient Safety Agency (NPSA) were notified of 20 incidents when the wrong tooth had been extracted, which accounted for 5% of all incidents reported. We have therefore developed a robust marking system for oral surgical procedures in our hospital, which improves on the World Health Organisation (WHO) checklist. We have audited patients' perceptions and the clinical application of our marking system, and have shown that the system is welcomed by patients, and is simple and effective for clinicians to use.
-
Br J Oral Maxillofac Surg · Jun 2013
Letter Comparative StudyDelays in head and neck surgery-managers, theatre usage and suboptimal efficiency.
-
Br J Oral Maxillofac Surg · Apr 2013
Comparative StudyEffect of different doses of transforming growth factor-β₁ on cartilage and subchondral bone in osteoarthritic temporomandibular joints.
Transforming growth factor-beta (TGF-β) plays an important part in the repair of cartilage in osteoarthritis. It has been hypothesised that intra-articular injection of TGF-β₁ promotes repair of cartilage and protects the subchondral bone from damage in osteoarthritic temporomandibular joints (TMJs). We made bilateral partial perforations of the disc to induce osteoarthritic joints in 36 rabbits. ⋯ Microcomputed tomography was used to quantify the three-dimensional microarchitecture of subchondral bone, followed by assessment of the proteoglycan content. All joints treated with TGF-β₁ were covered by a layer of well-organised fibrocartilage, and had increased proteoglycan content and normal microarchitectural properties, whereas the joint treated by vehicle alone had typical osteoarthritis-related degradation of cartilage and sclerosis of subchondral bone. These results suggested that TGF-β₁ is an effective way of treating osteoarthritis of the TMJ.
-
Br J Oral Maxillofac Surg · Mar 2013
Comparative StudyUse of the Venner™ A.P. Advance™ video laryngoscope for biopsy examination of the base of the tongue.
Biopsy specimens taken from the base of the tongue can be non-diagnostic, because of errors in sampling and tissue samples that are too small or superficial. The Venner™ A. ⋯ We present a pilot study that compares video laryngoscope-assisted biopsy examination of the base of the tongue with the standard technique using a surgical laryngoscope. The video laryngoscope gives a wide view of the base of the tongue and the ability to use sinus biopsy forceps, which can take larger and deeper specimens.
-
Br J Oral Maxillofac Surg · Mar 2013
Role of botulinum toxin A injection into the submandibular salivary glands as an assessment for the subsequent removal of the submandibular glands in the management of children with sialorrhoea.
Sialorrhoea is caused by an excessive production of saliva or a lack of muscular coordination at the initiation of the swallowing reflex during the voluntary phase. In children with neuromuscular disorders it can cause excoriation and social embarrassment. In adults, repeated injections of botulinum have been shown to be beneficial in the control of sialorrhoea, but in children, lack of cooperation necessitates general anaesthesia, and repeated injections would not be appropriate. ⋯ The mouth of one patient had become too dry after injection and the parents declined further surgery. The remaining 9 did not improve noticeably and continued to be managed medically. Injection of botulinum into the submandibular glands gives a reliable assessment of how much the salivary flow will be reduced after the submandibular gland has been removed.