The British journal of oral & maxillofacial surgery
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Br J Oral Maxillofac Surg · Sep 2011
Case ReportsA novel method of managing persistent parotid sialocele.
Sialocele formation is a recognised complication of parotid surgery. The initial management is usually conservative and often effective. We present a novel method that utilises an intra-oral approach and pig-tail catheter for safely and rapidly draining a large persistent sialocele. It is particularly appropriate when other methods have failed and the skin is at risk of breakdown.
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Br J Oral Maxillofac Surg · Sep 2011
Oral and maxillofacial surgical contribution to 21 months of operating theatre activity in Kandahar Field Hospital: 1 February 2007-31 October 2008.
Our aim was to assess oral and maxillofacial operating theatre activity at the NATO Multinational Medical Unit at Kandahar Airfield (MMU KAF). We made a retrospective analysis of the theatre logbook of the MMU KAF between 1 February 2007 and 31 October 2008. During that period, 1778 operations were done for 1639 patients. ⋯ Brain injuries were also more common among this group of patients than among the other groups, showing that helmets have only a limited effect in protecting against the effects of blast injury. Of all procedures, 163 operations (9%) were done for children. Training of general surgeons is becoming more specialised, which may result in greater dependence on larger teams of subspecialists (including oral and maxillofacial surgeons) in future conflicts.
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Br J Oral Maxillofac Surg · Sep 2011
Comparative StudyReducing postoperative pain by changing the process.
Untreated postoperative pain is an important ethical and financial issue that can lead to unnecessary suffering and prolonged stays in hospital. Despite the availability of effective analgesics and a growing body of published material that supports their use, postoperative pain remains a problem worldwide. To reduce acute postoperative pain, we introduced an intervention combining evidence-based analgesic protocols with the education of staff and patients on a surgical ward. ⋯ Inadequately controlled pain was significantly reduced after the intervention, which suggests that the introduction of analgesic protocols supported by the education of staff and patients can be beneficial. Despite this, severe pain remained relatively common, indicating room for improvement. Duration of pain and patient satisfaction were not affected by the intervention, and patient satisfaction remained high throughout the study.
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Br J Oral Maxillofac Surg · Jul 2011
Provision of oral medicine in departments of oral and maxillofacial surgery in the UK: national postal questionnaire survey 2009.
We investigated the current provision of oral medicine in oral and maxillofacial (OMF) departments in the UK. We examined the number of specialists in oral medicine in OMF departments, the training given to OMF consultants in oral medicine, and the estimated time dedicated to treating patients with oral medical conditions in outpatient clinics. We also examined the pattern and reasons for onward referrals to departments of oral medicine. ⋯ Sixteen surgeons (9%) referred 1-2 patients/week to departments of oral medicine, and 19 (10%) referred 2-4/month. Reasons for referral included need for specialist expertise, failure of treatment, and lack of time in outpatients. The proposal for a dentally qualified consultant-led oral medicine service was supported by 70 responding surgeons (38%).
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Anaesthesia for maxillofacial surgery presents unique challenges for the anaesthetist, and chiefly involves management of the airway. This article will review some of the recent advances in maxillofacial anaesthesia.