The British journal of oral & maxillofacial surgery
-
Br J Oral Maxillofac Surg · Mar 2011
Randomized Controlled TrialPostoperative analgesia in orthognathic surgery patients: diclofenac sodium or paracetamol?
Our aim was to compare the analgesic affects of paracetamol and the non-steroidal anti-inflammatory drug (NSAID) diclofenac sodium for the relief of postoperative pain in patients having bimaxillary osteotomy. Thirty patients were randomly allocated into two groups (n = 15 in each) using sealed envelopes. The first group was given paracetamol 1g intravenously and the second diclofenac sodium 75 mg intramuscularly. ⋯ The intensity of postoperative pain was recorded on a visual analogue scale (VAS), and postoperative requests for analgesia, haemodynamic variables (systolic blood pressure and heart rate), and complications were compared. The groups were comparable. A single dose of diclofenac or paracetamol effectively decreases the intensity of postoperative pain after bimaxillary osteotomy.
-
Br J Oral Maxillofac Surg · Dec 2010
Maxillofacial injuries in military personnel treated at the Royal Centre for Defence Medicine June 2001 to December 2007.
Since its formation in June 2001, the Royal Centre for Defence Medicine (RCDM) at Birmingham University Hospitals NHS Foundation Trust has treated most of the British military personnel who have sustained serious maxillofacial injuries while serving abroad. We retrospectively analysed all recorded maxillofacial injuries of personnel evacuated to the RCDM between June 2001 and December 2007. We know of no existing papers that describe oral and maxillofacial injuries of military personnel, or workload in the 21st century. ⋯ There were 54 facial fractures of which 17 primarily affected the maxilla, and 15 the mandible. Associated injuries were to the brain (24%), torso (26%), upper limb (39%), and lower limb (31%). The number of maxillofacial injuries has risen over the last 7 years, and has also increased in proportion to the total number of injured soldiers evacuated between 2005 and 2007.
-
Br J Oral Maxillofac Surg · Sep 2010
Communication of the anterior branch of the great auricular nerve with the marginal mandibular nerve: A prospective study of 25 neck dissections.
The great auricular nerve originates from the cervical plexus (C2, 3) and supplies sensation to the lower part of the pinna and the skin overlying the angle of the mandible. We have previously reported an unusual anatomical variant where the anterior division of the great auricular nerve passed into the submandibular triangle and was joined on its deep surface by the marginal mandibular division of the facial nerve. ⋯ This may have clinical implications during operations on the neck, particularly as stimulation of a communicating nerve of the cervical plexus might result in depression of the lip, and could potentially cause the operating surgeon to think that it was a branch of the facial nerve. We think that this finding merits a cadaveric study to evaluate the relation more fully.
-
Br J Oral Maxillofac Surg · Sep 2010
Preoperative Doppler assessment of perforator anatomy in the anterolateral thigh flap.
Despite its many evident merits as a donor site, the principal disadvantage of the anterolateral thigh flap is the variability in its vascular anatomy. Preoperative assessment by Doppler of the vascular perforators has been advocated as routine. We report the accuracy of this method, and describe the strategy for rescue where adequate perforators are not evident. ⋯ This overall trend towards false positives was exaggerated in thin thighs, but in the obese there were more false negative results. In 79% of cases explored medially it would have been possible to raise an apparently viable anteromedial thigh flap. As this can be done without extending the incision, it is the option of choice for rescue, although use of more proximal perforators may often be possible.