International journal of oral and maxillofacial surgery
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The American Society of Anesthesiologists difficult airway algorithm identifies two acceptable emergency surgical airways in the 'cannot intubate, cannot ventilate' scenario: cricothyrotomy and tracheotomy. Little has been published regarding the emergency surgical airway practices at different institutions. The authors investigated whether the primary choice of emergency surgical airway at a major level I trauma centre was cricothyrotomy or tracheotomy. ⋯ Despite the emphasis in resident training and Advanced Trauma Life Support, there was a paucity of cricothyrotomies during the study period. At the authors' institution, tracheotomy is preferentially used as the emergency surgical airway. A multicentre prospective study is recommended to evaluate current practice in emergency surgical airway and to include the emergency open tracheotomy in residency training and continuing education if needed.
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Int J Oral Maxillofac Surg · Feb 2013
Effect of in vitro chondrogenic differentiation of autologous mesenchymal stem cells on cartilage and subchondral cancellous bone repair in osteoarthritis of temporomandibular joint.
This study investigated the effects of in vitro chondrogenic differentiated mesenchymal stem cells (MSCs) on cartilage and subchondral cancellous bone in temporomandibular joint osteoarthritis (TMJOA). Four weeks after induction of osteoarthritis (OA), the joints received hylartin solution, non-chondrogenic MSCs or in vitro chondrogenic differentiated MSCs. The changes in cartilage and subchondral cancellous bone were evaluated by histology, reverse transcription polymerase chain reaction and micro-computed tomography (CT). ⋯ Transplanted cells were observed at cartilage, subchondral bone, and the synovial membrane lining at 4 weeks. Intra-articular injection of MSCs could delay the progression of TMJOA, and in vitro chondrogenic induction of MSCs could enhance the therapeutic effects. This provides new insights into the role of MSCs in cell-based therapies for TMJOA.
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Int J Oral Maxillofac Surg · Feb 2013
Influence of pharyngeal flap surgery on maxillary outgrowth in cleft patients.
The aim of this study was to investigate the influence of the pharyngeal flap procedure on the frequency of Le Fort I osteotomies in full-grown nonsyndromic cleft patients. A retrospective review of 508 full-grown cleft patients born between 1 January 1983 and 31 December 1992 was performed. Following data analysis, 140 males older than 18 years and 111 females over the age of 16 years were included. 69 of the 251 included cleft patients required pharyngeal flap surgery (27.5%). ⋯ A significantly lower age at time of the initial pharyngeal flap procedure was found in patients requiring revision surgery (5.6 years versus 6.8 years). The frequency of Le Fort I osteotomies was significantly higher in the patients with a pharyngeal flap (19%) compared to those without (8%) (p<0.05). The results of this study point towards the pharyngeal flap procedure being one of the possible limiting factors for maxillary antero-posterior growth in cleft patients.