Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery
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J Craniomaxillofac Surg · Jul 2014
What patients consider important: temporal variations by early and late stage oral, oropharyngeal and laryngeal subsites.
Functional outcomes are of high priority to cancer patients and are relevant when considering treatment strategies. This study aimed to collate and analyse importance rankings of UW-QOL over time for patients treated with curative intent for primary head and neck squamous cell carcinoma between 2000 and 2010, and to compare early and late stage oral, oropharyngeal and laryngeal subsites. There were 1614 patients comprising oral cavity 47% (751), oropharyngeal 24% (382), laryngeal 20% (320) and other HNC locations 10% (161). ⋯ Speech and activity were important for those with early laryngeal tumours, as were swallowing and speech for more advanced laryngeal tumours. Swallowing and saliva were more important in advanced tumours for all sites. This data confirms the priority patients place on swallowing, chewing, speech, and saliva, therefore curative treatments should optimise these functions wherever possible and provide access to post-treatment interventions as required.
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J Craniomaxillofac Surg · Apr 2014
Randomized Controlled Trial Comparative StudyComparison of general anaesthesia versus regional anaesthesia with sedation in selected maxillofacial surgery: a randomized controlled trial.
The airway is the foremost challenge in maxillofacial surgery. The major concerns are difficulty in managing the patient's airway and sharing it between the anaesthetist and surgeons. General anaesthesia, with endotracheal intubation, is the commonly used technique for maxillofacial procedures. We assessed the efficacy and safety of a regional block with sedation technique in certain maxillofacial operations, specifically temporomandibular joint (TMJ) ankylosis and mandibular fracture cases, and compared it with conventional general anaesthesia. We compared the time to discharge from the post anaesthesia care unit (PACU) and the occurrence of side effects, as well as surgeon and patient satisfaction with the anaesthetic technique, between the two groups. ⋯ Regional block with sedation is a safe alternative technique for patients undergoing surgery for mandible fracture or TMJ ankylosis, with clear advantages over general anaesthesia.
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J Craniomaxillofac Surg · Apr 2014
Epidemiological analysis of maxillofacial fractures treated at a university hospital, Xinjiang, China: A 5-year retrospective study.
To investigate the epidemiological characteristics of maxillofacial fractures treated at a university hospital, Xinjiang, China over a 5-year period. ⋯ Road traffic accident is the most common cause of maxillofacial fractures in China, which is characterized by an increasing prevalence and resulting in more associated injuries. Thus, more attention should be paid on the prevention and treatment of these injuries caused by road traffic accidents in our country.
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J Craniomaxillofac Surg · Mar 2014
Case ReportsOne-step primary reconstruction for complex craniofacial resection with PEEK custom-made implants.
Reconstruction of large craniofacial defects has largely improved since custom-made implants have been developed in the past decade. For large lesions in fronto-orbital region (such as osteomeningioma), we applied a simple and reliable protocol to perform optimal primary reconstruction with PEEK (polyetheretherketone) specific implant at the same time of the resection. ⋯ We provide a simple one-step technique to reconstruct the orbit while achieving symmetric cosmetic and functional results, reducing operative time and avoiding donor site morbidity.
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J Craniomaxillofac Surg · Dec 2013
Comparative StudyMicrovascular training of medical students and surgeons - a comparative prospective study.
Since microsurgical experience remains the most important skill in various surgical fields it should be in general part of the training program, either in medical studies or residency. This study compares the results of microsurgical education after completion of a comprehensive microsurgical course program between students and surgeons. 59 clinical medical students and 19 surgeons participated at a weekly 14-day microsurgical training course. Two examiners assessed the participants independently and blinded. ⋯ Prior to participation the students described an ambition to a career in a specialty performing microsurgery in 23 cases, after the microsurgical course following completion 50 participants worked in a surgical field. Microsurgical education can be part of undergraduate medical studies. The microsurgery training course influenced the students' ambition in relation to microsurgery as a future career.