Journal of Oral and Maxillofacial Surgery最新文献

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IF 2.3 3区 医学
Journal of Oral and Maxillofacial Surgery Pub Date : 2025-04-01 DOI: 10.1016/S0278-2391(25)00074-6
{"title":"AAOMS Author Disclosure forms","authors":"","doi":"10.1016/S0278-2391(25)00074-6","DOIUrl":"10.1016/S0278-2391(25)00074-6","url":null,"abstract":"","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"83 4","pages":"Pages A9-A11"},"PeriodicalIF":2.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143746977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Transdermal Buprenorphine Patch in the Management of Postoperative Acute Pain Following Mandibular Resection and Reconstruction 丁丙诺啡经皮贴片治疗下颌骨切除重建术后急性疼痛。
IF 2.3 3区 医学
Journal of Oral and Maxillofacial Surgery Pub Date : 2025-04-01 DOI: 10.1016/j.joms.2024.12.002
Abid Rather MDS , Ashok Kumar Jena MDS , Soumya Sarkar MD , Alok Kumar Sethi MDS
{"title":"Transdermal Buprenorphine Patch in the Management of Postoperative Acute Pain Following Mandibular Resection and Reconstruction","authors":"Abid Rather MDS ,&nbsp;Ashok Kumar Jena MDS ,&nbsp;Soumya Sarkar MD ,&nbsp;Alok Kumar Sethi MDS","doi":"10.1016/j.joms.2024.12.002","DOIUrl":"10.1016/j.joms.2024.12.002","url":null,"abstract":"<div><h3>Background</h3><div>Transdermal buprenorphine is used for the management of postoperative pain. Its effectiveness for the postoperative pain management following mandibular resection and reconstruction has yet to be evaluated.</div></div><div><h3>Purpose</h3><div>To evaluate the efficacy of transdermal buprenorphine patch (TBP) in managing postoperative pain after mandibular resection and reconstruction with anterior iliac crest graft.</div></div><div><h3>Study design, setting and sample</h3><div>This triple-blinded, randomized controlled trial included 30 subjects in the age range of 18 to 60 years with benign mandibular pathologies. Subjects visiting the outpatient department of the Dept. of Dentistry, All India Institute of Medical Sciences, Bhubaneswar, India, were included in the study. Subjects with known allergies to any drugs, using sedatives, alcohol, pregnant and lactating mothers, and with respiratory problems were excluded.</div></div><div><h3>Predictor</h3><div>The predictor variable was postoperative pain management and subjects were randomly assigned to TBP or a placebo patch group.</div></div><div><h3>Main outcome variable</h3><div>It was the postoperative pain, which was measured by visual analog scale (VAS) for 7 consecutive days. Secondary outcome variables were requirement of rescue analgesics and drug-related adverse effects.</div></div><div><h3>Covariates</h3><div>Age at surgery, sex, diagnosis, duration of the operation, and amount of fentanyl used during the operation were covariates.</div></div><div><h3>Analyses</h3><div>Descriptive statistics, Mann–Whitney U test, χ<sup>2</sup>, repeated measures analysis of variance, and post-hoc analysis (Bonferroni test) were used. A <em>P</em> value &lt;.05 was considered a level of statistical significance.</div></div><div><h3>Results</h3><div>Thirty subjects were randomly allocated to TBP and control group. The mean VAS score during the study period was 0.8 ± 2.37, and 3.49 ± 2.37 in TBP and control group subjects respectively (<em>P</em> &lt; .001). Compared to control group, the mean VAS score in TBP group subjects were significantly less till the end of postoperative day 4 (<em>P</em> &lt; .001). The mean rescue analgesic requirement during the postoperative period was 5.33 ± 15.8 mg and 47.6 ± 37.7 mg in the TBP and control group subjects, respectively (<em>P</em> &lt; .001). Nausea was the most common drug-related adverse effect in both the group subjects (46.7%) (<em>P</em> &gt; .9).</div></div><div><h3>Conclusion and relevance</h3><div>The highest VAS score in TBP group subjects was 1.53 ± 0.92 on the morning of postoperative day 1, whereas it was 6.47 ± 1.3 at 6 hours after operation in control group subjects. Thus, a TBP was adequate for the management of postoperative pain following mandibular resection and reconstruction.</div></div>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"83 4","pages":"Pages 476-484"},"PeriodicalIF":2.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142872208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Effects of Combined Antiemetic Protocol for the Prevention of Postoperative Nausea and Vomiting in Orthognathic Surgery: A Randomized Double Blinded Clinical Study 联合止吐方案预防正颌手术术后恶心呕吐的效果:一项随机双盲临床研究。
IF 2.3 3区 医学
Journal of Oral and Maxillofacial Surgery Pub Date : 2025-04-01 DOI: 10.1016/j.joms.2024.12.010
Ozge Doganay Ozyilmaz DDS , Kemal Atakan Bayburt DDS, PhD , Alper Alkan DDS, PhD , Harun Uysal MD
{"title":"Effects of Combined Antiemetic Protocol for the Prevention of Postoperative Nausea and Vomiting in Orthognathic Surgery: A Randomized Double Blinded Clinical Study","authors":"Ozge Doganay Ozyilmaz DDS ,&nbsp;Kemal Atakan Bayburt DDS, PhD ,&nbsp;Alper Alkan DDS, PhD ,&nbsp;Harun Uysal MD","doi":"10.1016/j.joms.2024.12.010","DOIUrl":"10.1016/j.joms.2024.12.010","url":null,"abstract":"<div><h3>Background</h3><div>Postoperative nausea and vomiting (PONV) after orthognathic surgery remains one of the most common side effects despite the use of several medications.</div></div><div><h3>Purpose</h3><div>The study aimed to compare the frequencies of PONV between a combination of metoclopramide with granisetron and granisetron alone.</div></div><div><h3>Study Design, Setting, Sample</h3><div>A randomized double-blind clinical trial was conducted in 66 consecutive patients who underwent orthognathic surgery at the Department of Oral and Maxillofacial Surgery at Bezmialem Vakif University. Patients with contraindications such as hypersensitivity to medications, gastrointestinal or metabolic disorders, renal insufficiency, electrolyte imbalances, pregnancy, neurological diseases, prolonged QT interval, or mental retardation were excluded.</div></div><div><h3>Predictor Variable</h3><div>The predictor variable was the antiemetic treatment (combination vs single therapy). Participants were randomized to either the metoclopramide with granisetron group (group GM) or the granisetron-only group (group G).</div></div><div><h3>Main Outcome Variable</h3><div>The outcome variable was PONV status, measured using the simplified postoperative nausea and vomiting impact scale. The participants were assessed at baseline (when fully awake) and during the subsequent 24 hours.</div></div><div><h3>Covariates</h3><div>Patient characteristics, total drug doses, systolic and diastolic blood pressure, peripheral arterial oxygen saturation, Apfel’s PONV risk score, total bleeding volume, infused fluid volume, surgery duration, PONV incidence, visual analog scale scores, tramadol requirement, and the use of rescue antiemetics were determined as covariates.</div></div><div><h3>Analyses</h3><div>Data were analyzed using the Mann–Whitney <em>U</em> test with <em>P</em> value less than.05 considered significant.</div></div><div><h3>Results</h3><div>The sample consisted of 60 participants, with 30 patients in each treatment group. The mean age was 30 ± 11.6 years in group G and 25.63 ± 10 years in group GM (<em>P</em> = .1); 42% of participants were male (<em>P</em> = .8). PONV scores at the second hour were 1.56 ± 1.45 in group G and 0.79 ± 0.90 in group GM (<em>P</em> = .03). The difference between the groups was statistically significant (<em>P</em> &lt; .001). Participants in group G had a 1.61-fold higher risk of vomiting than those in the group GM (<em>Relative risk</em> = 1.61; 95% CI, 1.313 to 1.962).</div></div><div><h3>Conclusion and Relevance</h3><div>Compared to granisetron alone, the combination of granisetron and metoclopramide was associated with significant PONV control in patients undergoing orthognathic surgery. A multimodal approach may be adopted to reduce the incidence of PONV in patients undergoing maxillofacial surgery.</div></div>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"83 4","pages":"Pages 429-438"},"PeriodicalIF":2.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
What Are the Complications of Temporomandibular Joint Arthrocentesis? 颞下颌关节置换术中及术后早期并发症有哪些?
IF 2.3 3区 医学
Journal of Oral and Maxillofacial Surgery Pub Date : 2025-04-01 DOI: 10.1016/j.joms.2024.12.012
Burcu Baş PhD, DDS , Emine Asena Singer DDS , Rabia Tül Adeviye Çankaya DDS
{"title":"What Are the Complications of Temporomandibular Joint Arthrocentesis?","authors":"Burcu Baş PhD, DDS ,&nbsp;Emine Asena Singer DDS ,&nbsp;Rabia Tül Adeviye Çankaya DDS","doi":"10.1016/j.joms.2024.12.012","DOIUrl":"10.1016/j.joms.2024.12.012","url":null,"abstract":"<div><h3>Background</h3><div>Arthrocentesis is a minimally invasive procedure for treating intra-articular temporomandibular disorders. While it is considered relatively safe, like any surgical intervention, it carries potential risks.</div></div><div><h3>Purpose</h3><div>The study purpose was to estimate the frequency of complications associated with temporomandibular joint arthrocentesis, identify risk factors, and improve preparedness for effective prevention and management strategies.</div></div><div><h3>Study design</h3><div>In this retrospective cohort study, the investigators analyzed data from patients who underwent arthrocentesis treatment between 2015 and 2024 at Ondokuz Mayıs University, Faculty of Dentistry. Inclusion criteria were a diagnosis of painful intra-articular temporomandibular disorders. Patients with prior temporomandibular joint surgery or systemic conditions affecting joint function were excluded.</div></div><div><h3>Independent variable</h3><div>The independent variables included age, sex, and the presence of unilateral or bilateral arthrocentesis.</div></div><div><h3>Main outcome variables</h3><div>The main outcome variables are major (intervention required) and minor (no intervention) complications observed during the procedure and in the early follow-up period in patients. These complications include fluid extravasation, minor bleeding, transient facial paralysis, subcutaneous emphysema, external auditory fluid, and preauricular inflammation.</div></div><div><h3>Covariates</h3><div>Not applicable in this study.</div></div><div><h3>Analyses</h3><div>Descriptive statistics were used to report the occurrence of complications. The χ<sup>2</sup> test was used for categorical variables. As this is a case series, hypothesis testing is not feasible. A <em>P</em> value &lt;.05 was considered statistically significant.</div></div><div><h3>Results</h3><div>The sample comprised 210 subjects (252 joints) with a mean age of 39.16 ± 14.59 (18-82 years). Nine (4.29%) were male, and 201 (95.71%) were female. Major and minor complication rates observed in patients are 2.84 and 28.1%, respectively. The distribution of complications in the treated joints is as follows: fluid extravasation (25.71%), transient facial paralysis (14.28%), minor bleeding (1.9%), subcutaneous emphysema (0.47%), fluid outflow from the ear (0.95%), and preauricular infection (1.42%). A statistically significant relationship was found between transient facial paralysis and fluid extravasation (<em>P</em> &lt; .001). Bilateral arthrocentesis was defined as a risk factor (<em>P</em> = .003). No significant relationship was found between the independent variables and complications.</div></div><div><h3>Conclusions and relevance</h3><div>The findings indicate that complications during and after arthrocentesis are common but manageable. Understanding these complications and their frequencies is crucial for surgeons to know the associated risks.</div></div>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"83 4","pages":"Pages 414-420"},"PeriodicalIF":2.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Third Rail 第三轨
IF 2.3 3区 医学
Journal of Oral and Maxillofacial Surgery Pub Date : 2025-04-01 DOI: 10.1016/j.joms.2024.09.007
Thomas B. Dodson DMD, MPH (Editor-in-Chief)
{"title":"The Third Rail","authors":"Thomas B. Dodson DMD, MPH (Editor-in-Chief)","doi":"10.1016/j.joms.2024.09.007","DOIUrl":"10.1016/j.joms.2024.09.007","url":null,"abstract":"","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"83 4","pages":"Pages 397-398"},"PeriodicalIF":2.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143746978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Condyle Preservation in Patients With Mandibular Resection Is Associated With Enhanced Quality of Life and Function 下颌切除术患者保留髁突与提高生活质量和功能相关。
IF 2.3 3区 医学
Journal of Oral and Maxillofacial Surgery Pub Date : 2025-04-01 DOI: 10.1016/j.joms.2024.12.014
Hassan Mirmohammad Sadeghi DMD, MD , Mohammad Khosousi Sani DMD , Sahba Khosousi Sani DMD , Reza Tabrizi DMD , Shervin Shafiei DMD , Seyed Sepehr Mirebeigi-Jamasbi DMD
{"title":"Condyle Preservation in Patients With Mandibular Resection Is Associated With Enhanced Quality of Life and Function","authors":"Hassan Mirmohammad Sadeghi DMD, MD ,&nbsp;Mohammad Khosousi Sani DMD ,&nbsp;Sahba Khosousi Sani DMD ,&nbsp;Reza Tabrizi DMD ,&nbsp;Shervin Shafiei DMD ,&nbsp;Seyed Sepehr Mirebeigi-Jamasbi DMD","doi":"10.1016/j.joms.2024.12.014","DOIUrl":"10.1016/j.joms.2024.12.014","url":null,"abstract":"<div><h3>Background</h3><div>Operative treatment of advanced mandibular tumors may require excision of a portion of the mandible including the condyle. It is not clear how condylar excision affects postoperative quality of life (QoL).</div></div><div><h3>Purpose</h3><div>The study purpose was to measure the association between operative management of the condyle and postoperative health-related QoL and temporomandibular joint (TMJ) function.</div></div><div><h3>Study design, setting, and sample</h3><div>This prospective cohort study included patients with benign mandibular lesions who underwent hemi-mandibulectomy and were treated at Taleghani and Imam Hossein Hospitals in Tehran, Iran. Patients were excluded from the study if they had a history of preoperative or postoperative radiotherapy and chemotherapy, previous TMJ surgery or trauma, autoimmune diseases that affect TMJ function, bruxism or clenching, previous TMJ problems such as degenerative joint disease, failed to return for follow-up, or refused study enrollment.</div></div><div><h3>Predictor variable</h3><div>The predictor variable was operative management of the condyle and it was grouped into 2 levels, preserved or resected.</div></div><div><h3>Main outcome variable(s)</h3><div>The primary outcome was the oral health-associated QoL, which was determined using the Oral Health Impact Profile-14 questionnaire. Secondary outcome variables included maximum mouth-opening values, visual analog scale pain score, joint clicking, and joint crepitus. Outcome variables were determined pretreatment, immediately postsurgery, and 6 and 12 months postsurgery.</div></div><div><h3>Covariates</h3><div>Age, sex, and defect size were the study covariates.</div></div><div><h3>Analyses</h3><div>Repeated measures analysis of variance was conducted to compare QoL questionnaire scores, maximum mouth opening, and visual analog scale pain scores (<em>P</em> &lt; .05).</div></div><div><h3>Results</h3><div>The sample was composed of 46 subjects. Mean age was 46 ± 13.1 years in both groups and 25 patients (54%) were male. Presurgery QoL scores were 79.22 ± 1.72 for the resection group and 82.38 ± 1.21 for the preservation group (<em>P</em> = .6). At 12 months postsurgery, QoL, maximum mouth-opening, and pain scores were 65.89 ± 3.82, 31.56 ± 2.30, and 5.44 ± 2.45 for the resection group, while the preservation group showed significantly better scores with 78.69 ± 2.10, 40.77 ± 2.20, and 1.15 ± 0.90, respectively (<em>P</em> &lt; .001 for all).</div></div><div><h3>Conclusion and relevance</h3><div>Condyle preservation in resection treatments is associated with higher QoL scores, reduced TMJ pain, and increased maximum mouth opening. Preservation of the condyle should be considered during surgery whenever possible.</div></div>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"83 4","pages":"Pages 485-493"},"PeriodicalIF":2.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143039621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Use of Bipolar Nerve Stimulator as an Alternative to Neural Integrity Monitor During Hypoglossal Nerve Stimulator Placement 双极双极神经刺激器作为神经完整性监测器在舌下神经探查中的应用。
IF 2.3 3区 医学
Journal of Oral and Maxillofacial Surgery Pub Date : 2025-04-01 DOI: 10.1016/j.joms.2024.12.008
Ketan Patel PhD, DDS , Hannah Afwerke Lynch DDS
{"title":"Use of Bipolar Nerve Stimulator as an Alternative to Neural Integrity Monitor During Hypoglossal Nerve Stimulator Placement","authors":"Ketan Patel PhD, DDS ,&nbsp;Hannah Afwerke Lynch DDS","doi":"10.1016/j.joms.2024.12.008","DOIUrl":"10.1016/j.joms.2024.12.008","url":null,"abstract":"<div><div>Hypoglossal nerve stimulation is a key step in insertion of a hypoglossal nerve stimulator for sleep apnea. The hypoglossal nerve stimulator works through assessment of apneic events that result in stimulation of the protrusion fibers of the hypoglossal nerve causing protrusion of the tongue and opening of the oropharynx resulting in ability for the patient to adequately breath. Therefore, during insertion of the hypoglossal nerve stimulator, a key portion of the procedure is inclusion of the protrusive fibers of the hypoglossal nerve and exclusion of the retrusive fibers. In the past, this was assessed by neural integrity monitor, which has limitations such as difficult and time-consuming setup, bulky equipment, and increased sharps injury. Our institution, North Memorial Hospital in Robbinsdale, Minnesota, has updated our protocol to utilize a bipolar nerve stimulator, which has decreased operating time and use of sharps and increased accuracy of the procedure. This article further discusses utilization and benefit of the bipolar nerve stimulator for placement of hypoglossal nerve stimulators for sleep apnea patients.</div></div>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"83 4","pages":"Pages 439-441"},"PeriodicalIF":2.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142983900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Self-Irrigation Device for Intraoral Home Care 技术说明:用于口腔内家庭护理的自冲洗装置。
IF 2.3 3区 医学
Journal of Oral and Maxillofacial Surgery Pub Date : 2025-04-01 DOI: 10.1016/j.joms.2024.12.013
Liszen Tang MDS (Oral & Maxillofacial Surgery) , Kar Tsyeng Ng BDS , Mukhriz Hamdan MClinDent (Oral & Maxillofacial Surgery) , Rithuan Awang MClinDent (Oral & Maxillofacial Surgery)
{"title":"Self-Irrigation Device for Intraoral Home Care","authors":"Liszen Tang MDS (Oral & Maxillofacial Surgery) ,&nbsp;Kar Tsyeng Ng BDS ,&nbsp;Mukhriz Hamdan MClinDent (Oral & Maxillofacial Surgery) ,&nbsp;Rithuan Awang MClinDent (Oral & Maxillofacial Surgery)","doi":"10.1016/j.joms.2024.12.013","DOIUrl":"10.1016/j.joms.2024.12.013","url":null,"abstract":"<div><div>Following surgical treatment of a jaw cyst, bony cavities are formed. These cavities are prone to infection when they communicate with the oral environment. Hence, proper irrigation is a crucial aspect of postsurgical care, as it helps to reduce debris buildup and the risk of infection. However, the irrigation method of using a cannula is ineffective due to poor patient compliance. In response, we present a novel solution to this problem.</div></div>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"83 4","pages":"Pages 456-458"},"PeriodicalIF":2.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143039623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Role of Anticoagulation Regimen on Flap Outcome in Microvascular Head and Neck Reconstruction 抗凝治疗方案对微血管头颈部重建皮瓣预后的影响。
IF 2.3 3区 医学
Journal of Oral and Maxillofacial Surgery Pub Date : 2025-04-01 DOI: 10.1016/j.joms.2024.12.011
Samah Mouzannar MD , Amirmohsen Jalaeefar MD , Mohammad Shirkhoda MD , Fereidoon Memari MD , Ali Arab Kheradmand MD , Ata Garajei MD , Arshia Zardoui MD , Seyed Masoumeh Valizadeh-Otaghsara MSc , Amirmohammad Bakhtiari MSc , Amirsina Sharifi MD
{"title":"The Role of Anticoagulation Regimen on Flap Outcome in Microvascular Head and Neck Reconstruction","authors":"Samah Mouzannar MD ,&nbsp;Amirmohsen Jalaeefar MD ,&nbsp;Mohammad Shirkhoda MD ,&nbsp;Fereidoon Memari MD ,&nbsp;Ali Arab Kheradmand MD ,&nbsp;Ata Garajei MD ,&nbsp;Arshia Zardoui MD ,&nbsp;Seyed Masoumeh Valizadeh-Otaghsara MSc ,&nbsp;Amirmohammad Bakhtiari MSc ,&nbsp;Amirsina Sharifi MD","doi":"10.1016/j.joms.2024.12.011","DOIUrl":"10.1016/j.joms.2024.12.011","url":null,"abstract":"<div><h3>Background</h3><div>Thrombus formation following flap reconstruction reduces perfusion and can lead to flap compromise. Effective anticoagulation protocols are essential to prevent this complication.</div></div><div><h3>Purpose</h3><div>The study’s purpose was to measure and compare flap compromise associated with 3 different anticoagulation protocols.</div></div><div><h3>Study Design, Setting, Sample</h3><div>This retrospective cohort study included patients with head and neck cancer who underwent flap reconstruction. Exclusion criteria included patients who did not consent to participate, did not receive the anticoagulation regimen, or had a history of adverse reactions to heparin or aspirin (ASA).</div></div><div><h3>Exposure</h3><div>The primary exposure was the anticoagulation protocol, which was divided into 3 groups: intravenous unfractionated heparin (IV-UFH), subcutaneous UFH (SC-UFH), and SC-UFH plus ASA.</div></div><div><h3>Main Outcome Variable</h3><div>The outcome variable was postoperative flap outcome coded as compromised or not.</div></div><div><h3>Covariates</h3><div>Covariates included patient demographics, cancer type, neoadjuvant therapy, flap type, surgical procedure, intensive care unit stay, medical history, and postoperative complications.</div></div><div><h3>Analyses</h3><div>χ<sup>2</sup>, Mann–Whitney U, and Kruskal–Wallis tests were used for baseline data analysis. Multivariate logistic regression was conducted to examine the adjusted association between anticoagulation protocol and flap outcome. <em>P</em> values &lt; .05 were considered statistically significant.</div></div><div><h3>Results</h3><div>The study sample consisted of 300 patients who met inclusion criteria with a mean age of 48.3 (±17.69) years, 202 (67.3%) of whom were male. There were 28 (9.3%) cases of flap compromise. The unadjusted analysis showed that patients receiving IV-UFH had a significantly higher risk of flap compromise compared to those receiving SC-UFH (relative risk: 3.43 [1.62 to 7.28]). Adding ASA to SC-UFH did not result in a statistically significant reduction in the risk of flap compromise (relative risk: 0.95 [0.35 to 2.61]). After adjusting for confounding factors, the anticoagulant type was not associated with flap compromise (<em>P</em> = .05). However, in the subgroup analysis, compared to SC-UFH, subjects receiving IV-UFH still had higher odds of flap compromise (odds ratio = 2.69, 95% CI [1.003 to 7.205], <em>P</em> = .049)</div></div><div><h3>Conclusion and Relevance</h3><div>Postoperative thrombosis in head and neck microsurgery remains a significant risk factor for poor outcomes. SC-UFH administration may be a practical approach to managing these risks compared to intravenous administration; however, the choice of anticoagulation protocol is not associated with the flap compromise.</div></div>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"83 4","pages":"Pages 467-475"},"PeriodicalIF":2.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Influence of Fluoxetine on the Sensorimotor Function of the Sciatic Nerve in Wistar Rats after Axonotmesis: An Experimental Animal Model 氟西汀对Wistar大鼠轴索知觉后坐骨神经感觉运动功能的影响
IF 2.3 3区 医学
Journal of Oral and Maxillofacial Surgery Pub Date : 2025-04-01 DOI: 10.1016/j.joms.2024.12.004
Michelly Cauás de Queiroz Gatis , Marcelo Moraes Valença , Heitor Ferreira de Souza Neto , Henrique Lima Ferreira de Souza , Carlos Augusto Pereira do Lago
{"title":"The Influence of Fluoxetine on the Sensorimotor Function of the Sciatic Nerve in Wistar Rats after Axonotmesis: An Experimental Animal Model","authors":"Michelly Cauás de Queiroz Gatis ,&nbsp;Marcelo Moraes Valença ,&nbsp;Heitor Ferreira de Souza Neto ,&nbsp;Henrique Lima Ferreira de Souza ,&nbsp;Carlos Augusto Pereira do Lago","doi":"10.1016/j.joms.2024.12.004","DOIUrl":"10.1016/j.joms.2024.12.004","url":null,"abstract":"<div><h3>Background</h3><div>Fluoxetine, a serotonin reuptake inhibitor antidepressant, raises extracellular serotonin levels and promotes angiogenesis and neurogenesis. Numerous animal models have shown its beneficial effects on recovery from peripheral nerve injury.</div></div><div><h3>Purpose</h3><div>The primary objective of this study was to analyze the influence of fluoxetine on the sensory-motor function recovery of the sciatic nerve in Wistar rats after axonotmesis.</div></div><div><h3>Study design, setting, and sample</h3><div>This study utilized an experimental rat model, conducted in the laboratory at the Federal University of Pernambuco. The sample consisted of 40 male Wistar rats.</div></div><div><h3>Predictor variable</h3><div>The primary predictor variable was the fluoxetine exposure. The animals were randomly divided into 4 groups (control and 3 experimental groups), with 10 animals in each group. They were injected subcutaneously with saline or fluoxetine 5, 10, and 20 mg/kg/day, respectively.</div></div><div><h3>Main outcome variables</h3><div>The main outcome variables were postoperative motor and sensory sciatic nerve function. Sensory nerve function was measured using the withdrawal reflex by thermostimulation. Motor nerve function was measured using the Sciatic Nerve Recovery Index and the Static Sciatic Nerve Index (SSI).</div></div><div><h3>Covariates</h3><div>None.</div></div><div><h3>Analyses</h3><div>Descriptive statistical analysis was performed using mean and SD. Analaysis of variance (ANOVA) was used for comparisons between the groups and Dunnett's multiple comparisons test was used in case of significant differences between the groups. Statistical Analysis System was the software used for statistical analyses.</div></div><div><h3>Results</h3><div>During the study, 15 animals were lost (3 in the control group and 4 in each experimental group), with no specific cause identified. On day 35, the latency time of the withdrawal reflex was significantly different, with decreased pain perception in the 5 mg/kg/day fluoxetine group (3.80 ± 1.20, <em>P</em> &lt; .05). On day 14, the Sciatic Nerve Recovery Index showed greater deficits in the l0 and 20 mg/kg/day groups (−65.67 ± 7.20 and −63.57 ± 11.59, respectively) compared to the control group (<em>P</em> &lt; .05). The SSI also showed a delay in recovery with the 10 mg/kg/day dose (−62.50 ± 6.72, <em>P</em> &lt; .05).</div></div><div><h3>Conclusion</h3><div>The daily treatment with fluoxetine failed to bring any improvement to motor or sensory recuperation after injury to the sciatic nerve in Wistar rats.</div></div>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"83 4","pages":"Pages 459-466"},"PeriodicalIF":2.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142895538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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