British Journal of Oral & Maxillofacial Surgery最新文献_第6页

Nationwide clinical practice variation for reconstructive surgery following oral cavity cancer from the Dutch Head and Neck Audit: are we all doing the same? 来自荷兰头颈审计的口腔癌重建手术的全国临床实践差异：我们都在做同样的事情吗？

IF 1.7 4区医学

British Journal of Oral & Maxillofacial Surgery Pub Date : 2025-04-01 DOI: 10.1016/j.bjoms.2024.10.232

Dominique V.C. de Jel , Hanneke D. van Oorschot , Puck C.A. Meijer , Ludwig E. Smeele , Danny A. Young-Afat , Hinne A. Rakhorst

{"title":"Nationwide clinical practice variation for reconstructive surgery following oral cavity cancer from the Dutch Head and Neck Audit: are we all doing the same?","authors":"Dominique V.C. de Jel , Hanneke D. van Oorschot , Puck C.A. Meijer , Ludwig E. Smeele , Danny A. Young-Afat , Hinne A. Rakhorst","doi":"10.1016/j.bjoms.2024.10.232","DOIUrl":"10.1016/j.bjoms.2024.10.232","url":null,"abstract":"<div><div>Quality registries provide real-world data that can drive quality improvement, which often starts with reducing inter-hospital variation. We explored outcomes and the extent of nationwide inter-hospital variation for patients undergoing reconstructive surgery after oral cavity cancer (OCC) using the Dutch Head and Neck Audit (DHNA). Within the DHNA, we selected all OCC patients who underwent curative reconstructive surgery between 2018 and 2022. Patient, tumour, and treatment characteristics were compared, including reconstruction strategies (skin grafting, local transposition, and pedicled and free flaps). Of those treated with free flap reconstruction, postoperative complications were scored according to the Clavien-Dindo (CD) classification and labelled minor (CD 1–2) or major (CD ≥3). A total of 1383 patients were included in the analysis. Especially in the case of patients with stage I tumours (10.1%) there was a wide variation in reconstructive surgery between centres, with a preference for local transposition (42.6%). Free flaps (n = 974) were used most often in patients with a more extensive tumour load (65.4–89.2%), with the radial forearm flap the preferred technique (54.7%, range range 37.1–80.8%). Thirty-four per cent of patients treated with a free flap had postoperative complications, with 38 cases of total flap loss (overall 3.9% complications). Strategies and percentages varied widely across centres, showing high inter-hospital variation in applied techniques and outcomes, and the need for national data improvement.</div><div><strong>Level of evidence:</strong> II.</div></div>","PeriodicalId":55318,"journal":{"name":"British Journal of Oral & Maxillofacial Surgery","volume":"63 3","pages":"Pages 195-202"},"PeriodicalIF":1.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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Re: Comment on current thinking in the management of temporomandibular disorders in children: a narrative review 儿童颞下颌障碍治疗的当前思路：叙述性回顾。

IF 1.7 4区医学

British Journal of Oral & Maxillofacial Surgery Pub Date : 2025-04-01 DOI: 10.1016/j.bjoms.2024.11.015

Toby Visholm, Nadeem Saeed

引用次数: 0

Comment on “Factors affecting the risk of trismus following maxillary ablative surgery comparing free flap reconstruction to prosthetic obturation: a retrospective observational study” 评论“影响上颌消融手术后牙关风险的因素：一项回顾性观察研究，比较游离皮瓣重建与假体封闭”。

IF 1.7 4区医学

British Journal of Oral & Maxillofacial Surgery Pub Date : 2025-04-01 DOI: 10.1016/j.bjoms.2025.01.011

James S. Brown, Andrew Schache

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Navigating treatment ambiguities in head and neck squamous cell carcinoma: A retrospective analysis of equivocal PET-CT findings and decision-making strategies following primary non-surgical treatment 头颈部鳞状细胞癌治疗中的模糊导航：对正电子发射计算机断层扫描（PET-CT）模棱两可的发现和初级非手术治疗后决策策略的回顾性分析。

IF 1.7 4区医学

British Journal of Oral & Maxillofacial Surgery Pub Date : 2025-04-01 DOI: 10.1016/j.bjoms.2025.02.001

Aaron Chai , Subegh Srao , Edward Walker , Nalinda Panditaratne , Michael W.S Ho

{"title":"Navigating treatment ambiguities in head and neck squamous cell carcinoma: A retrospective analysis of equivocal PET-CT findings and decision-making strategies following primary non-surgical treatment","authors":"Aaron Chai , Subegh Srao , Edward Walker , Nalinda Panditaratne , Michael W.S Ho","doi":"10.1016/j.bjoms.2025.02.001","DOIUrl":"10.1016/j.bjoms.2025.02.001","url":null,"abstract":"<div><div>Post-treatment positron emission tomography/computed tomography (PET-CT) scans for head and neck cancer are challenging due to radiation-induced inflammation, leading to equivocal results. The decision by the Leeds-Mid Yorkshire multidisciplinary team (MDT) to proceed with a targeted biopsy or a second PET-CT reflects the uncertainty of balancing timely intervention and potential delays in patient outcomes. A review of the Leeds-Mid Yorkshire radiology database identified 34 head and neck cancer patients with equivocal PET-CT results following chemoradiation between 2019 and 2023. This audit aims to inform the future clinical management of equivocal findings in head and neck squamous cell carcinoma (SCC). Among the 34 analysed cases, oropharyngeal cancer was the most common (n = 28, 70%). All PET-CT reports indicated partial metabolic response, leading to two main management strategies: a second PET-CT (n = 4, 12%) or other interventions (n = 30, 88%). Kaplan-Meier analysis indicated no difference in disease-specific survival between the second PET-CT group and other-interventions group (log rank = 0.758). Similarly, there was no significant difference in overall survival between patients in the two groups, as determined by the log-rank test (p = 0.498). Decision making in this patient cohort is complex and requires MDT input. Our analysis found no significant survival difference between second PET-CT scans and other intervention (for example, biopsy) pathways. We recommend that for primary and nodal sites, radiological reports should include qualitative and quantitative assessments, clear categorisation (negative, positive, or equivocal), and standardised uptake values (SUVmax).</div></div>","PeriodicalId":55318,"journal":{"name":"British Journal of Oral & Maxillofacial Surgery","volume":"63 3","pages":"Pages 220-226"},"PeriodicalIF":1.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143569002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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

Michael Wake Obituary 迈克尔·维克讣告

IF 1.7 4区医学

British Journal of Oral & Maxillofacial Surgery Pub Date : 2025-04-01 DOI: 10.1016/j.bjoms.2025.02.005

Stephen Dover (Consultant Oral and Maxillofacial Surgeon)

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Implementation of robotic systems in paediatric craniofacial and head and neck surgery: a narrative review of the literature 机器人系统在儿科颅面和头颈部手术中的应用：文献综述。

IF 1.7 4区医学

British Journal of Oral & Maxillofacial Surgery Pub Date : 2025-04-01 DOI: 10.1016/j.bjoms.2024.11.011

Elena Whiteman , Umar Rehman , Mehitab Hussien , Mohammad Sohaib Sarwar , Rebecca Harsten , Peter A. Brennan

{"title":"Implementation of robotic systems in paediatric craniofacial and head and neck surgery: a narrative review of the literature","authors":"Elena Whiteman , Umar Rehman , Mehitab Hussien , Mohammad Sohaib Sarwar , Rebecca Harsten , Peter A. Brennan","doi":"10.1016/j.bjoms.2024.11.011","DOIUrl":"10.1016/j.bjoms.2024.11.011","url":null,"abstract":"<div><div>Surgical challenges in paediatric craniofacial and head and neck surgery can include operating in a small cavity, limited depth perception, restricted access with difficult angulations, and poor visualisation. Delicate tissue handling, muscle dissection, and suturing at depth require surgical access in congruence with the use of operative microscopes. Robotic assistance may aid surgeons in operating in confined spaces with minimal access incisions by improving the degree of freedom of operative instrumentation. In this study, we aim to review the use of robotic systems in paediatric head and neck and craniofacial surgery by focussing on total complications and length of surgery together with patient and surgeon experience. A literature search was conducted in June 2023 by two independent reviewers on Pubmed, Dynamed, DARE, EMBASE, Cochrane and British Medical Journal (BMJ) electronic databases for articles published between 1960-2024. Seventeen papers met the inclusion criteria. Seventy-nine patients were included. The success rate for head and neck and craniofacial cases that included robotic-assistance was 93.7% (n = 74) and the complication rate was 16.0% (n = 12). Robotic-assisted surgery demonstrates a low complication rate in treating a range of different pathologies in the head and neck in our included studies. Robotic-assistance in craniofacial surgery demonstrates promise in preventing iatrogenic injury from more traditional methods, and could allow for operations to proceed earlier in life in the management of midface distraction, however, more research in the area is necessary with limited research published at present.</div></div>","PeriodicalId":55318,"journal":{"name":"British Journal of Oral & Maxillofacial Surgery","volume":"63 3","pages":"Pages 165-173"},"PeriodicalIF":1.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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

Immediate prosthetic nasal rehabilitation following rhinectomy: indications and limitations of the epiplating system – a case series 鼻切除术后立即修复鼻：表电镀系统的适应症和局限性-一个病例系列。

IF 1.7 4区医学

British Journal of Oral & Maxillofacial Surgery Pub Date : 2025-04-01 DOI: 10.1016/j.bjoms.2025.01.007

Ioan Davies (Speciality Registrar in Oral and Maxillofacial Surgery), R.M. Sumudu Himesha B. Medawela (Dental Core Trainee 3), Peter Llewelyn Evans (Maxillofacial Laboratory Services Manager), M.A. Kittur (Consultant Oral and Maxillofacial Surgeon), Ketan Shah (Consultant Oral and Maxillofacial Surgeon)

引用次数: 0

Surgical management of bilateral mandibular angle fractures: A systematic review 双侧下颌角骨折的外科治疗：系统回顾。

IF 1.7 4区医学

British Journal of Oral & Maxillofacial Surgery Pub Date : 2025-04-01 DOI: 10.1016/j.bjoms.2025.01.004

Samuel R. Bullis , Elizabeth Z. Goh , Nigel R. Johnson

{"title":"Surgical management of bilateral mandibular angle fractures: A systematic review","authors":"Samuel R. Bullis , Elizabeth Z. Goh , Nigel R. Johnson","doi":"10.1016/j.bjoms.2025.01.004","DOIUrl":"10.1016/j.bjoms.2025.01.004","url":null,"abstract":"<div><div>Bilateral mandibular angle fractures (BMAF) are rare and complex maxillofacial injuries. This review describes the patient factors, procedural factors and post-procedural outcomes of BMAF management. PubMed and Scopus were searched for English papers from 1993 to 2023 using the strategy: (bilateral AND angle) AND (mandib* OR bmaf) AND fracture AND (management OR repair OR surgery). Four papers were eligible for inclusion, representing 198 cases. The mean age of patients was 25 years, with 94.9% of cases male. Interpersonal violence was the leading cause of injury (76.8%). Transbuccal approach was the most common incision (53.2%). Non-rigid/rigid fixation was the most common approach to fixation (55.4%). Impacted lower third molars were present in 91.6% of cases and were extracted in 36.7% of these cases. The most common complications were infection (n = 11) and malocclusion (n = 9), with similar rates between rigid and non-rigid plates. Further studies are needed to address the scarcity of research. Standardised approaches to classifying fixation, injuries, fracture displacement and imaging protocols are needed.</div></div>","PeriodicalId":55318,"journal":{"name":"British Journal of Oral & Maxillofacial Surgery","volume":"63 3","pages":"Pages 182-188"},"PeriodicalIF":1.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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In response to “Comment on ‘Factors affecting the risk of trismus following maxillary ablative surgery comparing free flap reconstruction to prosthetic obturation: a retrospective observational study’” 针对 "关于'影响上颌消融手术后三趾畸形风险的因素：比较游离皮瓣重建与修复性闭锁的回顾性观察研究'的评论"，发表您的看法。

IF 1.7 4区医学

British Journal of Oral & Maxillofacial Surgery Pub Date : 2025-04-01 DOI: 10.1016/j.bjoms.2025.02.003

Glyndwr Jenkins

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United Kingdom and Ireland oral medicine and oral and maxillofacial surgery multidisciplinary clinics for the management of oral epithelial dysplasia 英国和爱尔兰口腔医学和口腔颌面外科多学科诊所的口腔上皮发育不良的管理。

IF 1.7 4区医学

British Journal of Oral & Maxillofacial Surgery Pub Date : 2025-04-01 DOI: 10.1016/j.bjoms.2025.01.001

L.A. Haywood, M.L. Simms, P.A. Atkin

{"title":"United Kingdom and Ireland oral medicine and oral and maxillofacial surgery multidisciplinary clinics for the management of oral epithelial dysplasia","authors":"L.A. Haywood, M.L. Simms, P.A. Atkin","doi":"10.1016/j.bjoms.2025.01.001","DOIUrl":"10.1016/j.bjoms.2025.01.001","url":null,"abstract":"<div><div>Oral epithelial dysplastic (OED) lesions have an increased risk of malignant change compared to normal mucosa. Multidisciplinary teams (MDTs) are widely used in medicine including for the management of patients with OED. There is little consensus in treatment, but a management algorithm from a joint oral medicine-oral and maxillofacial surgery (OM-OMFS) dysplasia management clinic was proposed in 2015 (the Liverpool Algorithm). We wished to determine the use of OM-OMFS MDTs for managing patients with OED in dental hospitals in the UK and Ireland using an online survey with results anonymised for analysis. We surveyed oral medicine units in the UK and Ireland reporting their use of joint clinics and management algorithms. All nineteen units responded with eight having OM-OMFS MDTs. Three used a published algorithm (Liverpool algorithm) and five used the algorithm with adaptations. 50% of units always excised lesions with moderate or severe dysplasia, with varying review intervals for different degrees of dysplasia. Seven of eight units kept patients with mild dysplasia under review for five years before discharge; for severe dysplasia some units never discharged. A total of 42% of oral medicine units in the UK and Ireland have MDTs for patients with OED. Most MDTs use the Liverpool Algorithm, or a slight variation of it, to help manage their patients. Wider adoption of MDTs and use of published algorithms may improve patient care by promoting consistent monitoring and management criteria.</div></div>","PeriodicalId":55318,"journal":{"name":"British Journal of Oral & Maxillofacial Surgery","volume":"63 3","pages":"Pages 227-231"},"PeriodicalIF":1.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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