British Journal of Oral & Maxillofacial Surgery最新文献

{"title":"Physical function of head and neck cancer survivors in the first year after treatment: an exploratory descriptive investigation.","authors":"Kelly Coghlan, Grainne Sheill, John Ed O Connell, Conor Bowe, Paul Lennon, Julie Broderick","doi":"10.1016/j.bjoms.2025.06.003","DOIUrl":"https://doi.org/10.1016/j.bjoms.2025.06.003","url":null,"abstract":"<p><p>The aim of this study was to explore the post-treatment physical function of head and neck cancer survivors (HNCS). A prospective cross-sectional study was conducted. Assessment included physical measures (The Short Physical Performance Battery (SPPB), Strength (30 second Sit to Stand Test and Grip Strength)), patient reported outcome measures (Neck Disability Index (NDI), and the FACT- H&N) and self-reported recovery measures. Participants (n = 30) were 66.7% men. Most had undergone surgery (87%, n = 26) and were less than six months post treatment (80%, n = 25). In total 41% (n = 12) of participants had low physical performance, 72% (n = 21) scored below average strength scores and 67% (n = 20) of participants had neck disability. The FACT H&N found a moderate impairment in quality of life [mean (SD) Trial Outcome Index 60.4 (20.2)] and 24% (n = 7) of participants screened positive for lymphoedema. Seventeen percent (n = 5) have participants reported having a fall in the last 12 months. This study provides descriptive data from a pilot study which may service as a foundation for future research.</p>","PeriodicalId":55318,"journal":{"name":"British Journal of Oral & Maxillofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144776974","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}

{"title":"Custom-made fibular cradle plate to optimise bone positioning for implant placement, restore maxillary contour, and preserve pedicle length in reconstruction of the maxilla.","authors":"J Pallot, L Dovgalski, P Evans, K Shah, M A Kittur","doi":"10.1016/j.bjoms.2025.06.005","DOIUrl":"https://doi.org/10.1016/j.bjoms.2025.06.005","url":null,"abstract":"","PeriodicalId":55318,"journal":{"name":"British Journal of Oral & Maxillofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144796203","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}

{"title":"Hospital-level variation in resection margins after oral cavity cancer surgery and associated survival outcomes.","authors":"Hanneke Doremiek van Oorschot, Jose Angelito Hardillo, Robert J J van Es, Guido B van den Broek, Robert Paul Takes, Gyorgy Bela Halmos, Dominique Valerie Clarence de Jel, Richard Dirven, Martin Lacko, Lauretta Anna Alexandra Vaassen, Jan-Jaap Hendrickx, Marjolijn Abigal Eva-Maria Oomens, Hossein Ghaeminia, Jeroen C Jansen, Annemarie Vesseur, Rolf Bun, Leonora Q Schwandt, Christiaan A Krabbe, Thomas J W Klein Nulent, Alexander J M van Bemmel, Reinoud J Klijn, Robert Jan Baatenburg de Jong","doi":"10.1016/j.bjoms.2025.06.004","DOIUrl":"https://doi.org/10.1016/j.bjoms.2025.06.004","url":null,"abstract":"<p><p>The main goal of surgery for oral squamous cell carcinoma (OSCC) is to obtain adequate resection margins as inadequate margins are associated with a worse prognosis and treatment intensification. However, reported rates of inadequate resections vary from 30%-85%. Clinical auditing is an upcoming tool to improve margin status. This study investigates resection margins after OSCC surgery and differences in hospital results, disease-free, and overall survival for <1 and ≤5 mm cut-offs. This Dutch nationwide registry-based cohort study includes all patients who underwent surgery for first primary OSCC between 2018 and 2021. Resection margins were categorised as <1, 1-5, and >5 mm. Hospital variation was visualised in funnel plots and corrected for case-mix and treatment variables. Two-year overall and disease-free survival were determined. A total of 2,085 patients from 14 hospitals could be included for analysis. Nationally, margins <1 mm were present in 16.4% which varied from 6.5%-31.6% at hospital level. For margins ≤5 mm, the national average was 61.3%, with hospital outcomes ranging from 50.0%-78.6%. Significant outliers remained after correction for case-mix and treatment variables. Two year overall and disease-free survival was worse in the <1 mm group. Obtaining negative or adequate margins during the resection of invasive OSCC is challenging. Significant hospital differences in resection margin outcomes remained after correction for case-mix characteristics. By identifying best practices in OSCC, surgical and survival outcomes can be improved.</p>","PeriodicalId":55318,"journal":{"name":"British Journal of Oral & Maxillofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144755188","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}

{"title":"Lingual lymph nodes in tongue cancers: a systematic review and meta-analysis","authors":"Rajarshi Ghosh ,&nbsp;Sameer Pandey ,&nbsp;Bineeta Sinha ,&nbsp;Rajesh K. Gupta ,&nbsp;Mitali Dandekar","doi":"10.1016/j.bjoms.2025.05.017","DOIUrl":"10.1016/j.bjoms.2025.05.017","url":null,"abstract":"<div><div>Lingual lymph nodes (LLN) are aberrant nodes located in the floor of mouth. Neither are metastases to these nodes routinely investigated nor are they included in the guidelines for management of tongue cancers. This article systematically collates published literature along with a meta-analysis to address clinically relevant questions pertaining to the lingual nodes. A systematic review and meta-analysis was conducted in accordance with PRISMA guidelines. Databases were searched to identify all articles on LLN in English until December 2024. A total of 24 articles were included. Proportional analysis showed an overall incidence of 8.98% (LLN metastasis). Pooled sensitivity of cross-sectional imaging to detect these nodes was 34%. Patients presenting with advanced tumour stage and/or nodal positivity have a higher risk of LLN metastasis. The analysis also showed a higher chance of recurrencein patients with metastatic LLN resulting in poorer outcomes in these tongue cancers.</div></div>","PeriodicalId":55318,"journal":{"name":"British Journal of Oral & Maxillofacial Surgery","volume":"63 8","pages":"Pages 554-561"},"PeriodicalIF":1.9,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144776973","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}

{"title":"Real-time indocyanine green angiography optimises anterolateral thigh flap reconstruction in oral and maxillofacial defects: a prospective clinical study","authors":"Zhongming Wu ,&nbsp;Weiqi Wang ,&nbsp;Yan Wang ,&nbsp;Xuejiao Han ,&nbsp;Jianhua Wei","doi":"10.1016/j.bjoms.2025.06.002","DOIUrl":"10.1016/j.bjoms.2025.06.002","url":null,"abstract":"<div><div><span><span>This study aimed to evaluate the clinical efficacy of indocyanine green<span> angiography (ICGA) in optimising anterolateral thigh (ALT) flap reconstruction for oral and maxillofacial defects<span>. Fifteen consecutive patients (10 males, mean (SD) age 53.8 (14.5) years) undergoing ALT flap reconstruction following tumour resection were prospectively enrolled. Intravenous indocyanine green (ICG) (2.5 mg/ml) administration combined with hand-held Doppler ultrasound (DUS) enabled preoperative mapping of the descending branch of the </span></span></span>lateral circumflex femoral artery and localisation of the perforator. Intraoperative real-time ICGA guidance facilitated precise flap trimming, while postoperative monitoring incorporated both DUS and ICGA assessments. Preoperative imaging revealed comparable perforator detection rates between modalities (DUS: 35/42 confirmed vs ICGA: 33/39 confirmed; accuracy 83.3% vs 84.6%, Z = 0.096, p = 0.081, kappa = 0.82, p = 0.026). ICGA-guided intraoperative modifications proved critical in seven cases, all achieving marginal flap viability. Four high-risk patients avoided </span>reoperation through ICGA-guided perfusion monitoring. Notably, ICGA detected salvageable perfusion in two cases with absent DUS signals, and confirmed arterial patency following re-anastomosis in one case. ICGA enhances surgical precision in ALT flap reconstruction through perfusion mapping, enabling real-time intraoperative decision-making and improved postoperative monitoring sensitivity.</div></div>","PeriodicalId":55318,"journal":{"name":"British Journal of Oral & Maxillofacial Surgery","volume":"63 8","pages":"Pages 596-601"},"PeriodicalIF":1.9,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144621220","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}

{"title":"Effectiveness of early active mandibular exercise in early recovery of mandibular movement and quality of life after orthognathic surgery: a single-centre randomised clinical trial.","authors":"Hyo-Jin Jang, Jae-Min Song, Yong-Il Kim, Sung-Hun Kim, Seong-Sik Kim, Youn-Kyung Choi","doi":"10.1016/j.bjoms.2025.05.016","DOIUrl":"https://doi.org/10.1016/j.bjoms.2025.05.016","url":null,"abstract":"<p><p>This study aimed to evaluate the effectiveness of early active mandibular exercise (AME) to address mouth-opening limitation following orthognathic surgery in patients with skeletal Class III malocclusion. This was a single-centre, randomised, controlled, and double-blinded experimental study. In 44 subjects, the experimental group (n = 21) performed AME 10 times daily and were asked to self-assess the degree of opening by counting the number of tongue depressors they could fit in, whereas the control group (n = 23) performed only basic finger exercises. Efficacy was assessed by the range of mandibular movement in four directions (maximum opening, and right lateral, left lateral, and anterior movements), and pain was assessed using a visual analogue scale. Opening-related quality of life (QoL) was assessed using a questionnaire. All variables were measured immediately (T0), and at one week (T1), two weeks (T2), four weeks (T3), and 12 weeks (T4) after the removal of intermaxillary fixation. Statistical analyses were performed using the Mann-Whitney U, Friedman, and chi-squared tests. The experimental group demonstrated earlier recovery of mandibular range of motion in all directions compared with the control group during T0-T1 (p < 0.05). The control group gradually recovered from T0-T4. At T1 the opening recovery rate was 56-68% in the experimental group and 18-39% in the control group. Pain scores were significantly lower in the experimental group than in the control group at T1 (p < 0.05). The experimental group also showed an earlier positive response to all daily living activities at T3 compared with T4 in the control group. AME not only effectively recovers mouth-opening limitation after orthognathic surgery, but also promotes early improvements in range of motion and pain scores. Furthermore, it is an effective intervention to facilitate an early return to the opening-related activities of daily living.</p>","PeriodicalId":55318,"journal":{"name":"British Journal of Oral & Maxillofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144719194","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}

{"title":"Craniofacial defect rehabilitation: long-term outcomes of implant-retained ear, nasal, and orbital prostheses – the Morriston experience","authors":"Ioan Davies (Speciality Registrar in Oral and Maxillofacial Surgery),&nbsp;Andrew Jenkinson (Consultant Oral and Maxillofacial Surgeon),&nbsp;Steven Key (Consultant Oral and Maxillofacial Surgeon),&nbsp;Peter Llewelyn Evans (Maxillofacial Laboratory Services Manager),&nbsp;Ketan Shah (Consultant Oral and Maxillofacial Surgeon),&nbsp;M.A. Kittur (Consultant Oral and Maxillofacial Surgeon)","doi":"10.1016/j.bjoms.2025.06.001","DOIUrl":"10.1016/j.bjoms.2025.06.001","url":null,"abstract":"<div><div>This retrospective study assessed the long-term outcomes of extraoral craniofacial implants used to support auricular, nasal, and orbital prosthesis in 138 patients treated at Morriston Hospital, Swansea, from 2004 to 2024. A total of 346 implants were reviewed, showing an overall implant survival rate of 91.9% and prosthesis survival rate of 89.6%. Long-term survival rates at 5, 10, and 20 years were highest for ear implants (100%, 90%, and 80%), respectively, followed by nasal (95.2%, 91.8%, and 91.8%) and orbital implants (89%, 86.6%, and 77%), respectively. Radiotherapy was associated with poorer implant survival, with a survival rate of 89.3% in irradiated implants compared with 97% in non-irradiated implants (p = 0.0219). Amongst the irradiated implants, those placed during ablative surgery showed a significantly improved survival rate (92.49%) than those placed following radiotherapy (68.42%, p = 0.0069). Emerging plating systems such as Epitek show promise in providing alternative nasal prosthesis retention but require further long-term follow up. The above findings underscore the necessity for careful planning alongside experienced lab technicians to optimise implant placement and enhance the long-term success of craniofacial prosthesis.</div></div>","PeriodicalId":55318,"journal":{"name":"British Journal of Oral & Maxillofacial Surgery","volume":"63 8","pages":"Pages 589-595"},"PeriodicalIF":1.9,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144762426","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}

{"title":"Patient reported outcome measures (PROMs) in bilateral sagittal split osteotomy with osseous genioplasty","authors":"Amit Dattani ,&nbsp;Amreeta Aytain ,&nbsp;Flora Menzies ,&nbsp;Luis Bruzual","doi":"10.1016/j.bjoms.2025.05.015","DOIUrl":"10.1016/j.bjoms.2025.05.015","url":null,"abstract":"<div><div>This study evaluates the impact of genioplasty combined with bilateral sagittal split osteotomy (BSSO) on patient-reported outcomes within the UK’s National Health Service (NHS). As the first study of its kind in the UK that we know of, it aims to provide evidence to support the continued commissioning of these procedures. A retrospective, multi-site cohort study was conducted using validated patient-reported outcome measures (PROMs) through postoperative telephone consultations. Outcomes assessed included satisfaction with facial appearance, self-confidence, and quality of life before and after surgery. Of 30 eligible patients, 21 completed follow up at a minimum of six months. Results showed high overall satisfaction rates of 90% and significant improvements in psychological wellbeing (40%), quality of life (32%), and social confidence (42%). Additionally, satisfaction with lower jaw appearance and chin aesthetics improved by 60% and 61%, respectively. These findings highlight the significant benefits of genioplasty with BSSO and support its continued commissioning in the NHS.</div></div>","PeriodicalId":55318,"journal":{"name":"British Journal of Oral & Maxillofacial Surgery","volume":"63 8","pages":"Pages 605-608"},"PeriodicalIF":1.9,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692529","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}

{"title":"The analgesic effect of adding magnesium sulphate to inferior alveolar nerve block in mandibular third molar surgery: a randomised controlled trial.","authors":"Warit Powcharoen, Yanisa Naruenartwongsakul, Kathawut Tachasuttirut","doi":"10.1016/j.bjoms.2025.05.014","DOIUrl":"https://doi.org/10.1016/j.bjoms.2025.05.014","url":null,"abstract":"<p><p>Achieving a prolonged analgesic effect from an inferior alveolar nerve block (IANB) following mandibular third molar (MTM) surgery remains a challenge. This study aimed to investigate the analgesic efficacy of adding magnesium sulphate to an IANB on postoperative pain within 24 h following MTM surgery. The eligible participants were randomly assigned to receive articaine with either 150 mg or 250 mg magnesium sulphate, or articaine alone. The primary outcomes were pain intensity at 6 and 24 h postoperatively, using the Heft-Parker visual analogue scale (VAS). Secondary outcomes included the success rate of IANB, characteristics of analgesic consumption, and occurrence of adverse events. Multivariate analysis including multivariate linear regression was performed with a significance level of 0.05. A total of 72 MTMs were included. At 6 h postoperatively, the estimated treatment differences in pain at rest were -42.02 (95% CI: -61.50 to -22.54) for the 150 mg magnesium group, and -42.76 (95% CI: -62.42 to -23.11) for the 250 mg magnesium group. For pain on movement, the differences were -38.07 (95% CI: -60.22 to -15.92) and -29.07 (95% CI: -51.42 to -6.72), respectively. By 24 h, pain intensity did not differ significantly among the groups. First analgesic use was significantly delayed in both magnesium groups. The addition of 150 mg magnesium sulphate to articaine for IANB significantly reduced pain intensity at 6 h following surgery with no adverse events.</p>","PeriodicalId":55318,"journal":{"name":"British Journal of Oral & Maxillofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144592987","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}

{"title":"Outcomes of temporomandibular joint replacement using an endaural incision and endoscopic assistance – A report of 104 cases","authors":"Miles Somers ,&nbsp;Sylvia Lim ,&nbsp;Samuel Seung Yeol Kim","doi":"10.1016/j.bjoms.2025.05.012","DOIUrl":"10.1016/j.bjoms.2025.05.012","url":null,"abstract":"<div><div><span>Temporomandibular joint<span> replacement is performed in patients with severe disorders of the temporomandibular joint with the aim of improving quality of life, function and pain. Traditionally, this has been carried out using a preauricular or endaural </span></span>incision<span> in addition to a submandibular incision. In this study, a novel technique was used wherein a total temporomandibular joint replacement was performed through an endaural incision with endoscopic assistance. This negated the need for a submandibular incision, with the aim of minimising the complications of open joint surgery<span>. This is a retrospective cohort study<span> of 104 joint replacements in 82 patients using this technique for the treatment of pathology or end-stage joint disease<span>. The primary outcome variable was improvement in pain and quality of life measurements, whilst secondary outcome variables were facial nerve function and mouth opening. Pain intensity (/10) decreased postoperatively for worst pain score (8.4 to 4.5, p &lt; 0.001) and average pain score (6.1 to 3.0, p &lt; 0.001). The average Graded Chronic Pain Scale score decreased postoperatively from 67.7 to 32.7 (p &lt; 0.001). The Jaw Function Limitation Scale had an overall reduction from 4.29 to 1.55 postoperatively (p &lt; 0.001). There were 20 cases (19.4%) of temporary facial nerve weakness, all of which had resolved by six months. Mouth opening increased from 31.6mm preoperatively to 36.5 mm postoperatively (p &lt; 0.01). This study shows similar or reduced rates of temporary facial nerve weakness compared to other studies whilst still significantly improving patients’ quality of life postoperatively, demonstrating that good clinical outcomes can be achieved through an endaural incision with endoscopic assistance.</span></span></span></span></div></div>","PeriodicalId":55318,"journal":{"name":"British Journal of Oral & Maxillofacial Surgery","volume":"63 8","pages":"Pages 583-588"},"PeriodicalIF":1.9,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144621219","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}