ABSTRACT
BACKGROUND: Road traffic crashes related maxillofacial injuries constitute a major part of the trauma workload of the maxillofacial surgeon. These injuries are sometimes fatal and may be associated with long term psychosocial sequelae. Several devices have been designed to reduce the severity of these injuries and therefore diminish the associated morbidity and mortality. AIM AND OBJECTIVE: To evaluate the influence of restraints and protective devices on the severity of road traffic maxillofacial injuries. DESIGN OF THE STUDY: A prospective study. METHOD: A prospective study of patients managed at the University College Hospital, Ibadan for road traffic crashes-related oral and maxillofacial injuries. Demographic variables, types of vehicles involved (categorized into A- 2 wheelers and B- 4whellers), seat position, use or non-use of protective devices and type of injury sustained as well as injury severity assessed based on the Maxillofacial Injury Severity Scale (MFISS) were recorded in a proforma. Correlations between injury types, severity, and use of protective devices were determined using IBM SPSS version 20.0 RESULTS: Out of 155 patients reviewed, 134(86.5%) were males while 21(13.5%) were females. There were 84(54.2%) participants in Category A vehicles and 71(45.8%) in Category B vehicles. About 15.5% (13/84) in Category A and 22.5% (16/71) in Category B used protective devices (crash helmet and seat belt respectively). However, there was no statistically significant difference between the median MFISS score for those that used protective devices and those who did not in both categories (P= 0.862 for Category A; P = 0.64 for Category B) Conclusion: The rate of use of protective devices was relatively low among commuters in the study. However, it was noted that the use of the devices made no difference to the severity of maxillofacial injuries using the MFISS. Public enlightenment on the proper use of restraint devices should be intensified.
ABSTRACT
We report a case of tongue swelling resulting from ectopic osseous proliferation within a pseudocystic stroma in a 24 year old healthy female. The patient presented a history of dull pain and gradual onset of a swelling at the ventral aspect of the tongue. The lesion had a mixed consistency with areas of sponginess andfluctuancy interspersed with nodular bony hardness and yielded a sanguinous aspirate. Doppler ultrasonographic scan and magnetic resonance imaging revealed a pseudocystic mass containing nodules of calcified bodies. Excision biopsy under general anaesthesia and histopathologic studies confirmed a case of ectopic osseous proliferation within the tongue. The lesion was marginally excised, wound healed satisfactorily with no complications as at 8(th) month follow-up period. This is a case of a lesion with conflicting clinical and histological characteristics. It underscores the need for routine immunohistochemistry and comprehensive aspirate analysis in our environment. The case has been reported to sensitize clinicians to a new possibility in the differential diagnosis of tongue swelling.
ABSTRACT
BACKGROUND: Accurate identification and interpretation of plain maxillofacial radiographs is key to making correct clinical decision. OBJECTIVE: To assess the ability of junior dental trainees to correctly identify and adequately interpret oral and maxillofacial plain radiographs. STUDY DESIGN: Comparative analysis Setting: University of Port Harcourt Teaching Hospital, Port Harcourt and University College Hospital, Ibadan. MATERIALS AND METHODS: Twenty six plain film radiographs were selected and serialized. The films were presented to three specialislts; a radiologist and two oral surgeons for independent identification and interpretation. The level of agreement between them was tested using kappa statistics (k) and intraclass coefficient (ICC). Minor areas of discrepancy were finally reconciled and the correct identification and interpretations of every radiograph confirmed. The same set of radiographs was subsequently presented to twenty junior dentists (House officers and Registrars) for identification and interpretation. Accuracy of performances in identification and interpretation exercises was assessed by a test of agreement using kappa statistics and a mathematical performance rating method respectively. RESULTS: In terms of identification, the agreement between the three specialists was very strong with ICC of 0.96. Kappa (k)-values of 1.00 suggesting perfect agreement was observed between the two oral surgeons. Agreement between each oral surgeon and the radiologist was very good (k= 0.84). The k-value for agreement in identification between trainees and specialists ranged between 0.23 and 1.00. As for interpretation, the percentage accuracy of the junior dental trainees ranged between 60.5% and 87.2% compared to specialists' range of 89.5% to 95.3%. The common areas of discrepancy in identification and interpretation are highlighted. CONCLUSION: Based on this study, dental trainees demonstrate varying levels of expertise in identification and interpretation of maxillofacial plain radiographs. Knowledge gaps were identified and modification of teaching method suggested.
