ABSTRACT
Many publications have addressed the medical complications of tattoos, but to our knowledge there are no reports of their use to alert people in our field of potentially dangerous conditions. We present a new way to inform oral and maxillofacial colleagues about patients with a history of malignant hyperthermia (or any other life-threatening medical problem) and discuss the potential advantages and disadvantages of medical alert tattoos.
Subject(s)
Malignant Hyperthermia , Oral Surgical Procedures , Tattooing , HumansABSTRACT
Vertebral metastases from primary head and neck cancers are uncommon, and so there are no clear guidelines about management. The spinal cord can be compressed by a vertebral fracture or invasion of a tumour, and may present as an oncological and spinal emergency. The goals of treatment are to relieve pain and maintain neurological function. However, surgical treatments in this group of patients have not been defined, and primary operative treatment of spinal metastases remains controversial. Here we discuss their contemporary management. Surgical options should be considered for treatment to achieve stability of the spine, relieve pain, and preserve neurological function in certain cases.
Subject(s)
Cervical Vertebrae , Head and Neck Neoplasms/pathology , Spinal Neoplasms/secondary , Clinical Decision-Making , Humans , Spinal Neoplasms/diagnosis , Spinal Neoplasms/therapyABSTRACT
Babies born with clefts of the lip, and the alveolus or palate, or both, require multidisciplinary, highly specialised treatment from birth to early adulthood. We review the contemporary management of clefts and outline the current treatment protocol adopted by cleft networks in the United Kingdom. We also look at the level of evidence and the restructuring of services that has defined current practice. In light of the recent Cleft Care UK study, we ask whether it is now time to adopt a new philosophy towards the surgical techniques that are used.
Subject(s)
Cleft Lip/surgery , Cleft Palate/surgery , Comprehensive Health Care , Critical Pathways , Evidence-Based Practice , Humans , Patient Care Team , Plastic Surgery Procedures/methods , United KingdomABSTRACT
The term 'woody neck' is widely used by surgeons and oncologists to describe the fibrosis that can occur following radiotherapy for head and neck malignancy. These soft tissue and skin changes can be compounded by neck dissection, either before or after radiotherapy. To our knowledge, there is no classification published in the literature to describe the degree of woody hardness following treatment. We propose a simple ABC classification for varying degrees of indurated oedema and neck fibrosis secondary to radiotherapy or long-standing pathology, using the hardness of different woods to enable a suitable description to be made of severity.
Subject(s)
Head and Neck Neoplasms/radiotherapy , Neck/radiation effects , Terminology as Topic , Edema/classification , Edema/pathology , Fibrosis , Hardness , Head and Neck Neoplasms/surgery , Humans , Neck/pathology , Neck Dissection/methods , Pliability , Pressure , Skin/pathology , Skin/radiation effects , Wood/classificationABSTRACT
With the increasing use of hyaluronic acid-based injectable fillers for cosmetic enhancement a variety of adverse reactions are being reported in the literature. Although most adverse outcomes occur early we describe an interesting case study of a female presenting with granulomatous complications ten years postoperatively. To our knowledge this is one of the longest reported delayed reactions. For the general dental practitioner offering such treatments it is important to be fully aware of the potential risks and how they may be managed in order to consent appropriately for cosmetic procedures.
Subject(s)
Cosmetic Techniques/adverse effects , Foreign-Body Reaction/etiology , Methylmethacrylate/adverse effects , Skin Aging/drug effects , Aged , Female , Humans , Hyaluronic Acid/administration & dosage , Injections, SubcutaneousABSTRACT
Facial skin lesions present routinely to clinic and are largely dermatological in origin. Odontogenic infections are an unusual cause of facial lesion and are well-described in the dental literature; however they are regularly overlooked and mismanaged, often to considerable aesthetic detriment. We present such a case and highlight important avoidable pitfalls.
Subject(s)
Cutaneous Fistula/surgery , Dental Fistula/surgery , Periapical Periodontitis/surgery , Adult , Chin , Chronic Disease , Cutaneous Fistula/diagnosis , Dental Fistula/diagnosis , Diagnosis, Differential , Humans , Magnetic Resonance Imaging , Male , Periapical Periodontitis/diagnosis , Radiography, Panoramic , Tooth ExtractionABSTRACT
BACKGROUND: Ophthalmic complications following inferior alveolar nerve anaesthesia are rare. They include transient blindness (amaurosis), ophthalmoplegia, ptosis, mydriasis and diplopia. These events may occur following the intravascular administration of anaesthetic solution and are distressing to both patient and operator alike. CASE REPORT: We report the unusual case of a young patient who experienced amaurosis, total ophthalmoplegia, complete upper eyelid ptosis, mydriasis and periorbital blanching following inferior alveolar nerve anaesthesia. Similar but less profound signs were observed in the same patient on a subsequent occasion. This was following general anaesthesia, during which she had received local anaesthetic prior to mandibular wisdom tooth removal. CONCLUSIONS: Ophthalmic complications following inferior alveolar nerve anaesthesia are rare but distressing events. In particular, amaurosis is an extremely rare event and usually heralds a more sinister pathology such as stroke. Clinicians should be aware of these complications to minimise anxiety and reassure their patients appropriately.
