Prospective, longitudinal assessment of quality of life in patients with cancer of the head and neck and their primary carers.

Cancer of the head and neck has profound psychosocial and physical effects on patients, so quality of life (QoL) is an essential consideration-not only is it of importance to the patient but it also provides a subjective measure of the success of treatment. However, we know of little work about its influence on carers. The aim of this study was to assess the impact of the diagnosis and treatment on the QoL of patients and their carers from baseline (preoperatively) to three months postoperatively. Thirty-six patients and 21 primary carers were enrolled, and patients completed one head-and-neck-specific measure, the University of Washington Head and Neck, Version Four (UW-V4), and three other questionnaires, both at the time of diagnosis and at one and three months postoperatively. The carers completed similar questionnaires except for the UW-V4. Analysis of the patients' data showed a serious deterioration in psychosocial and physical domains at one month postoperatively. However, the analysis of carers' data showed a highly significant deterioration in anxiety and depression domains (p<0.01), which remained low after three months. These findings highlight the need for psychological support not only for patients but also for their primary carers during the management of carcinoma of the head and neck.

A national survey of UK final year students' opinion of undergraduate oral surgery teaching.

BACKGROUND: A national survey was undertaken to establish a baseline of our final year students' perception of how their undergraduate oral surgery education has equipped them for key areas of general dental practice. MATERIALS AND METHODS: Questionnaires were distributed to the 13 UK schools with final year students, towards the end of the academic year in 2009. The questionnaires were completed anonymously and were optically scanned. RESULTS: In total, 632 questionnaires were returned, which represents 66% of the students of the graduating year. The majority (83%) of the respondents perceived that the teaching in oral surgery had given them sufficient knowledge to undertake independent practise. Most respondents (99%) felt confident to perform forceps exodontia, but confidence in the various aspects of surgical exodontia was lower. A majority (83%) had experience of an outreach scheme performing forceps exodontia (75%) and surgical exodontia (16%) in this environment. Twenty per cent indicated a desire to undertake a career in oral surgery, 6% in oral and maxillofacial surgery and 35% in another speciality. CONCLUSION: This survey suggests that the majority of the students perceive that the oral surgery education has prepared them well for key areas of general practice. It also suggests that there is, however, a need to provide further improvement in the delivery of surgical skills and knowledge.

Clinical medical sciences for undergraduate dental students in the United Kingdom and Ireland - a curriculum.

The technical aspects of dentistry need to be practised with insight into the spectrum of human diseases and illnesses and how these impact upon individuals and society. Application of this insight is critical to decision-making related to the planning and delivery of safe and appropriate patient-centred healthcare tailored to the needs of the individual. Provision for the necessary training is included in undergraduate programmes, but in the United Kingdom and Ireland there is considerable variation between centres without common outcomes. In 2009 representatives from 17 undergraduate dental schools in the United Kingdom and Ireland agreed to move towards a common, shared approach to meet their own immediate needs and that might also be of value to others in keeping with the Bologna Process. To provide a clear identity the term 'Clinical Medical Sciences in Dentistry' was agreed in preference to other names such as 'Human Disease' or 'Medicine and Surgery'. The group was challenged to define consensus outcomes. Contemporary dental education documents informed, but did not drive the process. The consensus curriculum for undergraduate Clinical Medical Sciences in Dentistry teaching agreed by the participating centres is reported. Many of the issues are generic and it includes elements that are likely to be applicable to others. This document will act as a focus for a more unified approach to the outcomes required by graduates of the participating centres and act as a catalyst for future developments that ultimately aim to enhance the quality of patient care.

A generic consensus assessment of undergraduate competence in forceps exodontia in the United Kingdom.

UNLABELLED: The assessment of competence in clinical skills has become more frequent in published healthcare curricula and syllabuses recently. There are agreed mechanisms for the assessment of competence in the post-graduate environment, but no consensus within the undergraduate curriculum. This paper seeks to develop an agreed generic checklist for the assessment of competence in forceps exodontia. MATERIALS AND METHODS: A modified Delphi process was undertaken with representatives from all UK dental schools (n = 13) to develop a generic checklist for the assessment of competence in forceps exodontia. A content analysis of the assessments employed by each school was used to help discussion and inform the Delphi process. RESULTS: Seven schools currently employ a summative assessment of competence in forceps exodontia, with the majority employing a structured clinical objective test (n = 6). From the seven assessments, there were a total of 29 putative items and 10 putative domains identified for a generic checklist. These were reduced to five domains and 19 items through the content analysis and Delphi process, and a generic overarching checklist was created. CONCLUSION: Using this generic checklist, it may now be possible to pool data inter-institution to perform more powerful analyses on how our students obtain, or fail to obtain competence in forceps exodontia.

Persistent idiopathic unilateral isolated hypoglossal nerve palsy: a case report.

Isolated hypoglossal nerve palsy (IHNP) although a rare condition, has been previously reported. A literature review revealed that in most cases, IHNP indicates the presence of an intracranial or extracranial space occupying lesion, head and neck injury, vascular abnormality, infection, autoimmune disease or neuropathy. Reports of idiopathic cases are rare and the vast majority of IHNP are reversible. We report a case of persistent idiopathic unilateral hypoglossal nerve palsy, with an emphasis on the investigations necessary to be undertaken on presentation of such a lesion.

Reconstruction of the eyebrow using a combination of hair-bearing composite graft and microsurgical hair follicle transplant techniques.

We present a patient whose eyebrow was restored following a road vehicle crash by a postauricular composite graft together with microfollicular hair transplants.

Simultaneous repair of an orbital floor fracture and removal of an ethmoid osteoma: case report and review of the literature.

A case is presented of an ethmoid osteoma, which was discovered during the investigation of an orbital floor fracture. The osteoma was removed at the same time as orbital floor repair and special attention paid to preserving the medical canthal structures.

Sublingual gland involvement in systemic Wegener's granulomatosis: a case report.

Wegener's granulomatosis is a systemic vasculitis characterized by necrosis, granulomatosis and inflammation. The usual targets are extra-oral, although salivary gland involvement has been recognized, usually confined to parotid and submandibular glands. A case report is presented of sublingual gland presentation, confirmed on biopsy, which proceeded to systemic involvement. Some evidence suggests that salivary gland involvement, if recognized, may lead to an early diagnosis and the potential for earlier therapeutic intervention.