Cleft Repair in Adults: A Report on a Case Series.

Speech defects and facial appearance due to untreated cleft lip and/or palate in the elderly population have associated life-long impacts on the quality of life for these patients. Treatment and rehabilitation in this patient group can be extensive and the problems not easily corrected. We report the outcomes of surgical repair of cleft in a series of elderly patients with unrepaired cleft lip and/or palate. Our results confirm an improvement in speech, quality of life and aesthetic outcomes after surgical repair in these patients. With this in mind, we advise cleft teams to consider surgical repair of untreated cleft lip and/or palate in the elderly population.

Spindle cell haemangioma of the tongue.

BACKGROUND: Spindle cell hemangioma (SCH) is an uncommon benign vascular tumor that rarely occurs in the mouth. METHODS AND RESULTS: We present an SCH arising in the tongue of a 52-year-old otherwise healthy woman. SCH should be considered in the differential diagnosis of vascular tumors in the oral cavity and not misinterpreted as a more aggressive vascular tumor. We describe the clinical presentation, investigation, differential diagnosis and management of this condition and a literature search showing published case reports. CONCLUSION: Although SCH rarely presents in the oral cavity it needs to be considered in the differential diagnosis of oral cavity tumors.

A guide to skin cancer of the face for the dental team.

UNLABELLED: The incidence of skin cancer in the United Kingdom is increasing and is associated with an ageing population and increasing lifetime exposure to sunlight. The three most common types of skin cancer are basal cell carcinoma, squamous cell carcinoma and malignant melanoma, all three of which may present on the skin of the face. The dental team are, therefore, well-placed to recognize suspicious lesions and arrange for further advice or assessment. This paper outlines the epidemiology, important clinical features and principles of modern management of facial skin cancers to aid dental practitioners in the recognition of suspicious lesions. In addition, some of these treatments have side-effects which have the potential to affect a patient's oral health or its management and these aspects are also discussed. CLINICAL RELEVANCE: The dental surgeon is ideally placed to recognize malignant or potentially malignant lesions on patients'faces and to advise on seeking further advice or refer for assessment, as appropriate. Dental practitioners will increasingly encounter patients who have undergone surgical or non-surgical management of facial skin cancer and should understand the potential oro-facial side-effects of such treatment.

Recurrent Langerhans cell histiocytosis of the mandible.

We report a case of Langerhans cell histiocytosis with a restricted presentation (eosinophilic granuloma of the mandible) complicated by multiple reactivations.

Surgical management of temporomandibular joint ankylosis in ankylosing spondylitis.

Relatively few patients develop such severe degenerative temporomandibular joint (TMJ) disease that they require total joint replacement. Current indications include those conditions involving condylar bone loss such as degenerative (osteoarthritis) or inflammatory joint disease (ankylosing spondylitis, rheumatoid, and psoriatic). Ankylosis of the temporomandibular joint (TMJ) secondary to ankylosing spondylitis remains an under investigated entity. We aim to provide an overview of treatment objectives, surgical procedures, and our experience with total TMJ replacement for this condition.

The outcome for secondary alveolar bone grafting in the South West UK region post-CSAG.

OBJECTIVE: In 1998 the delivery of cleft care in the United Kingdom was examined by the Clinical Standards Advisory Group, the outcomes of which led to the wide restructuring of cleft services in the United Kingdom. We present a retrospective study evaluating the radiographic outcome of 53 consecutively performed alveolar bone grafts following the regional centralization of secondary alveolar bone grafting to the South West Cleft Centre between 2004 and 2006. METHODS: A retrospective audit of one surgeon's outcome of 53 consecutively performed alveolar bone grafts, assessed radiographically using the Kindelan method. RESULTS: That 94% of bone-grafted sites achieved a successful radiographic outcome compares favorably with the previously published Clinical Standards Advisory Group data of 58% with Bergland scores. CONCLUSION: The radiographic outcome for alveolar bone grafting has improved with centralization. A small number of patients are being grafted after the ideal chronological age, and this needs to be addressed throughout the region. The Kindelan assessment provides a reliable method of early assessment for alveolar bone grafting.

Thrombosis of the internal jugular vein: A rare but important operative finding.

Free flap reconstruction following the surgical resection of head and neck malignancy optimally utilises the internal jugular vein as the main recipient vessel for venous anastamosis. We describe an unusual case of thrombosis having arisen de novo within the internal jugular vein and identified at the time of neck dissection. We believe this is the first case of this phenomenon in a patient without a history of thrombophilia, distant malignancy, or local invasion by tumour.