ABSTRACT
We compared two techniques of superficial parotidectomy: conventional antegrade dissection of the facial nerve, and retrograde dissection. A total of 89 parotidectomies were included and the results presented of a retrospective case study during a six-year period. Superficial parotidectomy involves identification of the facial nerve. We present 49 parotidectomies in 45 patients using the conventional technique of antegrade dissection of the nerve, and 40 parotidectomies in 39 patients using retrograde dissection of the buccal branch of the facial nerve from 4cm in front of the alatragal line to the main trunk of the nerve. The incidence of postoperative complications (facial nerve palsy, Frey syndrome, haematoma, and wound infection) were compared. The Facial nerve function was assessed by patient complaints and clinical examination. There was no significant difference in the incidence of postoperative complications between the groups. We describe an alternative technique for identifying the main trunk of the facial nerve.
Subject(s)
Dissection/methods , Facial Nerve/surgery , Parotid Gland/surgery , Adenolymphoma/surgery , Adenoma, Pleomorphic , Adult , Aged , Aged, 80 and over , Facial Paralysis/etiology , Female , Hematoma/etiology , Humans , Male , Middle Aged , Parotid Diseases/surgery , Parotid Neoplasms/surgery , Parotitis/surgery , Postoperative Complications , Postoperative Hemorrhage/etiology , Retrospective Studies , Surgical Wound Infection/etiology , Sweating, Gustatory/etiologyABSTRACT
We describe a case of rhabdomyolysis involving the masseter muscle. It involved an episode of muscle lysis of the left upper and lower limb and the left masseter, after ingesting an unknown quantity of alcohol, amphetamines and ecstasy with prolonged immobility for an unknown period after collapse. Musculoskeletal sonography was used to diagnose rhabdomyolysis of the left masseter muscle.
Subject(s)
Masseter Muscle/pathology , Rhabdomyolysis/diagnostic imaging , Acute Kidney Injury/etiology , Adult , Alcoholic Intoxication/complications , Amphetamine/poisoning , Coma/etiology , Drug Overdose , Edema , Face , Humans , Male , Masseter Muscle/diagnostic imaging , N-Methyl-3,4-methylenedioxyamphetamine/poisoning , Rhabdomyolysis/complications , Rhabdomyolysis/etiology , UltrasonographyABSTRACT
Since the introduction of the 14-day rule for referrals for cancer in 1999 there has been some suspicion that rates of detection of cancer are low and the number of inappropriate referrals is high. We undertook a prospective study of 150 consecutive patients with oral lesions referred to a department of oral and maxillofacial surgery in a teaching hospital that uses a "two week wait" fast-track referral system for head and neck cancers. The main outcome measures were the number of cancers detected, the age and sex of the patients, the number seen within 2 weeks, by whom, and the final diagnosis. Most patients (n=120, 80%) were referred with oral ulceration. All patients were seen within 2 weeks (mean 6 days). Nine patients (6%) had a diagnosis of malignancy and 17 (11%) had no detectable abnormality. The study confirms what others have shown, that the yield of diagnoses of malignant disease from fast-track referrals is low and the number of non-urgent referrals is high.
Subject(s)
Mouth Neoplasms/epidemiology , Referral and Consultation/statistics & numerical data , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Mouth Diseases/diagnosis , Mouth Neoplasms/diagnosis , Oral Ulcer/diagnosis , Prospective Studies , Time FactorsABSTRACT
This case illustrates the surgical use of wire localization, a well tried technique from a different field of surgery, in the removal of an ultrasound-detected, impalpable deep lower cervical lymph node in a high-risk patient. A localization needle with an echogenic tip was placed freehand under ultrasound guidance, immediately before surgery. The imaging and marking of the impalpable cervical lymph node resulted in a precise surgical dissection and a reduction in operating time whilst minimizing risks to the patient and staff.
Subject(s)
Lymph Node Excision/methods , Lymph Nodes/diagnostic imaging , Neck , Preoperative Care/methods , Adult , Equipment Design , Female , Humans , Palpation , Preoperative Care/instrumentation , UltrasonographyABSTRACT
A novel method for planning the placement of intra-oral lengthening devices using a paralleling device is described and illustrated with a case report. Simple radiographic measurements and study models are all that is required to construct a simple acrylic splint with guides, which allows accurate positioning of the distractors at surgery. The construction of ethylene vinyl acetate (EVA) baffles to prevent trauma to the labial mucosa from the intra-oral link arms is a technique that enhances patient comfort during distraction of the mandible. The case report demonstrates the application of the surgical planning technique and the use of EVA baffles for a patient with an overjet of 21.5 mm.
Subject(s)
Mandible/surgery , Mouth Protectors , Osteogenesis, Distraction/instrumentation , Polyvinyls/chemistry , Acrylic Resins , Adolescent , Computer-Aided Design , Equipment Design , Female , Humans , Malocclusion, Angle Class II/surgery , Malocclusion, Angle Class II/therapy , Models, Dental , Osteotomy/instrumentation , Patient Care Planning , SplintsABSTRACT
A 6-month prospective study of 166 patients was undertaken to assess whether general dental practitioners who referred patients for removal of wisdom teeth were following current national guidelines. It was found that 92% of referrals followed the guidelines of the Faculty of Dental Surgery of the Royal College of Surgeons of England and the National Institute for Clinical Excellence. There were 13 inappropriate referrals - 3 patients were asymptomatic, 9 patients had a single episode of pericoronitis and 1 had crowding of the lower anterior incisors. General dental practitioners in this study seem to be following current guidelines consistently. No teeth were removed prophylactically.
Subject(s)
General Practice, Dental/standards , Molar, Third/surgery , Practice Patterns, Dentists'/standards , Referral and Consultation/standards , Tooth Extraction , Adolescent , Adult , Aged , Female , Guideline Adherence , Humans , Male , Middle Aged , Practice Guidelines as Topic , Practice Patterns, Dentists'/statistics & numerical data , Prospective Studies , Referral and Consultation/statistics & numerical data , Societies, Dental , United KingdomABSTRACT
This article gives an account of contemporary methods in orthognathic surgery, highlighting which patients are appropriate for such surgery. In order to make the case relevant, a single patient is tracked through her orthodontic treatment, surgery and final outcome.
Subject(s)
Malocclusion/surgery , Female , Humans , Jaw Relation Record , Malocclusion/classification , Malocclusion/therapy , Malocclusion, Angle Class III/surgery , Malocclusion, Angle Class III/therapy , Orthodontic Retainers , Osteotomy/methods , Patient Care Planning , Prognathism/surgery , Splints , Tooth Movement Techniques/instrumentation , Treatment OutcomeABSTRACT
Reports of T-cell lymphomas in the oral cavity are rare. Most have presented as a persisting ulcerated swelling. This paper reports two men, one of whom presented with a short history of increasing facial swelling and pain apparently related to a lower premolar tooth, and the other who had recurrent oral ulceration in several sites over a period of years. These types of cases are likely to present initially to general dental practitioners.
Subject(s)
Lymphoma, B-Cell/diagnosis , Lymphoma, Non-Hodgkin/diagnosis , Lymphoma, T-Cell/diagnosis , Mouth Neoplasms/diagnosis , Oral Ulcer/diagnosis , Stomatitis, Aphthous/diagnosis , Aged , Biopsy , Diagnosis, Differential , Fatal Outcome , Humans , Male , Middle Aged , Mouth Neoplasms/pathologySubject(s)
Ambulatory Care Facilities , Anesthesia, Dental , Molar, Third/surgery , Tooth Extraction , Humans , United KingdomABSTRACT
We present a case of disseminated high-grade, T-cell-rich B-cell lymphoma in a 72-year-old white woman that presented as unilateral parotid swelling, and was initially diagnosed as xanthogranulomatous sialadenitis.
Subject(s)
Lymphoma, B-Cell/diagnosis , Lymphoma, Non-Hodgkin/diagnosis , Lymphoma, T-Cell/diagnosis , Parotid Diseases/diagnosis , Parotid Neoplasms/diagnosis , Sialadenitis/diagnosis , Aged , Diagnosis, Differential , Fatal Outcome , Female , Granuloma/diagnosis , Humans , Xanthomatosis/diagnosisABSTRACT
This article determines whether it is possible to decrease the number of review appointments following wisdom teeth removal without detriment to the patient. A prospective single-centre study was undertaken in a general hospital with 130 consecutive patients undergoing the removal of impacted wisdom teeth.
Subject(s)
Molar, Third/surgery , Postoperative Care , Tooth Extraction , Analgesia , Anesthesia, Dental , Follow-Up Studies , Humans , Patient Education as Topic , Tooth, Impacted/surgeryABSTRACT
We report a case of oral squamous cell carcinoma (SCC) originating in the buccal mucosa of an 18-year-old female patient with chronic graft-versus-host disease (GVHD) 9 years after HLA-identical sibling bone marrow transplantation (BMT) for Fanconi anaemia (FA). The case highlights the problems of malignant change in FA and also the increased risk of second malignancy after BMT. The literature is reviewed with regard to previous cases and the possible aetiology of tumour formation. A high index of suspicion to any epithelial lesion in FA is appropriate so that early diagnosis may lead to improved prognosis.
Subject(s)
Bone Marrow Transplantation/adverse effects , Carcinoma, Squamous Cell/etiology , Fanconi Anemia/therapy , Graft vs Host Disease/etiology , Mouth Neoplasms/etiology , Adolescent , Adult , Child , Fatal Outcome , Female , Humans , Male , Middle Aged , Transplantation, HomologousABSTRACT
Tumours of the sublingual salivary gland are exceptionally rare. The present case report describes an adenoid cystic carcinoma of the sublingual salivary gland occurring in a 16-year-old girl, in itself an uncommon event. In addition, an interesting feature of the presentation was obstruction of the ipsilateral submandibular gland due to involvement of Wharton's duct.
Subject(s)
Carcinoma, Adenoid Cystic/pathology , Sublingual Gland Neoplasms/pathology , Adolescent , Biopsy , Carcinoma, Adenoid Cystic/surgery , Female , Humans , Magnetic Resonance Imaging , Sublingual Gland/pathology , Sublingual Gland Neoplasms/surgeryABSTRACT
Fifty oral biopsy specimens were removed, 24 with a punch and 26 by conventional incision with a scalpel. All specimens were routinely processed in the histopathology laboratory and examined for artefacts. Significantly fewer artefacts were found in the punch biopsy group compared to the incisional biopsy group. Access for the punch was not found to be a problem.
Subject(s)
Artifacts , Biopsy/methods , Mouth Mucosa/pathology , Chi-Square Distribution , Humans , Lichen Planus, Oral/pathology , Mouth Mucosa/surgery , Mouth Neoplasms/pathologyABSTRACT
A case is reported in which an unexpected occlusal result arose following bimaxillary osteotomy for correction of a skeletal Class III discrepancy. In order to correct the occlusion, the mandible was protracted independently of the recently plated maxilla, by means of a fronto-sternal traction device.
Subject(s)
Extraoral Traction Appliances , Malocclusion, Angle Class III/surgery , Adult , Female , Humans , Mandible/surgery , Maxilla/surgery , Orthodontic Appliance Design , OsteotomyABSTRACT
Visceral leishmaniasis is an infectious disease with a classical clinical presentation of fever, anaemia and splenomegaly forming the three cardinal signs. A rare presentation of the disease is described where cervical lymph node enlargement was the only sign and there were no symptoms. It is emphasised that with extensive travel to and from areas of endemic leishmaniasis now established, it is important that clinicians and pathologists become acquainted with the characteristics of the disease.
Subject(s)
Leishmania infantum , Leishmaniasis, Visceral/diagnosis , Lymph Nodes/parasitology , Lymphadenitis/diagnosis , Lymphadenitis/parasitology , Animals , Diagnosis, Differential , Female , Head and Neck Neoplasms/diagnosis , Humans , Leishmania infantum/isolation & purification , Lymphoma/diagnosis , Middle Aged , NeckABSTRACT
Castleman's disease is a rare condition usually presenting as a localized mass of lymphoid tissue in the thorax. We report the CT and MRI appearances of a case of cervical Castleman's disease.
Subject(s)
Castleman Disease/diagnosis , Magnetic Resonance Imaging , Tomography, X-Ray Computed , Adolescent , Castleman Disease/diagnostic imaging , Female , Humans , Neck/diagnostic imaging , Neck/pathologyABSTRACT
The ossifying fibromyxoid tumour of soft parts was first described as recently as 1989 by Enzinger has not been previously reported in the maxillofacial literature. This tumour has a proven record of recurrence and a potential in a few cases to become malignant and to metastasise. Being such a rare and relatively newly described tumour it has proved to be difficult to diagnose and manage. In order to illustrate these difficulties we describe a case in which such a tumour occurred in the parotid/zygomatic arch region and recurred three times following surgical removal over a period of 24 years. Since the tumour has a pseudo-capsule containing nests of tumour cells, we recommend that it could be removed from the head and neck region with a wide margin of excision.
