RESUMEN
Trigeminal neuralgia is an extremely painful affliction of the face that is treated by various specialists including oral and maxillofacial surgeons. Some aspects of its management remain controversial, including screening for secondary trigeminal neuralgia, and the monitoring of treatment with carbamazepine. There is, however, little information available about current practice. A postal questionnaire was sent to 254 fellows of the British Association of Oral and Maxillofacial Surgeons (BAOMS) about v arious aspects of the management of trigeminal neuralgia. One hundred and seventy nine replies (70%) were received. Orofacial and cranial nerve examinations were undertaken by the majority of surgeons, but most did not routinely arrange computed tomograp hy or magnetic resonance imaging for all patients, nor did they refer the patient to a neurologist. In contrast with current recommendations, warnings about the adverse effects of carbamazepine were given by only a few surgeons, while most routinely monitored full blood counts.
Asunto(s)
Pautas de la Práctica en Odontología/estadística & datos numéricos , Cirugía Bucal/estadística & datos numéricos , Neuralgia del Trigémino/terapia , Anticonvulsivantes/efectos adversos , Carbamazepina/efectos adversos , Sistema Nervioso Central/efectos de los fármacos , Neoplasias de Cabeza y Cuello/complicaciones , Sistema Hematopoyético/efectos de los fármacos , Humanos , Imagen por Resonancia Magnética/estadística & datos numéricos , Esclerosis Múltiple/complicaciones , Derivación y Consulta/estadística & datos numéricos , Encuestas y Cuestionarios , Tomografía Computarizada por Rayos X/estadística & datos numéricos , Neuralgia del Trigémino/etiologíaRESUMEN
OBJECTIVE: To examine trends in lip cancer mortality and incidence during the 20th century, and its geographical distribution, in England and Wales as a prerequisite to establishing any essential differences in the aetiology of lip and intra-oral cancer. METHOD: Age-standardised rates for lip cancer mortality by gender from 1901 to 1991 were derived from archived OPCS data. Standardised incidence rates from 1962 to 1986 were also calculated. Registrations of lip cancer between 1979 and 1983 in the 15 RHAs covering England and Wales were obtained from the same source and standardised incidence ratios (SIR) computed. RESULTS: Progressive and sustained falls in lip cancer mortality and incidence were recorded in the period covered. In males, these related particularly to cohorts born after 1856. In addition, the incidence of lip cancer in both genders was found to be raised in a band stretching from East Anglia to the South West and also in the Trent and Wales RHAs. CONCLUSIONS: The findings support an hypothesis that employment in the agriculture, forestry and fishing industries, and also pipe smoking, were the major risk factors for lip cancer in the 20th century. Further research is required to differentiate between the aetiological risk factors for lip and intra-oral cancer.
Asunto(s)
Neoplasias de los Labios/epidemiología , Adulto , Distribución por Edad , Anciano , Estudios de Cohortes , Inglaterra/epidemiología , Femenino , Humanos , Incidencia , Neoplasias de los Labios/etiología , Neoplasias de los Labios/mortalidad , Masculino , Persona de Mediana Edad , Mortalidad/tendencias , Exposición Profesional/efectos adversos , Prevalencia , Salud Rural/estadística & datos numéricos , Razón de Masculinidad , Fumar/efectos adversos , Estadísticas no Paramétricas , Luz Solar/efectos adversos , Gales/epidemiologíaRESUMEN
The role of the major risk factors, tobacco smoking and alcohol consumption, on trends in intra-oral cancer mortality in England and Wales between 1911 and 1990 was investigated, using lung cancer and liver cirrhosis as surrogate markers for smoking and drinking. Standardised mortality data on lung cancer and liver cirrhosis from the Office of Population Censuses and Surveys, aggregated into 5-year time periods for ages 35-64 and 65+ years, were regressed on corresponding data for intra-oral cancer. The strongest associations were in males aged 35-64 with a high negative correlation between lung and intra-oral cancer (rho=-0.98, 95% CI -0.99 to -0.96, P<0. 01) and, conversely, a positive correlation between liver cirrhosis and intra-oral cancer (rho=0.71, 95% CI 0.34 to 0.89, P<0.01). The findings suggest that rising alcohol consumption since the 1950s is more closely related to increasing intra-oral cancer incidence and mortality than smoking, most notably among younger males since the early 1970s.
Asunto(s)
Consumo de Bebidas Alcohólicas/mortalidad , Neoplasias de la Boca/mortalidad , Adulto , Distribución por Edad , Anciano , Consumo de Bebidas Alcohólicas/efectos adversos , Femenino , Humanos , Cirrosis Hepática Alcohólica/mortalidad , Neoplasias Pulmonares/mortalidad , Masculino , Persona de Mediana Edad , Neoplasias de la Boca/etiología , Factores de Riesgo , Estadísticas no Paramétricas , Reino Unido/epidemiologíaRESUMEN
Oral cancer in young adults is fortunately uncommon in the UK. However, since it is so rare, when cases present they are often misdiagnosed and inappropriately treated leading to delay in definitive treatment. This may, in turn, lead to a poorer prognosis for these patients. It is debatable if oral cancer in younger adults carries an inherently poor prognosis and presents with more aggressive tumours. Three cases of oral cancer in young adults, aged under 30 years are presented and the literature reviewed with respect to oral cancer in this group of patients.
Asunto(s)
Carcinoma de Células Escamosas/diagnóstico , Neoplasias de la Lengua/diagnóstico , Adulto , Diagnóstico Diferencial , Femenino , Estudios de Seguimiento , Humanos , Masculino , Úlceras Bucales/diagnóstico , Enfermedades de la Lengua/diagnósticoRESUMEN
OBJECTIVES: 1) To describe the relationships between intra-oral cancer incidence, in England and Wales and the corresponding incidence of lung cancer (a surrogate for cigarette smoking), and liver cirrhosis mortality (a surrogate for alcohol consumption). 2) To elucidate the role and relative importance of cigarette smoking and alcohol consumption in the aetiology of intra-oral cancer. METHOD: Registration data for intra-oral cancer in males and females aged 35 years and over for the 15 regional health authorities (RHAs) in England and Wales in 1979-1983 were obtained from the Office of Population Censuses and Surveys and aggregated for the five-year period. Census-based population data enabled standardised incidence ratios (SIR) to be calculated for each RHA. Using the identical method. SIRs were also computed for lung cancer and standardised mortality ratios (SMR) for liver cirrhosis, the latter for the period 1974-1978 to reflect the shorter induction time for liver disease than for cancer. Correlation coefficients (Spearman's rho) were calculated between the surrogate measures and intra-oral cancer incidence. RESULTS: For all three diseases a north-south gradient, favouring the more southerly RHAs was generally apparent. For males, the correlation between liver cirrhosis mortality and intra-oral cancer incidence was greater and statistically more significant (rho=0.75, P<0.01) than that between lung and intra-oral cancer incidence (rho = 0.63, P<0.05). For females, the corresponding correlation coefficients were positive but not significant. CONCLUSION: For males at least, the association between a surrogate marker for alcohol consumption and intra-oral cancer was greater than that observed for cigarette smoking. This adds further evidence to the current view that alcohol consumption may be more important in the aetiology of intra-oral cancer than cigarette smoking.
Asunto(s)
Consumo de Bebidas Alcohólicas/efectos adversos , Cirrosis Hepática/mortalidad , Neoplasias Pulmonares/epidemiología , Neoplasias de la Boca/epidemiología , Neoplasias de la Boca/etiología , Fumar/efectos adversos , Adulto , Biomarcadores de Tumor , Inglaterra/epidemiología , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Análisis de Regresión , Factores Sexuales , Análisis de Área Pequeña , Estadísticas no Paramétricas , Gales/epidemiologíaRESUMEN
OBJECTIVES: To examine the epidemiology of oral cancer in England and Wales from 1901 to 1990 using trends in mortality and incidence rates. SETTING: Data were obtained from OPCS archives for mortality and incidence of malignant neoplasia of the oral cavity (ICD 141, 143-146). Age-specific and age-standardised rates were calculated for both genders. Mortality data were available from 1901 but national incidence figures only commenced in 1962. RESULTS: Despite overall reductions for oral cancer in England and Wales during this century, significant increases in mortality and incidence have occurred in younger males during the last 30 years. These are associated with clear birth cohorts. No such cohort effects are apparent in females, despite similar though less pronounced trends. CONCLUSIONS: These results support similar studies in other parts of the UK and Europe. In the future there may be a substantial increase in the burden of new cases of oral cancer as birth cohorts with rising incidence rates enter age groups with higher disease frequencies. It is possible that raised alcohol consumption during the last 40 years may be responsible for the increases. This report reinforces the necessity to evaluate preventive programmes for oral cancer in the UK.
Asunto(s)
Neoplasias de la Boca/epidemiología , Adulto , Distribución por Edad , Anciano , Anciano de 80 o más Años , Consumo de Bebidas Alcohólicas/efectos adversos , Efecto de Cohortes , Estudios de Cohortes , Inglaterra/epidemiología , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Neoplasias de la Boca/etiología , Neoplasias de la Boca/mortalidad , Razón de Masculinidad , Gales/epidemiologíaRESUMEN
A case of malignant hyperpyrexia (MH) occurring in a patient undergoing orthognathic surgery is reported which resulted in the procedure being abandoned prior to completion. The oral surgeon's role in recognising the early clinical signs of masseteric spasm and central cyanosis is highlighted. The case shows that with proper investigation and management the MH susceptible patient was able to have a second anaesthetic with safety to complete the surgery.
Asunto(s)
Anestesia Dental/efectos adversos , Anestesia por Inhalación/efectos adversos , Complicaciones Intraoperatorias , Hipertermia Maligna , Succinilcolina/efectos adversos , Adulto , Cianosis/etiología , Femenino , Humanos , Hipertermia Maligna/etiología , Maloclusión/cirugía , Músculo Masetero/fisiopatología , Procedimientos Quirúrgicos Ortognáticos , Osteotomía/efectos adversos , Trismo/etiologíaRESUMEN
This study reveals that changes are occurring in the pattern of oral cancer. Despite decreases in the number of lip and salivary gland cases, intra-oral cancer is increasing. The number of new cases is rising, especially in females, and it is presenting at a younger age in males. Intra-oral cancer deaths have increased, with females showing a 40% rise. The mortality rate has deteriorated to 62%. It is possible that these increases could be attributed to continued lack of public awareness of the disease and a considerable rise in alcohol consumption per head of population in the UK.