Effect of two fascial incision options for access to the temporomandibular joint on facial nerve function: objective investigation.

This study was performed to compare the effects on facial nerve (FN) function of the deep supra-temporalis muscle subfascial approach (DSFA) and traditional fascial approach (TFA) for access to the temporomandibular joint (TMJ), via qualitative and quantitative evaluations. Thirty patients requiring open TMJ surgery were randomly allocated to one of two groups: group A patients underwent the DSFA approach, while group B patients underwent the TFA approach. The TMJ was accessed via modified endaural incision with temporal extension. Clinical examinations, FN conduction tests, and electromyography (EMG) of the frontalis and orbicularis oculi muscles were used to assess FN function. A FN function deficit was noted in 50% of the whole sample population immediately after surgery, with no statistically significant difference between the groups (P = 0.082). Overall, 37.5% of the total study population experienced temporary loss of frontalis muscle activity, while zygomatic nerve injury was seen only in 25% of group A. Within 2-6 months, normal function returned in both groups. Nerve conduction studies showed no statistically significant difference between the groups in terms of nerve amplitude or latency after surgery. However, EMG of orbicularis oculi activity showed a significant difference between the groups after 6 months (P = 0.010). The results suggest that the traditional dissection approach is more protective of the FN, especially the zygomatic branch, than the deeper dissection technique.

Evaluation of the paraskeletal clamp system (Mennen plate) in treatment of mandibular fractures.

In this study, we used the relatively recent Paraskeletal clamp system (Mennen plate) to evaluate its effectiveness in the treatment of mandibular fractures. This study was conducted on eight patients with mandibular fractures selected from the out patient clinic, Oral Surgery Department, Faculty of Oral and Dental Medicine, Cairo University. Patient sample consisted of six males and two females, four patients were children below the age of 11 years, while the other four were edentulous above the age of 58. Each patient was thoroughly examined both clinically and radiographically. Data collected from each patient were recorded in a special examination chart. Under general anesthesia, the fracture was exposed using a submandibular approach. The fractured segments were reduced and fixed using micro-5 Mennen plates. All patients were followed up both clinically and radiographically for six months postoperatively. Results obtained from this study showed uneventful healing of all patients with no cases of non-union, bony infection or osteomyelitis as proven both clinically and radiographically. All the patients presented normal functioning occlusion and facial symmetry. No bony step deformities were detected.

Study of knowledge and attitudes of nurses in Alexandria towards female circumcision.

PIP: A study of 135 nurses' attitudes toward female circumcison was conducted at the Shatby maternity hospital, Dar el Welada, and other hospitals. Only 6.7% of all nurses could identify the 3 types of female circumcison: 20% knew the sunna type; 5.2% knew the pharaonic type; and 25.1% knew clidorectomy. 43% were unable to identify any type. The disadvantages of female circumcision mentioned by the nurses were decrease of libido (21.5%), hemorrhage (20.7%), and disfigurement (1.5%). 76.4% did not know whether female circumcision was legal in Egypt. 28.1% believed the operation to be advantageous either for cleanliness (10.3%), to decrease libido and protect the girl against extramarital sex (8.9%), and for both reasons (8.9%). One third of the nurses said they would circumcise their own daughters. 20% felt that they would do so for esthetic reasons; 10.4% to decrease sexual desire; and 2.2% had religious reasons. 64.4% stated that female circumcison had no religious basis; 13.3% said that it had a religious basis but did not know the source. Younger nurses (under age 25) were less inclined to circumcise their daughters (19.5%), compared to those over age 30 (49.6%). Nurses with less than 5 years experience in maternity practice were more reluctant to circumcise their daughters (22.7%) than those with 10 years or more in the field (45.7%).^ieng