Oral and Maxillofacial Surgery

Information for oral and maxillofacial patients: can it be improved? Publication date: Available online 1 May 2019 Source: British Journal of Oral and Maxillofacial Surgery Author(s): H. Parvez, M.S. Noorani, N. Pandis, M.T. Cobourne, J. Seehra Abstract The aim and objective of this study was to evaluate the quality and readability of leaflet and online Oral and Maxillofacial Surgery patient information leaflets (PILs). The quality, readability and grade level of each PIL was assessed using the DISCERN, Flesch Reading Ease and Flesh-Kincaid Grade Level instruments respectively. In total, 140 patient information leaflets were assessed. For both leaflet and online PILs, many items of the DISCERN instrument were deemed of low quality and poorly reported. The median overall quality score was 30.2. Variation in the quality and readability scores between leaflet and online PILs and those produced by various societies was evident. Overall, PILs were deemed to be of moderate quality. Online PILs were of lower quality, more difficult to read and aimed at a higher reading age level.

Rare lesion, unusual location, uncommon presentation: a case of angiolymphoid hyperplasia with eosinophilia Publication date: Available online 1 May 2019 Source: British Journal of Oral and Maxillofacial Surgery Author(s): N. Ciaramicolo, M. Custódio, S.C.O.M. de Sousa, M.G. Naclério-Homem Abstract Angiolymphoid hyperplasia with eosinophilia (ALHE) is a rare vascular proliferation of unknown pathogenesis that may be related to trauma. Although it affects mainly the head and neck, the zygomatic area is rarely involved. We report a case that affected the zygomatic region of a 46-year-old black man. The lesion had been present for about a year and the patient reported that it appeared after a facial injury during a soccer match. Clinical and tomographic investigations suggested a benign tumour, and the lesion was excised through an intraoral approach. Histopathological examination showed the unexpected diagnosis of ALHE. This tumour was interesting because of its rarity, and also because of its unusual site within the head and neck region. The diagnosis of ALHE is hardly ever considered in the differential diagnosis of zygomatic nodules.

Hyoid bone syndrome masquerading as temporomandibular joint dysfunction Publication date: Available online 1 May 2019 Source: British Journal of Oral and Maxillofacial Surgery Author(s): Anson Jose, Shakil Ahmed Nagori, Saurabh Arya, Ajoy Roychoudhury Abstract Hyoid bone syndrome is a type of cervicofacial pain that is caused by degeneration of the greater cornu of the hyoid at the attachment of the stylohyoid ligament. We report four patients who presented with deep-seated dull aching temporomandibular (TMJ) pain that radiated from the greater cornu of the hyoid bone and did not respond to conservative management. Diagnostic tests included a local anaesthetic block and digital palpation of the greater cornu of the hyoid bone. All four patients responded well to methylprednisolone 40 mg/ml at the greater cornu of the hyoid bone, which resulted in complete resolution of their symptoms. No patients developed postoperative complications. Oral and maxillofacial surgeons involved in the treatment of orofacial pain should consider this less documented condition in their differential diagnosis when treating temporomandibular disorders.

Importance of activity and recreation for the quality of life of patients treated for cancer of the head and neck Publication date: Available online 1 May 2019 Source: British Journal of Oral and Maxillofacial Surgery Author(s): Shruti Khatana, Sandeep Kumar Yadav, Rachit Khatana, Priyanka Kathuria

Raising the transcrestal sinus floor in the presence of antral pseudocysts, and in sinus floors with a normal Schneiderian membrane: a retrospective cohort study Publication date: Available online 30 April 2019 Source: British Journal of Oral and Maxillofacial Surgery Author(s): Ting Gong, Chen Hu, Yaqian Chen, Nan Zhou, Hongkun Wu, Yi Man Abstract In this study we sought to investigate the influence of antral pseudocysts on the raising of the transcrestal sinus floor. We retrospectively studied two groups (test group: those with antral pseudocysts, and controls: those with normal Schneiderian membranes). The crestal approach with simultaneous placement of implants was used for all patients. Cone-beam computed tomography was done before, immediately afterwards, and 4-6 months postoperatively. Nineteen participants (16 male, three female, mean (SD) age 48 (10) years) were enrolled in the test group, and 73 (38 male, 35 female, 44 (11) years) in the control group. Immediately postoperatively the mean (SD) residual bone height was 5.15 (1.34) mm in the test group and 5.36 (1.28) mm in the control group (p = 0.15), and the raised heights of the sinus floor were 4.98 (2.01) mm and 5.47 (2.13) mm (p = 0.35) in the test and control groups, respectively. Four to six months postoperatively the endo-sinus bone gain values were 3.55 (2.46) mm and 4.03 (2.33) mm in the test and control groups, respectively (p = 0.26). All pseudocysts swelled immediately after operation. Four to six months postoperatively, two had remained unchanged, three had increased in volume, six had disappeared, and eight had decreased in volume. The survival rate of implants was 100% for both groups. Within the limitations of this study, transcrestal raising of the sinus floor in the presence of antral pseudocysts may be a viable technique, as they may not influence the clinical effects of raising the sinus floor during healing.

Correction of a genioplasty Publication date: Available online 26 April 2019 Source: British Journal of Oral and Maxillofacial Surgery Author(s): T. Dennis, A. Bains, D. Doumpiotis

Congenital epulis: a rare case of feeding obstruction in a neonate Publication date: Available online 25 April 2019 Source: British Journal of Oral and Maxillofacial Surgery Author(s): P. McAllister, T. O'Neill, M. Devlin

Incidental finding of an accessory inferior alveolar nerve Publication date: Available online 25 April 2019 Source: British Journal of Oral and Maxillofacial Surgery Author(s): L. Sibanda, R. Elledge, E.M. Twohig

Oncological benefits of postoperative radiotherapy in node-negative early stage cancer of the oral cavity with isolated perineural invasion Publication date: Available online 25 April 2019 Source: British Journal of Oral and Maxillofacial Surgery Author(s): S.K. Rajappa, D. Ram, H. Shukla, G. Mandal, M. Venkatasubramaniyan, A. Dubey, M. Agarwal, R. Kumar, A.K. Dewan Abstract Perineural invasion has been widely regarded as a poor prognostic factor in cancer of the oral cavity, but adjuvant treatment based only on this is still debatable. We have made an effort to address the question in a retrospective analysis of data from 2009–15 of patients with early node-negative cancers of the oral cavity. Patients with perineural invasion were divided into those who were treated with radiotherapy and those who were not. The records of a total of 169 patients were analysed, and 118 were given adjuvant radiotherapy and 51 were not. The median (range) duration of follow up was 45 (26–86) months. Of 169 patients, 47 (28%) developed recurrence, 28 in the treated, and 19 in the untreated, group. There was a significant disease-free survival benefit for adjuvant treatment (p = 0.047) but no overall survival benefit (p = 0.54). We conclude that adjuvant radiotherapy should be considered for patients with perineural invasion, even in early cancers of the oral cavity.

Watchful waiting in carefully selected metachronous cystadenolymphomas of the parotid gland: a reliable option? Publication date: Available online 20 April 2019 Source: British Journal of Oral and Maxillofacial Surgery Author(s): K. Mantsopoulos, M. Goncalves, M. Koch, H. Iro Abstract The aim of this study was to evaluate the potential of watchful waiting in the treatment of metachronous cystadenolymphomas, taking the experience of our department into consideration. All patients suspected of having a metachronous cystadenolymphoma, and who had a minimum follow-up time of 12 months, were studied (n = 26). Data about the growth rate, number of lesions, and symptoms of inflammation were recorded. Mean (range) follow-up was 36 (13–94) months. Metachronous tumours developed in three cases on the ipsilateral side, in 22 cases on the contralateral side, and on both sides in one case. The mean rate of growth /lesion was 15% /year (range: 22%–158%). There were no signs of local inflammation. The extreme variability in the behaviour of metachronous cystadenolymphomas points to the need for an individualised approach, accurate investigation of the sonographic characteristics, and continuous watchful waiting in affected patients.