Current thinking in lower third molar surgery.

The removal of lower third molar teeth is one of the most common surgical procedures performed worldwide, but many concepts in this surgery have been unclear and have engendered different opinions. This paper aims to review current thinking in certain pertinent aspects of this surgery to update the reader on the most current research and synthesise it to make clinical recommendations. Topics covered include preoperative imaging, timing of removal, flap design, lingual retraction, coronectomy, lingual split, closure techniques, and use of antibiotics, steroids, and drains.

When can patients blow their nose and fly after treatment for fractures of zygomatic complex: the need for a consensus.

PURPOSE: To determine current professional advice to patients about refraining from nose blowing and air travel following treatment of zygomatic fractures. METHODS: A postal questionnaire was sent to 261 consultant oral and maxillofacial surgeons (OMFS) in the UK. They were asked about advice given to patients regarding length of time to refrain from nose blowing and air travel following treatment of zygomatic fractures. RESULTS: A total of 184 (71%) replies were received. Advice regarding the length of time to refrain from nose blowing and air travel ranged from no advice to 8 weeks. About 90% of respondents based their advice on common sense and traditional practice. CONCLUSIONS: Advice given to the patients following the treatment of zygomatic fractures varies widely. Most consultants based their advice on traditional practice and common sense. In the absence of widely accepted guidelines, there is a need for an agreement among clinicians on advice given to the patients.

Women who wish breast reconstruction: characteristics, fears, and hopes.

The aims of the present study were to identify the characteristics of a consecutive series of women with newly diagnosed breast cancer and to evaluate the perceived benefits and disadvantages of breast reconstruction. A consecutive series of 125 women completed the Breast Reconstruction Questionnaire, the Hospital Anxiety and Depression Scale, and the Eysenck Personality Questionnaire. The median age was 48 years (range, 28 to 75 years). A total of 49.6 percent (n = 62) indicated that, if it were possible, they would like breast reconstruction. Logistic regression (simultaneous entry) revealed that younger women (p = 0.0001) and more depressed women (p = 0.026) were more likely to wish reconstruction. Marital status, tumor size, extroversion, neuroticism, and tough-mindedness did not independently predict the desire for reconstruction. If given a choice of reconstruction at 3 months or 6 months after mastectomy, of the women who wished reconstruction, 74 percent would prefer it at 3 months. Of the women who wished reconstruction and expressed a preference, 63 percent were afraid reconstruction might mask recurrence, 39 percent were afraid that reconstruction might cause the cancer to return, and 89 percent thought they would be concerned with their appearance after the operation. Positively, 94 percent considered that reconstruction would be beneficial in terms of their self-esteem, 86 percent indicated that reconstruction would give greater freedom to wear any clothing, and 86 percent thought that the cosmetic appearance of breast reconstruction was better than that of a prosthesis. Concerns about recurrence were common. A better understanding of the concerns of women with regard to reconstruction would allow more informed preoperative discussion.