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INTRODUCTION: The aim of unilateral cleft lip repair is to restore form and function, including symmetrisation of cleft and non-cleft philtral height. Expectation of best outcome is achieved in situations with minimal asymmetry and is assumed occurs most often in incomplete cleft lip only patients. We sought to investigate philtral height discrepancy (PHD) in children with unilateral cleft lip + /-palate from a single nation cohort. METHODS: Review of prospectively collected PHD measurements taken at time of surgery for all children undergoing unilateral cleft lip repair in Scotland born Jan 2017-December 2020. Data was collected using Microsoft Excel and analysed using embedded statistical software. RESULTS: 102 consecutive patients with unilateral lip involvement were identified from the national database. 94 had prospectively documented PHD (92.2%). The majority of patients had an isolated cleft lip (51.1%). Incomplete clefts presented more frequently (52.1%) than complete clefts (47.9%). Mean PHD for the whole cohort was 3.91mm (standard deviation 1.01mm, range 1-6mm). The difference in mean PHD (in-complete versus complete) was 1.1mm (3.4 vs. 4.5, p < 0.001). For lip only versus lip and palate the difference in mean PHD was 1.0mm (3.4 vs. 4.4, p < 0.001). CONCLUSIONS: This single country consecutive cohort review of PHD in children undergoing unilateral cleft lip repair statistically supports the anecdote that patients with an incomplete cleft lip and isolated cleft lip have lesser asymmetry at presentation. This study presents a consecutive cohort with a greater range of PHD than has previously been reported in the literature.
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METHODS: Retrospective case note review was undertaken of all patients treated in the clinic over a two-year period. RESULTS: 20 patients underwent HA filler injections to the upper lip 26 times. Most were female (F:M = 3:1) and patients were aged 18-58 years. Most patients had a unilateral cleft lip +/- palate (n = 13, 65%). The most common indication was to address upper lip volume (n = 13, 65%). Other indications included vermillion notch (n = 5, 25%), cupid bow peak height asymmetry (n = 4, 20%), scar asymmetry (n = 1, 5%) and nasal sill flattening (n = 1, 5%). Small volumes of filler were used with an average of 0.34â ml (range 0.05-1.2â ml). There were no complications and one patient reported pruritis post procedure. CONCLUSIONS: HA filler is a safe and reliable treatment for certain aspects of asymmetry following cleft lip repair. It can be used to address volume deficiency and asymmetry, cupid bow peak height discrepancies and a vermillion notch for patients who do not want surgery. Injection of HA to the lips can be performed easily, with appropriate training, in the outpatient setting.
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We present a novel device which is an alternative to surgical wire for per operative maxillo-mandibular fixation prior to plate placement. It is easy to apply, causes minimal mucosal trauma and can be used in association with elastic chain.
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Técnicas de Fixação da Arcada Osseodentária/instrumentação , Desenho de Equipamento , Humanos , Cetonas/química , Plásticos/química , Propriedades de SuperfícieRESUMO
A case of Cowden's disease is reported, and possible differential diagnosis for the oral lesions is suggested.
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Síndrome do Hamartoma Múltiplo/patologia , Mucosa Bucal/patologia , Neoplasias Bucais/patologia , Papiloma/patologia , Feminino , Humanos , Pessoa de Meia-IdadeRESUMO
Treatment of fractured mandibular condyles remains controversial. In this paper we present data collected prospectively on 42 fractured condyles treated by open reduction and internal fixation. The central issue, which is sometimes forgotten, is the informed consent of our patients. To this end we have looked at the surgical morbidity related to the retromandibular approach.
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Fixação Interna de Fraturas/métodos , Côndilo Mandibular/lesões , Côndilo Mandibular/cirurgia , Fraturas Mandibulares/cirurgia , Procedimentos Cirúrgicos Bucais/métodos , Adulto , Cicatriz/etiologia , Traumatismos do Nervo Facial/etiologia , Fixação Interna de Fraturas/efeitos adversos , Fraturas Mal-Unidas/etiologia , Humanos , Consentimento Livre e Esclarecido , Procedimentos Cirúrgicos Bucais/efeitos adversos , Estudos ProspectivosRESUMO
Training is a central component of the work of many units around the UK. Many changes to the way that junior doctors are trained have taken place over the past few years and maxillofacial surgery, of all the surgical specialities, has perhaps undergone the most far-reaching. A postal survey of 93 maxillofacial specialist registrars (SpRs) in all regions of the UK was carried out, of whom 81 (87%) responded. The aim was to seek their views on subjects directly related to the quality of, and access to, training. Information was gathered on age of trainees, entitlement to annual and study leave, certification for Advanced Trauma Life Support (ATLS) and office and research facilities.
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Atitude do Pessoal de Saúde , Equipe Hospitalar de Odontologia/psicologia , Educação de Pós-Graduação em Odontologia/estatística & dados numéricos , Cirurgia Bucal/educação , Adulto , Equipe Hospitalar de Odontologia/estatística & dados numéricos , Educação de Pós-Graduação em Odontologia/economia , Educação de Pós-Graduação em Odontologia/normas , Educação de Pós-Graduação em Medicina/economia , Educação de Pós-Graduação em Medicina/normas , Educação de Pós-Graduação em Medicina/estatística & dados numéricos , Avaliação Educacional , Humanos , Internato e Residência/estatística & dados numéricos , Cuidados para Prolongar a Vida , Corpo Clínico Hospitalar/psicologia , Corpo Clínico Hospitalar/estatística & dados numéricos , Satisfação Pessoal , Inquéritos e Questionários , Apoio ao Desenvolvimento de Recursos Humanos , Traumatologia/educação , Reino UnidoRESUMO
We aimed to compare the reliability of the Kindelan system using one postoperative radiograph to assess the success of alveolar bone grafts with the use of two occlusal radiographs (before and after operation). This retrospective reliability study took place at Glasgow Dental Hospital cleft unit, and two examiners scored 84 radiographs two weeks apart. The sample was taken from a database of patients having alveolar bone grafts between 2007 and 2010. They had an upper anterior occlusal radiograph taken before the graft and another at a mean of 6 months (range 3-12 months) postoperatively. Kappa scores were used to measure intraobserver and interobserver agreement. Intraexaminer agreement ranged from good to very good using one or two radiographs, and interexaminer agreement ranged from moderate to good for both systems. Reliability when scoring with either one or two radiographs was similar, and ranged from good to very good.
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Processo Alveolar/diagnóstico por imagem , Transplante Ósseo/diagnóstico por imagem , Processo Alveolar/cirurgia , Transplante Ósseo/métodos , Fenda Labial/cirurgia , Fissura Palatina/cirurgia , Humanos , Radiografia/métodos , Procedimentos de Cirurgia Plástica/métodos , Reprodutibilidade dos Testes , Resultado do TratamentoAssuntos
Cirurgia Bucal/educação , Adulto , Fatores Etários , Educação em Odontologia , Educação Médica , Humanos , Fatores de Tempo , Reino UnidoRESUMO
We present a summary of a prospective study of 50 consecutive cases into the morbidity associated with open reduction and internal fixation of the fractured mandibular condyle through the transparotid approach. It is acceptably safe, and the data can now be presented to patients to help them make an informed choice about options for treatment.