The effectiveness of bone anchored maxillary protraction (BAMP) in the management of class III skeletal malocclusion in children aged 11-14 years compared with an untreated control group: A multicentre two-arm parallel randomised controlled trial.

OBJECTIVE: To evaluate the effectiveness of bone anchored maxillary protraction (BAMP) in the management of class III skeletal malocclusion in children aged 11-14 years compared with an untreated control group in terms of perceived need for orthognathic surgery, skeletal and dental change, and psychological impact. DESIGN: A multicentre two-armed parallel randomised controlled trial. SETTING: Six UK hospital orthodontic units. METHODS: A total of 57 patients were randomly allocated into either the BAMP group (BAMPG) (n = 28) or a no treatment control group (CG) (n = 29). OUTCOMES: Data collection occurred at registration (DC1),18 months (DC2) and 3 years (DC3), where skeletal and dental changes were measured from lateral cephalograms and study models. Oral Aesthetic Subjective Impact Score (OASIS) and Oral Quality of Life (OHQOL) questionnaires were used to assess the psychological impact of treatment. RESULTS: The mean age was 12.9 ± 0.7 years and 12.6 ± 0.9 years in the BAMPG and CG, respectively. At DC2, the BAMPG achieved a class III ANB improvement of +0.6° compared with -0.7° in the CG (P = 0.004). The overjet improvement was +1.4 mm for the BAMPG and -0.2 mm for the CG (P = 0.002). There was no evidence of any other group differences for the other skeletal or dental cephalometric outcomes (P > 0.05) or the questionnaire data (OASIS P = 0.10, OHQOL P = 0.75). At DC2, the 18-month follow-up, 22% of the BAMPG achieved a positive overjet. At the 3-year follow-up (DC3), fewer patients in the BAMPG were perceived to need orthognathic surgery (48%) compared with 75% of patients in the CG (P = 0.04), with an odds ratio of 0.31 (95% confidence interval = 0.10-0.95). CONCLUSION: The BAMP technique did not show any social or psychological benefits; however, the skeletal class III improvement in ANB and the overjet change were sufficient to reduce the perceived need for orthognathic surgery by 27% compared with the CG.

Oral and maxillofacial injuries associated with e-scooter use at Broomfield Hospital: a cohort study of 24 months of data since e-scooter legalisation in the UK.

Introduction Rental electronic scooters (e-scooters) were legalised in July 2020 in the UK for use on public roads. This has led to higher numbers of emergency department (ED) attendances for head and neck injuries managed by the oral and maxillofacial surgical (OMFS) department.Aim The aim of this research is to assess the increase in e-scooter injuries requiring OMFS input and analyse factors and management associated.Method Data were collected over a 24-month period. A total of 212 e-scooter-related ED presentations were recorded, with 34 patients requiring input from the OMFS department. For the patients referred to OMFS, numerical and categorical factors used independent T-tests and one-way Analysis of Variance tests, respectively, to determine statistical significance at the 5% confidence level (p <0.05).Results The mean age was 32.8 years (SD = 15.9) in a predominately male cohort (79.4%). Alcohol intoxication was observed in 55.8% of accidents. Injuries were most common on Saturdays (41.2%). Soft tissue injuries were present in 64.7% of patients, bony injuries in 38.2% of patients and dental injuries in 11.8% of patients. Imaging was required for 76.5% of patients. In total, 44% of patients required surgical treatment, 5.9% required major surgery and 38.2% required minor surgery.Conclusion This research supports the literature suggesting significant growth in e-scooter-related injuries and their associated burden of conditions managed by the OMFS department.

Description of a method: computer generated virtual model for accurate localisation of tumour margins, standardised resection, and planning of radiation treatment in head & neck cancer surgery.

Communication between the surgeon, the pathologist and the radiation oncologist is improved by a virtual model of the final resection combining 3D imaging with computer aided navigation. The pathologist localises any questionable margins and the oncologist plans focussed delivery of radiation to native tissue in an area of complex anatomy.

Malignant peripheral nerve cell sheath tumour of the upper lip: a rare case.

We present the case of a malignant peripheral nerve sheath tumour (MPNST) that developed on the upper lip of an 86 year old woman. MPNSTs are highly aggressive sarcomas that very rarely occur in the face. We know of no other reported cases of a malignant peripheral nerve sheath tumour arising from the upper lip.

Metastatic renal cell carcinoma in the neck: an unusual presentation.

UNLABELLED: Metastasis of renal cell carcinoma (RCC) to the head and neck region is infrequent. A rare case of metastatic RCC, presenting as an enlarging neck mass and radiologically mimicking a carotid body tumour clinically and radiographically, presented in a 68-year-old male patient, 18 months after radical nephrectomy for RCC. It is estimated that 14-16% of all patients with renal cell carcinomas have metastases above the clavicle. However, there are no reported cases of metastatic renal cell carcinoma to the neck mimicking a carotid body tumour. CLINICAL RELEVANCE: Renal cell carcinoma is the third most common neoplasm to metastasize to the head and neck region following breast and lung carcinomas.

Dealing with aberrant vessels in radial forearm flaps - report of a case and review of literature.

INTRODUCTION: Anomalies of the radial artery are uncommon. A brief tabulated review of the literature is presented. CASE REPORT: We report a rare anomaly of the forearm vascular anatomy we encountered when elevating a radial forearm free flap. This is a previously unreported anatomical variation. The radial artery divided into medial and lateral branches (accompanied by their respective venae commitantes) about 1.5 cm below the bifurcation of the brachial artery. The skin paddle was predominantly supplied by the aberrant medial branch and was raised on this branch along with its venae commitantes up to the point of division. CONCLUSION: This case highlights the need for vigilance when raising free flaps and the techniques employed to avoid compromising both limb and skin paddle perfusion.

Squamous cell carcinoma arising in the lining of an epidermoid cyst within the sublingual gland--a case report.

We present the case of squamous cell carcinoma that arose in the lining of an epidermoid cyst that developed within the sublingual gland in a 64-year-old woman. Malignant transformation in epidermoid cysts is rare, particularly in the floor of the mouth. We know of no cases reported of an epidermoid cyst arising within the sublingual gland.

Removal of miniplates in maxillofacial surgery: a follow-up study.

PURPOSE: We sought to follow-up a cohort of patients who had miniplates (plates) inserted in the oral and maxillofacial region during a 13-month period over 4 years to study the incidence and factors associated with plate removal. PATIENTS AND METHODS: One hundred fifty-three patients had plates inserted in the oral and maxillofacial region in the Department of Oral & Maxillofacial Surgery, University Hospital Birmingham, UK, between November 1, 1998, and November 30, 1999. All 153 patients' records were revisited on or after October 31, 2002, giving a minimum follow-up of 3 years and a maximum of 4 years. RESULTS: During a period of 13 months (November 1, 1998 through November 30, 1999), 308 plates were inserted into 153 patients. A total of 32 plates were removed from 21 patients by October 31, 2002, (10.4%) over 4 years; 27 plates were removed from 16 patients for purely plate-related symptoms, with infection being the most common cause accounting for 16 plates (50%) in 9 patients. Symptoms necessitating plate removal occurred within 52 weeks after insertion in 16 patients, accounting for 23 of the plates removed (72%). The age of the patient at plate insertion may have some influence on plate removal but this was not significant. Seniority of the operator did not affect plate removal. CONCLUSION: Our experience with the removal of miniplates compares with previously published reports. Longitudinal follow-up at 4 years indicates that plate-related problems leading to removal are likely to occur in the first year after insertion.

Removal of miniplates in maxillofacial surgery: University Hospital Birmingham experience.

PURPOSE: We sought to study the incidence and causes of removal of osteosynthesis miniplates (plates) in oral and maxillofacial surgery in a single unit over a 13-month period and to identify factors associated with plate removal. PATIENTS AND METHODS: We conducted a retrospective study of 172 patients attending the Department of Oral and Maxillofacial Surgery, University Hospital Birmingham, between November 1, 1998, and November 30, 1999, in whom maxillofacial osteosynthesis plates were inserted or removed. Not all patients who had plates removed had them inserted within the same time frame. RESULTS: During a period of 13 months (November 1, 1998, through November 30, 1999), 308 plates were inserted into 153 patients. During the same period, 51 plates were removed from 28 patients, of whom 9 underwent plate insertion and subsequent removal of 25 plates within the time period of the study. Thirty-four (67%) of the plates removed from 20 patients were symptomatic. Infection was the most common cause for removal, occurring in 14 patients (50% of patients who had plates removed) and accounting for 22 plates (43% of plates removed). Symptoms relating to plates necessitating removal occurred in the first year after insertion in 15 patients (53%), accounting for 21 plates. CONCLUSIONS: Our experience with the removal of miniplates is comparable with that of previous studies. Plate-related problems leading to removal are more likely to occur within the first year after insertion.