Brief alcohol intervention in alcohol involved facial fracture patients-a survey of patient attitudes to screening and intervention.

PURPOSE: Alcohol intoxication is an important contributor to traumatic facial injuries. The period following injuries afford clinicians a useful window of opportunity to provide alcohol screening and brief intervention (SBI) which may affect changes in patients' future drinking behaviour. Although SBI has been reported to decrease at risk drinking and potentially trauma recurrence, it is not routinely utilised in most clinical settings in the world. This study aims to assess utilisation of, as well as patients' knowledge and attitude towards SBI in the management of patients presenting with alcohol-related facial fractures. METHODS: Twenty consecutive patients who presented to Western Health with facial fractures who met selection criteria were offered an alcohol screening and survey questionnaire. RESULTS: Ninety percent of patients were male and 50% were aged between 19 and 34. ASSIST score showed 65% were in the moderate risk category; 75% reported this was their first admission with alcohol related trauma. Although 75% acknowledged alcohol as a main cause of injury, only 40% agreed they drink too much. Forty-four percent felt that talking to a healthcare worker might help and 33% would consider accepting help. Forty-seven percent felt reading materials would be helpful in changing future drinking habits. Whilst 63% would like to know safe drinking limit, only 45% would like to have a discussion about alcohol-related harms. CONCLUSIONS: Most patients presented in this survey were in moderate risk category who are amenable to behavioural change with provision of SBI. However, there is resistance to implementation of this intervention due to lack of knowledge, self-awareness and willingness to change. Nonetheless, patients are prepared to accept advice from clinicians and some formats of intervention. It is important to formulate a simple screening questionnaire and intervention strategy that are easy to administer to affect positive changes in patients with harmful drinking behaviours.

Bilateral submandibular gland oncocytoma in a patient with multiple endocrine neoplasia 2B syndrome and neurofibromatosis type 1: an unusual case.

Oncocytomas are unusual neoplasms of the head and neck that occur mainly in the parotid gland. The authors report a case of bilateral submandibular gland oncocytoma in a patient with multiple endocrine neoplasia 2B syndrome and neurofibromatosis type 1. Histopathology of the resection specimens demonstrated lymphovascular invasion but no other aggressive features. This was a highly unusual feature in an otherwise rare benign tumour.

A survey of the career-defining determinants of prospective UK oral and maxillofacial surgical trainees.

Increasing numbers of medics are applying to dental school to pursue a career in oral and maxillofacial surgery (OMFS), particularly in the aftermath of Modernising Medical Careers (MMC), but their perspectives, experience, and training up to this point differ widely. We aimed to characterise these differences in the light of MMC and beyond by doing a survey of 20 dentists and 24 medics who were applying for their second degree. They were questioned about factors that influenced their choice of career and university, the motivation to pursue specialty training, and were asked for their opinions on suggested measures for workforce planning. The medics were subdivided into those who had trained before MMC (n=18), and those who had not (n=6). Dentists had considerably more OMFS experience than medics (mean 22 months compared with 4.2 months), and 46% (11/24) of medics had no substantive OMFS experience. Of those who had trained before MMC 3/18 considered OMFS as their first choice of career, compared with 4/6 who have trained since, and 15/20 of dentists. Eighty-three percent (20/24) of medics admitted that MMC had influenced their choice of career, and 54% (13/24) had applied for training in a specialty other than OMFS, notably otolaryngology. The most favoured method of workforce planning among all respondents (25/44) was "roughly matching" places on a second degree to projected OMFS training posts.