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Bradford, United Kingdom

Mathew P.,Ninewells Hospital | Gibbons A.J.,Maxillofacial Surgery | Christie M.,Coventry NHS Trust | Eisenburg M.F.,Ludwig Maximilians University of Munich
British Journal of Neurosurgery

The operative management and early post-operative outcome of 16 consecutive cases of paediatric penetrating head injury treated by a single surgeon at a military trauma centre in Southern Afghanistan are retrospectively analysed. The majority of cases of injury were caused by fragments from exploding munitions. The aim of neurosurgical intervention in penetrating head injury is the prevention of wound infection and treatment or prevention of a critical rise in intracranial pressure. In 14 cases in this study, these aims were fulfilled without resort to brain resection, although a delayed cranioplasty procedure was required in 6 patients. Despite the ongoing conflict, families, local communities and coalition forces transport teams combine to make the latter a viable option in Southern Afghanistan, with an excellent short-term outcome. © 2013 The Neurosurgical Foundation. Source

Maxillofacial/neck vascular injuries caused by improvised explosive devices IEDs or ballistics injuries are life threatening when they cause severe haemorrhage resulting in airway compromise. One should always keep in mind that the best technique used is that which saves the patient's life and not the most expensive and/or technologically advanced. Medical professionals on the scene should have the necessary experience to handle the emergency situations of airway compromise and haemorrhage control. In this instance there is only, «one to a few minutes» to clear airway obstruction and arrest haemorrhage to prevent death. The patients in this study had life-threatening shrapnel injuries of the carotid and/or jugular vessels, and facial primary blast affect implosion of facial middle third air-containing cavities injuries. In a massive casualties arenas, where time = lifesaving, we should need to replace «non-battlefield» civilian techniques with «time driven», combat management for IEDs injuries. In these cases, the immediate and effective compression tamponade using digital, Foley catheter tamponade, packs and/or vessels ligation for severe facial/neck haemorrhage were used successfully. © 2011 European Association for Cranio-Maxillo-Facial Surgery. Source

Mohlhenrich S.C.,RWTH Aachen | Modabber A.,RWTH Aachen | Steiner T.,RWTH Aachen | Mitchell D.A.,Maxillofacial Surgery | Holzle F.,RWTH Aachen
British Journal of Oral and Maxillofacial Surgery

To identify factors that minimise damage during the drilling of sites for dental implants, we reviewed published papers on the amount of heat that is generated. We systematically searched English language studies published between January 2000 and February 2014 on MEDLINE/PubMed and found 41 articles, of which 27 related to an increase in temperature during preparation of the site. We found only basic research with a low level of evidence. Most of the studies were in vitro, and osteotomies were usually made in non-vital bone from cows or pigs. To measure heat in real time, thermocouples were used in 18 studies and infrared thermographs in 7. Three studies reported the use of immunohistochemical analysis to investigate immediate viability of cells. The highest temperature measured was 64.4°C and the lowest 28.4°C. Drill wear was reported after preparation of 50 sites, and there was a significant increase in temperature and a small change in the physiological balance of the proteins in the bone cells. Differences in the study designs meant that meta-analysis was not appropriate. For future work, we recommend the use of standard variables: an axial load of 2 kg, drilling speed of 1500 rpm, irrigation, standard artificial bone blocks, and the use of infrared thermography. © 2015 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved. Source

Pittore B.,Head and Neck Surgery | Tan N.,Head and Neck Surgery | Salis G.,Paolo Dettori Hospital | Brennan P.A.,Maxillofacial Surgery | And 2 more authors.
Acta Otorhinolaryngologica Italica

Dacryocystorhinostomy allows by-passing saccal and post-saccal stenoses and has traditionally been performed via an external approach, namely, external dacryocystorhinostomy. Over the past two decades, advances in endoscopic equipment have led to the widespread use of the endoscopic transnasal approach to the lacrimal pathway. A retrospective evaluation has been made of personal success rates in endoscopic dacryocystorhinostomy without stenting in 56 patients (15 male, 41 female) treated for nasolacrimal duct obstruction (48 unilateral, 8 bilateral). Of these, 53 were primary endoscopic dacryocystorhinostomy and 11 procedures were revisions of external dacryocystorhinostomy. A total of 64 endoscopic dacryocystorhinostomies were performed. Mean follow-up was 37.3 months (range 12-84 months). The success of surgery was defined by resolution of signs (epiphora and dacryocystitis) and objectively by endoscopic evaluation of the rhinostomy on routine follow-up. Results from patients undergoing primary endoscopic dacryocystorhinostomy were better than those for revision of external dacryocystorhinostomy with overall anatomical and functional results of 94.3% and 90.9%, in our series. The present study confirms that endoscopic dacryocystorhinostomy without stenting is effective for the treatment of nasolacrimal duct obstruction. The endoscopic approach allows simultaneous treatment of associated anatomic anomalies and sino-nasal disorders. Results obtained confirm that a functionally patent dacryocystorhinostomy can be achieved without the need for routine nasolacrimal stenting. Source

Saban Y.,Maxillofacial Surgery | De Benito J.,International Society Aesthetic and Plastic Surgery ISAPS | Massa M.,University of Genoa
Facial Plastic Surgery

Abstract In the context of nasal obstruction treatment, an alternative, no invasive technique is described. It consists in the suspension of the nasal valve or in the association of the suspension of the valve and rotation of the tip, through the placement of one or two absorbable threads, already known in aesthetic medicine. This technique allows to open the nasal valve and to correct the moderate closure of the nasolabial angle obtaining an immediate benefit of breathing. Functional improvement has been evaluated at regular intervals, that is, 1, 3, 6, and 12 months and then provided for every 6 months, through the use of a visual scale of 0/10 to 10/10. In our experience, the technique allows to obtain satisfactory results, avoiding more invasive techniques and postoperative recovery days. Copyright © 2014 by Thieme Medical Publishers, Inc. Source

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