Stability of fixation methods in large mandibular advancements after sagittal split ramus osteotomy: an in vitro biomechanical study
Sagittal split ramus osteotomy (SSRO) with large mandibular advancements is a common surgical procedure and could be indicated for patients with sleep apnoea. As a large variety of fixation methods is used for the stabilisation of SSRO, a biomechanical test model was used to analyse which fixation technique was most stable. For this in vitro study, 80 polyurethane hemimandibles with a prefabricated SSRO were used as substrates. Loads in Newtons were recorded at displacements of the mandibular incisive edge at 1mm, 3mm and 5mm. (Source: The British Journal of Oral and Maxillofacial Surgery)
Source: The British Journal of Oral and Maxillofacial Surgery - January 16, 2021 Category: ENT & OMF Authors: K. Kuik, J.-P.T.F. Ho, M.H.T. de Ruiter, C. Klop, C.J. Kleverlaan, J. de Lange, A. Hoekema Source Type: research

Re: Use of CAD-based pre-bent implants reduced theatre time in orbital floor reconstruction: results of a prospective study
We recently read the above mentioned article by von Wilmowsky et al, an interesting study which aimed to demonstrate how the use of CAD-based pre-bent custom orbital floor plates could reduce theatre time1. (Source: The British Journal of Oral and Maxillofacial Surgery)
Source: The British Journal of Oral and Maxillofacial Surgery - January 15, 2021 Category: ENT & OMF Authors: Roseanna Victoria Morgan, David Laraway Tags: Letter to the Editor Source Type: research

Orbital Hematoma after Orbital Fracture Repair using Silicone, Polytetrafluorethylene, and Poly-L-Lactic Acid/Hydroxyapatite Implants
To report the incidence of orbital hematoma formation following orbital fracture repair with silicone, polytetrafluorethylene (PTFE), and poly-L-lactic acid/hydroxyapatite (PLLA/HA) implants. (Source: The British Journal of Oral and Maxillofacial Surgery)
Source: The British Journal of Oral and Maxillofacial Surgery - January 15, 2021 Category: ENT & OMF Authors: S. Kono, P.A.L. Lee, H. Kakizaki, Y. Takahashi Source Type: research

Prognostic Indicators and Outcomes following Surgical Management of Metastatic Cutaneous Squamous Cell Carcinoma of the Head and Neck
Metastatic cutaneous SCC carries a poor prognosis with 5-year survival of 25-57%. The aim of this study is to examine the outcomes following surgery with adjuvant therapy for management of metastatic cSCC in a UK based population. (Source: The British Journal of Oral and Maxillofacial Surgery)
Source: The British Journal of Oral and Maxillofacial Surgery - January 15, 2021 Category: ENT & OMF Authors: J.E. O ’Connell, A. Saeed, H.B. Jones, C.J. Lloyd Source Type: research

Safer Surgical Practice: A Guide for Surgeons (not just for pandemics)
This article sets out to explore the roles and responsibilities of the surgeon during these extraordinary times and discuss how we can improve our practice to reduce the risk of harm to patients, surgical staff and ourselves. (Source: The British Journal of Oral and Maxillofacial Surgery)
Source: The British Journal of Oral and Maxillofacial Surgery - January 15, 2021 Category: ENT & OMF Authors: A.G.C. Hay-David, J.B.T. Herron, P.A. Brennan Source Type: research

Repair of facial scars using free and pedicle-expanded deltopectoral flaps
This study aimed to evaluate the effectiveness and long-term outcomes of free and pedicled expanded deltopectoral flaps with perforation of the internal thoracic artery in repairing facial scars. (Source: The British Journal of Oral and Maxillofacial Surgery)
Source: The British Journal of Oral and Maxillofacial Surgery - January 15, 2021 Category: ENT & OMF Authors: C. Liu, D. Hao, Y. Li, J. Ding, W. Yao, Z. Yu, X. Ma, P. Peng Source Type: research

Patients ’ narratives of orthognathic treatment for facial asymmetry: a qualitative study
To explore patients ’ experiences of orthognathic treatment for facial asymmetry and their adaptation to facial changes after surgery, we did a qualitative, cross-sectional study of patients after treatment for non-cleft asymmetry at two UK sites. A total of 15 patients aged 19-40 years were approached after being id entified using patient databases and clinical notes. Individual and photo-elicitation interviews were conducted covering experiences prior to treatment, during treatment, and after surgery. (Source: The British Journal of Oral and Maxillofacial Surgery)
Source: The British Journal of Oral and Maxillofacial Surgery - January 12, 2021 Category: ENT & OMF Authors: J.E. Kettle, Z. Marshman, L. Winchester, L. Hardwick, R. Bolt, N. Lee Source Type: research

Pleomorphic dermal sarcoma: a clinical and histological review of 49 cases
Pleomorphic dermal sarcoma (PDS) is a rare mesenchymal neoplasm that shares histopathological features with atypical fibroxanthoma (AFX), but has additional features of deep invasion of the superficial subcutis, tumour necrosis, and vascular and perineural invasion, which confers a risk of local recurrence and metastases. To study the clinical and pathological spectrum more comprehensively, we retrieved 49 cases of pleomorphic dermal sarcoma from our departmental files. There was a strong male predominance (n=45). (Source: The British Journal of Oral and Maxillofacial Surgery)
Source: The British Journal of Oral and Maxillofacial Surgery - January 10, 2021 Category: ENT & OMF Authors: C.M. Bowe, B. Godhania, M. Whittaker, S. Walsh Source Type: research

Extranodal extension in head and neck squamous cell cancer: is there a role for further stratification?
To investigate the prognostic significance of the stratification of extranodal extension (ENE) into ENE minor (ENEmi, up to 2mm) and ENE major (ENEma, over 2mm) in non-HPV-related squamous cell cancers of the head and neck, we retrospectively reviewed microscopic slides from neck dissection specimens of ENE-positive patients and subcategorised them into ENEmi and ENEma. We then compared the two groups in terms of overall survival (OS), disease-specific survival (DSS), and disease-free survival (DFS). (Source: The British Journal of Oral and Maxillofacial Surgery)
Source: The British Journal of Oral and Maxillofacial Surgery - January 10, 2021 Category: ENT & OMF Authors: G. Tirelli, M. Tofanelli, E. Sacchet, R. Bussani, V. Shafiei, A. Gatto, P. Boscolo-Rizzo, N. Gardenal Source Type: research

Stability and surgical complications of tooth-borne and bone-borne appliances in surgical assisted rapid maxillary expansion: a systematic review
The objective of this systematic review was to evaluate the stability and complications of tooth-borne (TB), bone-borne (BB) and hybrid (TB-BB) appliances in surgically assisted rapid maxillary expansion (SARME). Database searches were conducted (PubMed, Embase, Cochrane Library and SciELO), as well as a grey literature search (Google Scholar) and hand searches of reference lists. Forty-six articles were included after study selection ( κ=0.854). After eligibility assessment, 16 articles and one article from the grey literature were processed (κ=0.866) and six articles were selected by hand searching, for a tot...
Source: The British Journal of Oral and Maxillofacial Surgery - January 8, 2021 Category: ENT & OMF Authors: M.E. Mu ñoz-Pereira, O.L. Haas-Junior, L. Da Silva Meirelles, A. Machado-Fernández, R. Guijarro-Martínez, F. Hernández-Alfaro, R.B. de Oliveira, R.M. Pagnoncelli Tags: Review Source Type: research

Role of Carnoy ’s solution as treatment adjunct in jaw lesions other than odontogenic keratocyst: A systematic review
Carnoy ’s solution (CS) is routinely used as adjuvant therapy in the management of odontogenic keratocyst (OKC) and a few other benign lesions. The purpose of this study was to explore the evidence of application and efficacy in benign lesions other than OKC. We have systematically reviewed published art icles to identify the evidence of CS in benign jaw lesions other than OKC following the PRISMA guidelines. The search was conducted in PubMed, Google Scholar, Semantic Scholar, and Cochrane Library database, to find relevant articles from 1980 to March 2020. (Source: The British Journal of Oral and Maxillofacial Surgery)
Source: The British Journal of Oral and Maxillofacial Surgery - January 8, 2021 Category: ENT & OMF Authors: Babu Lal, Rudra Deo Kumar, Ragavi Alagarsamy, Shanmuga Sundaram D, Ongkila Bhutia, Ajoy Roychoudhury Tags: Review Source Type: research

Prevalence of lower limb venous disease in surgeons: a case study and results of a survey by the BAOMS Reconstruction Surgical Subspecialty Interest Group (SSIG)
We report a case of venous leg ulceration in a Reconstructive Oral and Maxillofacial Surgeon. An online survey was created by the BAOMS Reconstruction SSIG primarily targeting head and neck surgeons to investigate the perceived risk and occurrence of venous leg disease. Two respondents had received treatment for lower limb venous disease thus compromising their ability to work, while 13 had symptoms of early venous disease. Our study shows an interesting area of concern for occupational health in surgeons, particularly those carrying out long operations as will be the case for Reconstruction SSIG members. (Source: The Brit...
Source: The British Journal of Oral and Maxillofacial Surgery - January 8, 2021 Category: ENT & OMF Authors: Derek Falls, Michael Nugent, Ajay Wilson, Michael Ho Tags: Short communication Source Type: research

The management of odontogenic cervicofacial infections presenting to Oral and Maxillofacial Units during the first wave of the COVID-19 pandemic in the United Kingdom
On 25th March 2020, the Chief Dental Officer issued national guidance restricting the provision of all routine, non-urgent dental services in response to the spread of COVID-19. We analysed odontogenic cervicofacial infections (CFI) presenting to Oral and Maxillofacial Surgery (OMFS) departments during the first wave of COVID-19 in the United Kingdom. (Source: The British Journal of Oral and Maxillofacial Surgery)
Source: The British Journal of Oral and Maxillofacial Surgery - January 7, 2021 Category: ENT & OMF Authors: F.A. Puglia, Harmony Ubhi, B. Dawoud, P. Magennis, G.A. Chiu Source Type: research

Management of oral and maxillofacial trauma during the first wave of the COVID-19 pandemic in the United Kingdom
We assess the effect of Coronavirus disease 2019 (COVID-19) on UK oral and maxillofacial (OMF) trauma services and patient treatment during the first wave of the pandemic. (Source: The British Journal of Oral and Maxillofacial Surgery)
Source: The British Journal of Oral and Maxillofacial Surgery - January 7, 2021 Category: ENT & OMF Authors: F.A. Puglia, A. Hills, B. Dawoud, P. Magennis, G.A. Chiu, List of collaborators who participated in the Trauma Study Source Type: research

Dental implant placement through impacted teeth or residual roots as an alternative to invasive extraction surgeries: a systematic literature review
This work systematically reviews dental implant placement through impacted teeth or residual roots, as alternative to invasive extraction surgeries, evaluated in terms of survival rates, marginal bone loss, surgical and prosthetic complications (Source: The British Journal of Oral and Maxillofacial Surgery)
Source: The British Journal of Oral and Maxillofacial Surgery - January 7, 2021 Category: ENT & OMF Authors: Fabi án Pérez-González, Luis Sánchez-Labrador, Pedro Molinero-Mourelle, Luis Miguel Sáez-Alcaide, Jorge Cortés-Bretón-Brinkmann, Jesús Torres García-Denche, Juan López-Quiles, José María Martinez-González Tags: Review Source Type: research

Retraction notice to “The association between metformin therapy and risk of gynecological cancer in patients: two meta-analyses” [British Journal of Oral and Maxillofacial Surgery, Volume 57, Issue 8, October 2019, Pages 782-787]
This article has been retracted: please see Elsevier Policy on Article Withdrawal (http://www.elsevier.com/locate/withdrawalpolicy). (Source: The British Journal of Oral and Maxillofacial Surgery)
Source: The British Journal of Oral and Maxillofacial Surgery - January 1, 2021 Category: ENT & OMF Authors: M. Rana, H. Holtmann, M. Rana, A.N. Kanatas, D.D. Singh, C.K. Sproll, N.R. K übler, R. Ipaktchi, K. Hufendiek, N.-C. Gellrich Source Type: research

Editorial Board
(Source: The British Journal of Oral and Maxillofacial Surgery)
Source: The British Journal of Oral and Maxillofacial Surgery - January 1, 2021 Category: ENT & OMF Source Type: research

Training Groups
(Source: The British Journal of Oral and Maxillofacial Surgery)
Source: The British Journal of Oral and Maxillofacial Surgery - January 1, 2021 Category: ENT & OMF Source Type: research

Reviewer thank you list
(Source: The British Journal of Oral and Maxillofacial Surgery)
Source: The British Journal of Oral and Maxillofacial Surgery - January 1, 2021 Category: ENT & OMF Source Type: research

Comparison of Provision of Maxillofacial Emergency Service During the Two COVID-19 National Lockdowns in the United Kingdom
We previously published a study on the provision of emergency maxillofacial services during the first UK COVID-19 pandemic national lockdown. We have repeated the study during the second lockdown, and present our findings highlighting the main differences and learning issues as the services have evolved during the pandemic. (Source: The British Journal of Oral and Maxillofacial Surgery)
Source: The British Journal of Oral and Maxillofacial Surgery - December 29, 2020 Category: ENT & OMF Authors: Kristian K. Blackhall, Ian P. Downie, Stephen Walsh, Rawa Burhan, Parkash Ramchandani, Atul Kusanale, Badri Srinivasan, Peter A. Brennan, Rabin P. Singh Tags: Short communication Source Type: research

Use of knotless barbed sutures for closure of intraoral incisions for maxillofacial trauma: a randomised controlled trial
The objective of this study was to assess the efficacy of knotless barbed sutures in intraoral wound closure for maxillofacial trauma in comparison with conventional (vicryl) sutures. This was a randomised controlled clinical trial involving 40 patients with isolated mandibular angle fractures who required intraoral incisions for open reduction and internal fixation (ORIF). The sample was randomised into the study group (20 patients) and control group (20 patients). Following fracture fixation by a standardised surgical protocol, the wound closure was done with bidirectional knotless barbed suture and vicryl for the study ...
Source: The British Journal of Oral and Maxillofacial Surgery - December 28, 2020 Category: ENT & OMF Authors: A.K. Sharma, G.P. Thulasi Doss, E. Panneerselvam, S.K. Ganesh, V.B. Krishna Kumar Raja Source Type: research

Effect of glucosamine sulphate on the temporomandibular joint of ovariectomised rats
This study aimed to determine the in vivo effects of glucosamine sulphate (GS) on the temporomandibular joint (TMJ) of ovariectomised rats (OVX).Thirty-two rats were distributed into four groups as follows: G1, sham-OVX+saline solution; G2, sham-OVX+glucosamine sulphate (80mg/kg) – oral administration; G3, OVX+saline solution; G4, OVX+glucosamine sulphate (80mg/kg) – oral administration. (Source: The British Journal of Oral and Maxillofacial Surgery)
Source: The British Journal of Oral and Maxillofacial Surgery - December 28, 2020 Category: ENT & OMF Authors: S.R. Figueroba, J.C. Moreira, K.S. Amorim, L.D.L.L. Cunha, T.M.L. Morais, L.E.N. Ferreira, F.C. Groppo Source Type: research

Remifentanil-related muscle rigidity during osteotomy procedures
We write to draw attention to muscle rigidity as an important adverse effect of remifentanil use in anaesthesia. Remifentanil is a short-acting synthetic opioid often used in combination with propofol as a form of TIVA (total intra-venous anaesthesia) or with inhalational agents. These drug combinations provide good equilibrium between depth of anaesthesia and recovery time and obtund noxious stimuli. Use of remifentanil in orthognathic surgery has been advocated to produce conditions of hypotensive anaesthesia, associated with reduced blood loss and haemodynamic stability intra-operatively. (Source: The British Journal of...
Source: The British Journal of Oral and Maxillofacial Surgery - December 28, 2020 Category: ENT & OMF Authors: Ben J Steel, Katrina A Denholm, Upma Misra, David JW Keith, Robert J Banks Tags: Letter to the Editor Source Type: research

Some weighing of publication rates should be used to more fairly reflect the productivity of trainees Response to Variation in UK Deanery publication rates in the British Journal of Oral and Maxillofacial Surgery: where are the current 'hot spots'? J. Turner D. Hammond M. Goodson1
We commend the authors for their hard work but would point out that without balancing the BJOMS productivity of trainees against their number in each training rotation risks misrepresenting their enthusiasm. (Source: The British Journal of Oral and Maxillofacial Surgery)
Source: The British Journal of Oral and Maxillofacial Surgery - December 25, 2020 Category: ENT & OMF Authors: Begley Anne, Magennis Patrick Tags: Letter to the Editor Source Type: research

Evaluation of segmental mandibular resection without a microvascular reconstruction in patients affected by medication-related osteonecrosis of the jaw: a systematic review
Medication-related osteonecrosis of the jaw (MRONJ) is a severe condition, which affects the jaw in patients exposed to specific drugs. More often, it has been described in association with patients receiving primarily bisphosphonate (BP) therapy. However, nowadays it has been observed with the usage of other medications, such as RANK ligand inhibitor and monoclonal antibody agent (Denosumab) and antiangiogenic drugs. Managing this condition has unfortunately proven difficult and still remains a major challenge for clinicians and surgeons. (Source: The British Journal of Oral and Maxillofacial Surgery)
Source: The British Journal of Oral and Maxillofacial Surgery - December 24, 2020 Category: ENT & OMF Authors: Roberto Sacco, Gezala Umar, Raphael Capelli Guerra, Oladapo Akintola Tags: Review Source Type: research

Response to: “Some weighing of publication rates should be used to more fairly reflect the productivity of trainees. Response to Variation in UK Deanery publication rates in the British Journal of Oral and Maxillofacial Surgery: where are the current 'hot spots'?
Thank you for your comments on our paper, as you rightly say (and this was also a feature of the original article In 20122) it would be useful to evaluate publication rates to BJOMS against number of trainees per deanery or percentage of trainees in each deanery. Such metrics may as a mathematical exercise give a more accurate representation of where trainees are being supported to write papers and engage in research or evidence based medicine. We shouldn ’t forget however, that some trainees will submit papers to International and non specialty. (Source: The British Journal of Oral and Maxillofacial Surgery)
Source: The British Journal of Oral and Maxillofacial Surgery - December 24, 2020 Category: ENT & OMF Authors: J. Turner, D. Hammond, M. Goodson Tags: Letter to the Editor Source Type: research

RE: Assessment of surgical outcomes and oncologic safety for submental artery perforator flap reconstruction after ablation of oral cancer
We read the paper by Shen et al with great interest1. This paper retrospectively compared outcomes following the use of the Submental Island Flap (SIF), Submental Artery Perforator Flap (SAPF), and the Anterolateral Thigh Perforator Flaps (ALTPF) and we commend the authors on their work. Of significance, they looked at the oncological safety associated with transferring the SIF with level 1-tissue versus SAPF not harbouring level 1-tissue. (Source: The British Journal of Oral and Maxillofacial Surgery)
Source: The British Journal of Oral and Maxillofacial Surgery - December 23, 2020 Category: ENT & OMF Authors: Khemanand Maharaj, Mark Singh, Jamal Siddiqi, A Ghaly Ghaly Tags: Letter to the Editor Source Type: research

Some pragmatic comments on “You Have Control: aviation communication application for safety-critical times in surgery”
After reading the review by Hardie et al1 on aviation communication for use within the operation room (OR), I wish to share some lessons learnt by me, trying to adapt and implement communication strategies from high-risk organizations for surgical safety. (Source: The British Journal of Oral and Maxillofacial Surgery)
Source: The British Journal of Oral and Maxillofacial Surgery - December 23, 2020 Category: ENT & OMF Authors: A. Ramasamy Tags: Letter to the Editor Source Type: research

Are extranodal extension and lymph node yield of pN0 to lymph node ratio useful as prognostic parameters for patients with oral squamous cell carcinoma?
We investigated the value of the weighted lymph node ratio (WLNR), a new marker that incorporates prognostic information regarding the number of metastatic lymph nodes (LNs) with the extranodal extension (ENE) and the lymph node yield (LNY) of pN0 patients, in the prognosis and postsurgical management of oral squamous cell carcinoma (OSCC). We designed a retrospective study and enrolled patients who were diagnosed with OSCC and treated with neck dissection (ND). The predictor variable was WLNR, and the outcome variable was overall survival (OS). (Source: The British Journal of Oral and Maxillofacial Surgery)
Source: The British Journal of Oral and Maxillofacial Surgery - December 22, 2020 Category: ENT & OMF Authors: Kenji Yamagata, Satoshi Fukuzawa, Fumihiko Uchida, Makiko Okubo-Sato, Naomi Ishibashi-Kanno, Hiroki Bukawa Source Type: research

Latency phase in mandibular distraction osteogenesis: a systematic review in animal models
The aim of the present study was to perform a systematic review of the need for the latency period in distraction osteogenesis to obtain adequate bone formation. Searches were performed in the Web of Science, Pubmed/MEDLINE, Scopus and Cochrane electronic databases. Nine articles were selected for qualitative analysis. Quality assessment was performed using the 10-item SYRCLE tool. Clinical stability was evaluated in two articles. Histology was analyzed in seven articles. Histomorphometry was analyzed in three articles and mechanical testing was used in two articles. (Source: The British Journal of Oral and Maxillofacial Surgery)
Source: The British Journal of Oral and Maxillofacial Surgery - December 22, 2020 Category: ENT & OMF Authors: Tania Camila Ni ño-Sandoval, Ewerton Daniel Rocha Rodrigues, Belmiro C.E. Vasconcelos Tags: Review Source Type: research

Biomechanical analysis in mandibular advancement and occlusal plane rotation with finite element analysis
We used finite element analysis to assess stress on the cortical bone and plate fixation system, as well as mandibular resistance after sagittal split ramus osteotomy with different mandibular advancements and rotations of the occlusal plane. Three-dimensional mandibular models were obtained, and 6mm and 12mm advancements were planned associated with linear, clockwise, and counter-clockwise rotation of the angle of the occlusal plane. Each model was then fixed with one or two 2.0mm system plates and secured with four monocortical screws. (Source: The British Journal of Oral and Maxillofacial Surgery)
Source: The British Journal of Oral and Maxillofacial Surgery - December 21, 2020 Category: ENT & OMF Authors: M.L.M. da Silveira, M.L. de Oliveira Bueno, J.S.P. da Silva, A.R. Germano Source Type: research

External validation of OroGrams as a predictive model for overall and progression-free survival in Scottish patients with oropharyngeal squamous cell carcinoma: a retrospective cohort study
The aims of this study were to externally validate the OroGrams (oropharyngeal cancer survival calculator) nomogram in a Scottish cohort with high endemic smoking rates, and to compare survival rates with the original validation cohort. A retrospective cohort study in Greater Glasgow and Clyde ENT and OMFS surgery departments was performed to investigate survival outcomes of patients with oropharyngeal squamous cell carcinoma (OPSCC) from January 2012 - December 2017. The main outcome measures were progression-free (PFS) and overall survival (OS), and Kaplan Meier curves. (Source: The British Journal of Oral and Maxillofacial Surgery)
Source: The British Journal of Oral and Maxillofacial Surgery - December 21, 2020 Category: ENT & OMF Authors: A. Mentel, C.M. Douglas, J. Montgomery, J. McMahon Source Type: research

Difficult airways: a 3D printing study with virtual fibreoptic endoscopy
We describe the use of 3D augmented reality software combined with 3D printed models to assess the anatomy of difficult airways and to assist in the formulation of the most optimal airway management strategy in such patients. The reported patients had computed tomograms (CT) of the neck prior to their anaesthetic and surgical management. (Source: The British Journal of Oral and Maxillofacial Surgery)
Source: The British Journal of Oral and Maxillofacial Surgery - December 20, 2020 Category: ENT & OMF Authors: D. Ormandy, B. Kolb, S. Jayaram, O. Burley, P. Kyzas, H. Vallance, L. Vassiliou Source Type: research

Postoperative delirium in patients with head and neck oral cancer in the West of Scotland
Our aims were to determine the prevalence and association of postoperative delirium (POD) in head and neck (H&N) cancer patients undergoing free flap reconstruction at the oral and maxillofacial surgery (OMFS) unit, Queen Elizabeth University Hospital (QEUH) Glasgow, and to assess whether these determinants can be modified to optimise patient care and reduce the occurrence of POD. Delirium remains an important problem in the postoperative care of patients undergoing major H&N surgery, and early detection and management improve overall outcomes. (Source: The British Journal of Oral and Maxillofacial Surgery)
Source: The British Journal of Oral and Maxillofacial Surgery - December 20, 2020 Category: ENT & OMF Authors: J.E. Crawford, F. Zubair, G. Baniulyte, C.J. Wales, M. Ansell, E. Thomson, S. Hislop, C. MacIver, J. Devine, J. McCaul, D. Young, J. McMahon Source Type: research

Modification of a face shield to allow point-of-view (POV) assisted training during the COVID-19 pandemic
The COVID-19 pandemic has changed the landscape of surgical practice. It has limited access to the operating theatre due to the redeployment of theatres, staff, and equipment to support critically ill patients, and only emergency and cancer surgeries have been performed because of the risk posed by the COVID-19 infection to both patients and staff. The reduction in operating has had an adverse effect on surgical training. Opportunities for surgical trainees will remain limited and it is essential to optimise the training experience. (Source: The British Journal of Oral and Maxillofacial Surgery)
Source: The British Journal of Oral and Maxillofacial Surgery - December 19, 2020 Category: ENT & OMF Authors: T. Sato, S.N. Rogers Tags: Technical note Source Type: research

Re: dental and medical dual qualification in Oral and Maxillofacial Surgery: a global identity
Oral and Maxillofacial Surgery has learnt much from the world of aviation. Mostly this has been about improving patient safety, for example by reducing stress in the operating theatre and/or reducing the rigid confines of the traditional heirachical structure in surgical teams, especially when problems arise during surgery. (Source: The British Journal of Oral and Maxillofacial Surgery)
Source: The British Journal of Oral and Maxillofacial Surgery - December 19, 2020 Category: ENT & OMF Authors: B. Speculand Tags: Letter to the Editor Source Type: research

Virtual postgraduate exams and assessments: the challenges of online delivery and optimising performance
The COVID-19 pandemic has catalysed the computerisation and online delivery of postgraduate examinations. Social distancing regulations and lockdown measures resulted in many written and clinical examinations being cancelled during the initial surge of the virus. In an effort to reinstate the assessment of trainees and enable career progression, the UK medical regulator, the General Medical Council (GMC) has approved unprecedented changes to clinical examinations, including virtual assessment. We outline the changes made and the advantages and disadvantages of these new examination formats. (Source: The British Journal of ...
Source: The British Journal of Oral and Maxillofacial Surgery - December 19, 2020 Category: ENT & OMF Authors: R. Ellis, R.S. Oeppen, P. Brennan Source Type: research

Insertion of a vacuum based drain for post-parotidectomy non-resolving seroma in an outpatient setting
We describe a novel technique for the insertion of a vacuum drain, in an outpatient setting, for persistent seroma post-parotidectomy. This is a retrospective case series of a single academic centre. The complete medical records of all patients who underwent parotidectomy between 2014 and 2019 were reviewed. Data regarding demographics, comorbidities, and intraoperative and postoperative courses were extracted for patients for whom a vacuum drain was inserted due to persistent seroma. A size 8 Fr drain was inserted using a novel approach through the parotidectomy incision using ‘Biovac’ (Biometrix) 50ml, Trocar...
Source: The British Journal of Oral and Maxillofacial Surgery - December 18, 2020 Category: ENT & OMF Authors: O. Cohen, S. Gabay, A. Khafif Source Type: research

Validating the Asher-McDade score to assess facial aesthetic outcomes in 22 consecutive complete bilateral cleft lip repairs
Most scoring systems used to assess facial aesthetics in cleft patients tend to lack consistency, and the absence of an internationally agreed system makes comparison challenging. The most widely used and validated tool is the five-point Asher-McDade index. We note that there are currently no reports (to our knowledge) of its use for scoring outcomes after bilateral cleft lip repair. To validate it for this use, the aim was to describe the outcomes of 22 consecutive bilateral cleft lip repairs assessed using this scale. (Source: The British Journal of Oral and Maxillofacial Surgery)
Source: The British Journal of Oral and Maxillofacial Surgery - December 18, 2020 Category: ENT & OMF Authors: R.M. Thomson, E. Azzopardi, D. Drake Source Type: research

Synovial chondromatosis of temporomandibular joint. technical details of the artrhoscopic management
Synovial chondromatosis (SC) is a rare and benign joint disorder characterized by the metaplasia of the synovial membrane associated with the formation of cartilaginous nodules within the subsynovial connective tissue. The temporomandibular joint (TMJ) is rarely affected1,2 Historically, arthrotomy has been the gold standard for SC treatment.3 In the last decades, arthroscopy has increased its popularity as isolated approach or in combination with arthrotomy.4,5 (Source: The British Journal of Oral and Maxillofacial Surgery)
Source: The British Journal of Oral and Maxillofacial Surgery - December 17, 2020 Category: ENT & OMF Authors: Lourdes Deutor Garc ía, Blas García Medina, Ángel Martínez-Sahuquillo Rico Tags: Short communication Source Type: research

Following the Trend in Maxillofacial Surgery Literature
The practice of evidence-based medicine relies on the integration of high quality research with clinical expertise and patient values. The hierarchy of evidence allows the clinician to assign value to research, based on the methodological quality of the study design and applicability to the clinical question. Improvements in the quality of Oral and Maxillofacial Surgery research, aim to strengthen evidence-based medicine and patient care. Analysing the trends in maxillofacial surgery literature identifies the strengths and weakness of the current body of research, and directs to areas where the quality of current research ...
Source: The British Journal of Oral and Maxillofacial Surgery - December 17, 2020 Category: ENT & OMF Authors: Brenton Wilson, Jesse Lewis, Phoebe O ’hare, Chris Lim Tags: Review Source Type: research

The personal limitations checklist: human factors insights from air accidents to reduce intra-operative harm
High Reliability Organisations (HRO), including healthcare and aviation, have a common focus on risk management. The human element is a ‘weak link’ which may result in accidents or adverse events taking place. Surgeons and other healthcare professionals can learn from aviation’s rigorous approach to the role of human factors (HF) in such events, and how we can minimise them.Air Accident Investigation Branch (AAIB) reports show that fatal accidents are frequently caused by pilots flying outside their own personal limits, those of the aircraft or environment. (Source: The British Journal of Oral and Maxillofacial Surgery)
Source: The British Journal of Oral and Maxillofacial Surgery - December 17, 2020 Category: ENT & OMF Authors: JA Hardie, PA Brennan Tags: Review Source Type: research

RE: Bocchialini et al. Intraconal orbital displacement of a dental implant treated with an endoscopically-assisted approach
We want to share our experience with a similar incidence to highlight the possible cause for intraorbital displacement of dental implant. Such complications are very rarely reported and few case reports1,2 that describe similar presentation have mainly stressed on the treatment aspect. (Source: The British Journal of Oral and Maxillofacial Surgery)
Source: The British Journal of Oral and Maxillofacial Surgery - December 15, 2020 Category: ENT & OMF Authors: Mudit Agarwal, R Muthunagai, Vijay P Nautiyal, Atul Singh Source Type: research

Nasopharyngeal Airway and Subcranial Space Analysis in Pfeiffer Syndrome
This study attempts to investigate the regional abnormalities of the nasopharyngeal airway in Pfeiffer syndrome, to provide an anatomic basis for the upper airway surgical treatment and decannulation. (Source: The British Journal of Oral and Maxillofacial Surgery)
Source: The British Journal of Oral and Maxillofacial Surgery - December 15, 2020 Category: ENT & OMF Authors: Xiaona Lu, Antonio Jorge Forte, Omar Allam, Kitae Eric Park, Alexandra Junn, Michael Alperovich, Derek M. Steinbacher, Cristiano Tonello, Nivaldo Alonso, John A. Persing Source Type: research

Operative time, length of stay and reoperation rates for orthognathic surgery
Orthognathic surgery improves quality of life in terms of oral function and facial aesthetics. Our aim was to establish and compare operative time and length of inpatient stay for orthognathic procedures, and to assess the reoperation rate. Departmental electronic data base was used to identify all patients undergoing orthognathic surgery in a single unit between the 01/01/2016 and the 01/08/2018. 251 patients were identified who underwent 409 orthognathic surgery procedures. The mean operating time for a bimaxillary osteotomy (n=107) was 139.3 min. (Source: The British Journal of Oral and Maxillofacial Surgery)
Source: The British Journal of Oral and Maxillofacial Surgery - December 14, 2020 Category: ENT & OMF Authors: C.M. Bowe, B. Gurney, J. Sloane, P. Johnson, C. Newlands Source Type: research

Operative time, length of stay and re-operation rates for orthognathic surgery
Orthognathic surgery improves quality of life in terms of oral function and facial aesthetics. Our aim was to establish and compare operative time and length of inpatient stay for orthognathic procedures, and to assess the re-operation rate. (Source: The British Journal of Oral and Maxillofacial Surgery)
Source: The British Journal of Oral and Maxillofacial Surgery - December 14, 2020 Category: ENT & OMF Authors: CM Bowe, B Gurney, J Sloane, P Johnson, C Newlands Source Type: research

Process mapping and Lean principles applied to orthognathic surgery
Process mapping in industry is a well-established tool to improve efficiency. It is defined as a quality improvement technique that breaks down a process, or task, into its individual components, or steps, then analyses it. Lean principles are used to reduce waste and produce consistently good outcomes.Improving the operative efficiency of orthognathic surgery has many benefits. There is increasing demand for this complex surgery, and patients have appropriately high expectations with relation to their outcome. (Source: The British Journal of Oral and Maxillofacial Surgery)
Source: The British Journal of Oral and Maxillofacial Surgery - December 14, 2020 Category: ENT & OMF Authors: CM Bowe, B Gurney, J Sloane, C Newlands Source Type: research

Oral and maxillofacial surgery patient satisfaction with telephone consultations during the COVID-19 pandemic
Due to the COVID-19 pandemic most oral and maxillofacial surgical (OMFS) units have moved to conducting patient consultations over the telephone. The aim of this study was to assess patients' satisfaction with telephone consultations during the COVID-19 pandemic. A retrospective survey was conducted of OMFS patients at our hospital who had telephone consultations between 1 April - 8 June 2020. The survey was conducted by independent interviewers and used the Generic Medical Interview Satisfaction Scale (G-MISS) along with a previously published additional questionnaire. (Source: The British Journal of Oral and Maxillofacial Surgery)
Source: The British Journal of Oral and Maxillofacial Surgery - December 8, 2020 Category: ENT & OMF Authors: T.J. Horgan, A.Y. Alsabbagh, D.M. McGoldrick, S.K. Bhatia, A. Messahel Source Type: research

Clinical application of a surgical navigation system for the retrieval of fractured dental needles
In this report, a three-dimensional navigation system was used to determine the precise location and direction of the separated needle. (Source: The British Journal of Oral and Maxillofacial Surgery)
Source: The British Journal of Oral and Maxillofacial Surgery - December 7, 2020 Category: ENT & OMF Authors: K.J. Chen, W.F. Lo, I. Chen, M.Y.C. Chen Tags: Letter to the editor Source Type: research

RE: Two-week rule: suspected head and neck cancer referrals from a general medical practice perspective
I read with interest the article by Talwar et al entitled “Two-week rule: suspected head and neck cancer referrals from a general medical practice perspective”1. The authors make an interesting finding of a 5.5% conversion rate from 2 week wait referral to malignant diagnosis. Clearly there is a difficult balance between early diagnosis and appropriate use of resources. It should be noted that The National Institute for Health and Care Excellence (NICE) guidelines for the recognition and referral of cancer currently have a set “risk threshold” of 3%2. (Source: The British Journal of Oral and Maxillofacial Surgery)
Source: The British Journal of Oral and Maxillofacial Surgery - December 7, 2020 Category: ENT & OMF Authors: John Murphy Tags: Letter to the Editor Source Type: research