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First signs of late nodal metastases

This is a retrospective review of 65 patients who had late metastases during follow-up after initial curative treatment. They analyse the detection methods of palpation, ultrasound, CT and subjective symptoms. Palpation detected the nodes in 31 patients, ultrasound in 17,...

Basic principles of bioengineering and regeneration

The ability to create de novo tissue to replace that removed from patients during surgery is a relatively recent advance. However, this is a fast-moving field and one which surgeons must be aware of from practical, ethical and scientific viewpoints....

Honey in the management of mucositis

This is a meta-analysis of randomised controlled trials. Despite some limitations, they were able to identify that honey could reduce the severity of radio/chemotherapy induced oral mucositis. They acknowledge that the exact aetiology in the effect of honey is not...

Safe distances in the infratemporal fossa

This analysis from China involved 50 enhanced CT datasets to reconstruct the skull, internal carotid artery and the internal jugular vein. The anatomical routes of these vessels were related to the styloid process, height of the pterygoid plates, distance from...

Maxillary osteotomy stability

This systematic review assesses inferior repositioning of the maxilla six months after surgery. Two articles were identified with a total of 22 patients. The repositioning was of a mean of 3.2 to 4.5mm anteriorly and 0.1 to 1.8mm posteriorly. Six...

Bad splits

This is a meta-analysis of reported risk factors of a ‘bad split’ in a sagittal split mandibular osteotomy. They identified 30 observational articles and therefore acknowledged it is based on low quality studies. It is compounded by the definition of...

Carnoy’s and the KOT

This is a retrospective review of 105 patients with keratocystic odontogenic tumours treated over a 23-year period with a mean follow up of 86 months. The recurrence rate was 11.4%. Permanent neuro-sensory deficit of the inferior alveolar nerve 16%. Younger...

What can the anterior cranial fossa fracture pattern tell us?

This assessment involves 81 patients treated between two regional major trauma centres in the UK. Fifty sustained a predominantly anterior directed force and 31 a lateral impact. They found that anterior impacts reduce the incidence of fracture propagated beyond the...

Is it time for cone-beam CTs to replace the traditional orthopantomogram in the primary diagnosis of temporomandibular joint disorders?

Cone-beam CT requires a lower dose of radiation compared to the multidetector CT and provides much more detailed information in 3D about the bony structures of the temporomandibular joint (TMJ) when compared to the traditional orthopantomogram (OPG). In this article...

Risks of tracheostomy in head and neck cancer

Tracheostomy is associated with several complications, with rates quoted as high as 8-45%, including: bleeding; displacement; obstruction; surgical emphysema; pneumothorax; fistulae and failure to decannulate. There are now many studies that confirm the increased length of stay and complications of...

Sinonasal Complications of Dental Disease and Treatment: Prevention - Diagnosis - Management

As otorhinolaryngologists, we are trained to examine the computed tomography (CT) scans of all patients with maxillary chronic rhinosinusitis (CRS) for potential dental disease. The mainstay of managing this is generally limited to referring the patient to their dentist or...