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Tranexamic acid and blood loss in bimaxillary surgery

This is a randomised double-blind placebo-controlled trial from Thailand to clarify the most effective dose of Tranexamic acid in reducing blood loss during a bimaxillary osteotomy. They confirmed that the dose of 10mg per kg is the most efficacious and...

Keep the condyle if you can

This is a study of 41 patients who underwent benign tumour resection and reconstruction over a four year period. Patients fell into three groups; condyle preserved, condyle sacrificed, condyle frozen in combination with a DCIA free flap. Following this, they...

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...

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...