Maxillofacial space infection (MSI) is one of the most common conditions encountered in oral and maxillofacial surgery clinics. Early recognition and proper management of MSI could prevent a life-threatening event. Ob...Maxillofacial space infection (MSI) is one of the most common conditions encountered in oral and maxillofacial surgery clinics. Early recognition and proper management of MSI could prevent a life-threatening event. Objectives: To report a series of MSI managed with antibiotics, surgical intervention and exogenous steroids as an adjunct, highlighting functional improvement following steroid administration. Methods: A retrospective cohort study was carried out from December 2013 to September 2016, involving 30 patients (n = 30, 22 males, 8 females) diagnosed with MSI. All patients were initially managed with intravenous empirical antibiotics, analgesics and removal of potential source of infection. A course of 3 doses of IV Dexamethasone 8 mg at an interval of 8 hours was started during the first day of hospital admission. Results: This series reports 30 patients presenting with MSI, who received prompt antibiotics and 3 doses of steroids as inpatients. Significant clinical improvement was noted in the form of amelioration of pain, rapid reduction in edema, and improved trismus, shortening hospital stay to an average of 3.5 days, and omission of surgical intervention in 50% of our cases. No adverse effects or drug reaction was noted. Conclusion: In conclusion, the value of synergistic use of corticosteroids with antibiotics in management of MSI is significant. Despite these promising findings, there is scarce evidence in the literature to fully support the use of corticosteroids in abscess management. The role of corticosteroids in treatment of MSI should be explored further.展开更多
Purpose: To compare the complication rates arising from surgical removal of lower third molars (L3M) under general anaesthesia (GA) versus local anaesthesia (LA) in the Oral and Maxillofacial Surgery (OMFS) Department...Purpose: To compare the complication rates arising from surgical removal of lower third molars (L3M) under general anaesthesia (GA) versus local anaesthesia (LA) in the Oral and Maxillofacial Surgery (OMFS) Department, Hospital Sultanah Nora Ismail (HSNI), Batu Pahat, Johor, Malaysia. Materials and methods: This is a retrospective clinical audit of patients who underwent L3M removal under LA or GA from 1/1/2013 to 31/3/2018, with recorded complications such as surgical site infection (SSI), wound breakdown, severe pain, trismus, retained tooth structure, nerve injury and dry socket evaluated at different time intervals. Results: A total of 313 patients with 375 L3M were included in this study (male: 160, 51.1%;female: 153, 48.9%) with an age range of 18 to 40 years (mean = 27.43 years). 79 L3M were removed under GA (34.2% were classified as mild;65.8% were moderate), whereas 296 L3M were removed under LA, (31.4% were mild impaction, 63.9% moderate and 4.7% severe. Preoperative antibiotics were given before all L3M removal under GA, while only 23 out of 296 L3M removal under LA had antibiotics. 15.2% of L3M removal under GA and 16.6% of those done under LA were associated with complications. Generally, patient with GA had lesser complications;however only SSI outcome was significant (p = 0.034). Conclusion: L3M removal under LA may have a higher risk of SSI when compared to GA. This raises the possibility that a single prophylactic antibiotic dose may prevent SSI in LA procedures.展开更多
Purpose of the Study: To understand the reasons for charm needle insertions, chemical constituents of charm needles and their significance to magnetic resonance imaging. Materials and Methods: Confidential interviews ...Purpose of the Study: To understand the reasons for charm needle insertions, chemical constituents of charm needles and their significance to magnetic resonance imaging. Materials and Methods: Confidential interviews were used to collect information from charm needle wearers. Two attempts at surgical removal of charm needles were carried out. Charm needle samples were chemically analyzed using EPMA method. A review of literature on the possible complications of charm needles in relation to MRI was made. Results: Patients had varied reasons for wearing charm needles including to be physically attractive, to overcome personal problems and for protection. Charm needles were made of gold alloy consisting of gold (85.2%-88.6%), copper (9.3%-10.8%) and trace elements of aluminium and silver. As such, MRI may not be a hazard to charm needle wearers given the fact that gold is non-ferromagnetic. However, artefacts may potentially distort the MR imaging. Conclusion: A tactful manner in handling these patients may be to ignore the needles unless a clinical need warrants intervention. The surgical removal of these needles may be a straightforward procedure, but the localization is usually a challenging task. At present, the pertinent literature does not contain carefully controlled studies that demonstrate the absolute safety of charm needle exposure to powerful magnetic fields.展开更多
The original online version of this article (Hui Woon Lim (2019) Wisdom Tooth Surgery Complications-Local Anaesthesia versus General Anaesthesia. Volume 9, 51-63. doi:10.4236/ojst.2019.93006) needs some further amendm...The original online version of this article (Hui Woon Lim (2019) Wisdom Tooth Surgery Complications-Local Anaesthesia versus General Anaesthesia. Volume 9, 51-63. doi:10.4236/ojst.2019.93006) needs some further amendments and clarification.展开更多
文摘Maxillofacial space infection (MSI) is one of the most common conditions encountered in oral and maxillofacial surgery clinics. Early recognition and proper management of MSI could prevent a life-threatening event. Objectives: To report a series of MSI managed with antibiotics, surgical intervention and exogenous steroids as an adjunct, highlighting functional improvement following steroid administration. Methods: A retrospective cohort study was carried out from December 2013 to September 2016, involving 30 patients (n = 30, 22 males, 8 females) diagnosed with MSI. All patients were initially managed with intravenous empirical antibiotics, analgesics and removal of potential source of infection. A course of 3 doses of IV Dexamethasone 8 mg at an interval of 8 hours was started during the first day of hospital admission. Results: This series reports 30 patients presenting with MSI, who received prompt antibiotics and 3 doses of steroids as inpatients. Significant clinical improvement was noted in the form of amelioration of pain, rapid reduction in edema, and improved trismus, shortening hospital stay to an average of 3.5 days, and omission of surgical intervention in 50% of our cases. No adverse effects or drug reaction was noted. Conclusion: In conclusion, the value of synergistic use of corticosteroids with antibiotics in management of MSI is significant. Despite these promising findings, there is scarce evidence in the literature to fully support the use of corticosteroids in abscess management. The role of corticosteroids in treatment of MSI should be explored further.
文摘Purpose: To compare the complication rates arising from surgical removal of lower third molars (L3M) under general anaesthesia (GA) versus local anaesthesia (LA) in the Oral and Maxillofacial Surgery (OMFS) Department, Hospital Sultanah Nora Ismail (HSNI), Batu Pahat, Johor, Malaysia. Materials and methods: This is a retrospective clinical audit of patients who underwent L3M removal under LA or GA from 1/1/2013 to 31/3/2018, with recorded complications such as surgical site infection (SSI), wound breakdown, severe pain, trismus, retained tooth structure, nerve injury and dry socket evaluated at different time intervals. Results: A total of 313 patients with 375 L3M were included in this study (male: 160, 51.1%;female: 153, 48.9%) with an age range of 18 to 40 years (mean = 27.43 years). 79 L3M were removed under GA (34.2% were classified as mild;65.8% were moderate), whereas 296 L3M were removed under LA, (31.4% were mild impaction, 63.9% moderate and 4.7% severe. Preoperative antibiotics were given before all L3M removal under GA, while only 23 out of 296 L3M removal under LA had antibiotics. 15.2% of L3M removal under GA and 16.6% of those done under LA were associated with complications. Generally, patient with GA had lesser complications;however only SSI outcome was significant (p = 0.034). Conclusion: L3M removal under LA may have a higher risk of SSI when compared to GA. This raises the possibility that a single prophylactic antibiotic dose may prevent SSI in LA procedures.
文摘Purpose of the Study: To understand the reasons for charm needle insertions, chemical constituents of charm needles and their significance to magnetic resonance imaging. Materials and Methods: Confidential interviews were used to collect information from charm needle wearers. Two attempts at surgical removal of charm needles were carried out. Charm needle samples were chemically analyzed using EPMA method. A review of literature on the possible complications of charm needles in relation to MRI was made. Results: Patients had varied reasons for wearing charm needles including to be physically attractive, to overcome personal problems and for protection. Charm needles were made of gold alloy consisting of gold (85.2%-88.6%), copper (9.3%-10.8%) and trace elements of aluminium and silver. As such, MRI may not be a hazard to charm needle wearers given the fact that gold is non-ferromagnetic. However, artefacts may potentially distort the MR imaging. Conclusion: A tactful manner in handling these patients may be to ignore the needles unless a clinical need warrants intervention. The surgical removal of these needles may be a straightforward procedure, but the localization is usually a challenging task. At present, the pertinent literature does not contain carefully controlled studies that demonstrate the absolute safety of charm needle exposure to powerful magnetic fields.
文摘The original online version of this article (Hui Woon Lim (2019) Wisdom Tooth Surgery Complications-Local Anaesthesia versus General Anaesthesia. Volume 9, 51-63. doi:10.4236/ojst.2019.93006) needs some further amendments and clarification.
