Referral patterns of emergency physicians regarding head and neck pathology in Western Australia

2018 ◽  
Vol 9 (4) ◽  
pp. 147-150
Author(s):  
Jo Ann Ong ◽  
Dieter Gebauer ◽  
Estie Kruger ◽  
Marc Tennant
Keyword(s):  
Maxillofacial Surgery ◽  
Temporomandibular Joint Disorders ◽  
Scope Of Practice ◽  
Oral And Maxillofacial Surgery ◽  
Facial Fractures ◽  
Emergency Physicians ◽  
The Us ◽  
Head And Neck Pathology ◽  
Salivary Gland Disease ◽  
The Uk

Those dual qualified in oral and maxillofacial surgery (OMFS) in Australia have a scope of practice that includes dentoalveolar surgery, facial fractures, craniofacial deformities, salivary gland disease, temporomandibular joint disorders, and the treatment of oral and facial cancers with reconstruction. This differs from other countries such as the UK, the US, France and Brazil, which can lead to complexities of interaction when internationally trained health professionals, who may be unaware of this wide breadth of practice, are the ‘gatekeepers’ at tertiary health facilities. 1 – 3

scholarly journals Regulating health professional scopes of practice: comparing institutional arrangements and approaches in the US, Canada, Australia and the UK

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Kathleen Leslie ◽  
Jean Moore ◽  
Chris Robertson ◽  
Douglas Bilton ◽  
Kristine Hirschkorn ◽  
...  
Keyword(s):  
Health Professional ◽  
Health Professionals ◽  
Swot Analysis ◽  
Institutional Arrangements ◽  
Scope Of Practice ◽  
Comparative Case Study ◽  
Specific Reference ◽  
The Public ◽  
The Us ◽  
The Uk

Abstract Background Fundamentally, the goal of health professional regulatory regimes is to ensure the highest quality of care to the public. Part of that task is to control what health professionals do, or their scope of practice. Ideally, this involves the application of evidence-based professional standards of practice to the tasks for which health professional have received training. There are different jurisdictional approaches to achieving these goals. Methods Using a comparative case study approach and similar systems policy analysis design, we present and discuss four different regulatory approaches from the US, Canada, Australia and the UK. For each case, we highlight the jurisdictional differences in how these countries regulate health professional scopes of practice in the interest of the public. Our comparative Strengths, Weaknesses, Opportunities, Threats (SWOT) analysis is based on archival research carried out by the authors wherein we describe the evolution of the institutional arrangements for form of regulatory approach, with specific reference to scope of practice. Results/conclusions Our comparative examination finds that the different regulatory approaches in these countries have emerged in response to similar challenges. In some cases, ‘tasks’ or ‘activities’ are the basis of regulation, whereas in other contexts protected ‘titles’ are regulated, and in some cases both. From our results and the jurisdiction-specific SWOT analyses, we have conceptualized a synthesized table of leading practices related to regulating scopes of practice mapped to specific regulatory principles. We discuss the implications for how these different approaches achieve positive outcomes for the public, but also for health professionals and the system more broadly in terms of workforce optimization.

Patterns of Pediatric Facial Fractures

2021 ◽  
pp. 194338752199173
Author(s):  
Kevin Hong ◽  
James Jeong ◽  
Yehudah N. Susson ◽  
Shelly Abramowicz
Keyword(s):  
Motor Vehicle ◽  
Maxillofacial Surgery ◽  
Maxillofacial Trauma ◽  
Oral And Maxillofacial Surgery ◽  
Facial Fractures ◽  
Inclusion Criteria ◽  
Motor Vehicle Collisions ◽  
Vehicle Collisions ◽  
Peak Incidence ◽  
Maxillofacial Fractures

Objective: The aim of this study was to assess patterns of maxillofacial trauma in the pediatric population in Atlanta. This information is important to help guide management and allocate resources for treatment of maxillofacial injuries at Children’s Healthcare of Atlanta (CHOA). Methods: This study was a retrospective chart review of children who presented from 2006 to 2015. Inclusion criteria were: (1) age 18 years old or younger, (2) presentation to emergency department, (3) diagnosis of maxillofacial fractures, and (4) evaluation by Oral and Maxillofacial Surgery, Otolaryngology, or Plastic Surgery services. Medical records were reviewed to record demographic, mechanism of injury, fracture location, and yearly incidence of injury. Descriptive statistics were computed to summarize findings and overall trends. Results: During the study period, 39,833 patients were identified. Of them, 1995 met the inclusion criteria. The majority were male (n = 1359, 68%) with an average age of 9.4 years old (range of 1 month to 18 years old). Mechanisms of injury were motor vehicle collisions (MVC) (n = 597, 29.9%), fall (n = 565, 28.3%), sports injury (n = 317, 15.9%), pedestrian struck (n = 215, 10.8%), assault/abuse (n = 204, 10.2%), other (n = 81, 4.1%), or gunshot wound (n = 16, 0.8%). Fracture sites were mandible (n = 519, 26%), complex (n = 479, 24%), nasal (n = 419, 21%), dentoalveolar (n = 279, 14%), orbital (n = 259, 13%), and maxilla (n = 40, 2%). Males had a higher incidence of assault than females (n = 185, 91% of assaults). The incidence of maxillofacial trauma increased with age with a peak incidence in 13 to 16-year-olds (n = 566, 28.3%). During the years examined, there was an upward trend in MVCs as the etiology with a peak incidence of facial fractures due to MVCs occurring in 2015. All other mechanisms remained constant during this time period. Conclusions: There was an increase in pediatric facial fractures secondary to motor vehicle collisions from 2007 to 2015 despite improvements in regulations, traffic safety, and technology.

scholarly journals A Morphometric Analysis of Intra-articular Disc of Temporomandibular Joints in Cadavers

2021 ◽  
Author(s):  
Pratik Ashokkumar Agrawal ◽  
Navin S Shah ◽  
Ramnarayan A Gandotra ◽  
Karan Vasantray Panchal ◽  
Rishabh Navin Shah
Keyword(s):  
Temporomandibular Joint ◽  
Anatomic Variation ◽  
Maxillofacial Surgery ◽  
Temporomandibular Joint Disorders ◽  
Research Centre ◽  
Oral And Maxillofacial Surgery ◽  
Articular Disc ◽  
Chi Square ◽  
Temporomandibular Joints ◽  
Human Cadavers

Introduction: Temporomandibular Joint (TMJ) has been a controversial topic in Oral and Maxillofacial Surgery speciality especially regarding temporomandibular joint disorders and internal derangement of articular disc. The aetiology behind it has been related to the anatomic variations of the disc and its impact on the functioning of the articular disc. To understand such anatomic variation, the study has been conducted that will help future maxillofacial surgeon’s in designing accurate prosthetic articular disc that will improve the overall mechanics of the functioning of the prosthetic disc. Aim: To analyse the morphometric variations of the intra-articular disc in terms of circumference of the disc, perforations and their thickness within the disc in cadavers. Materials and Methods: The present observational study was carried out on cadavers in the Department of Anatomy. SBKS Medical College and Research Centre, Sumandeep Vidyapeeth University, Gujarat, India. The study was done from January 2017 to October 2018. Temporomandibular joints were dissected bilaterally from 10 human cadavers, i.e., 20 articular discs. The disc was removed and was measured with the help of thread, vernier callipers and standardised metallic scale and the circumference and thickness in the disc were evaluated. Descriptive statistical test was used and Chi-square test was applied. Results: Mean thickness of disc, both in males as well as females ranged from 1.4-2.0 mm in the Posterio-Medial (PM) and Posterio- Lateral (PL) region, while in Anterio-Medial (AM) and Anterio- Lateral (AL) region it ranged from 1.6-1.8 mm. Maximum length of disc ranged from 12-13 mm in anterio-posterio dimension while in Medio-Lateral (ML) it was 22-23 mm. Conclusion: The study gives an indepth knowledge about the various morphometric variations of articular disc and also shows its impact on the functioning of the disc. The study also directs maxillofacial surgeons to design prosthetic articular disc with greater accuracy and anatomical knowledge so that the procedures like surgical replacement of the disc can be carried out with greater potency and efficacy for the betterment of the patient.

“AN ANALYSIS OF OPHTHALMIC INJURIES IN PATIENTS WITH MAXILLOFACIAL TRAUMA”

2021 ◽  
pp. 81-83
Author(s):  
Sharmila. S ◽  
Abhilash Balakrishnan ◽  
Saji Nair .A ◽  
Ajith Kumar.K
Keyword(s):  
Maxillofacial Surgery ◽  
Maxillofacial Trauma ◽  
Facial Trauma ◽  
Oral And Maxillofacial Surgery ◽  
Ocular Injury ◽  
Age Group ◽  
Facial Fractures ◽  
Periorbital Oedema ◽  
Maxillofacial Fractures ◽  
Ocular Injuries

PURPOSE OFTHE STUDY: To estimate the proportion and types of ophthalmic injuries in patients with maxillofacial fractures PATIENTS AND METHODS: All patients with maxillofacial trauma, who came to the Department of Oral and Maxillofacial surgery Government Dental college Thiruvananthapuram from November 2020 to June 2021were included in this study. The information and data collected included age, sex, mechanism of injury, type of maxillofacial fracture and type of ophthalmic injury. RESULTS: Ocular injury was sustained by 209 patients out of which 180 (86.1%) were males and 29(13.9%)were females. The largest age group of patients associated with ophthalmic injuries were 30-39 years. The etiology of facial fractures or ocular injuries showed that road trafc accidents more frequently resulted in ocular injuries 66.5% followed by assault 18.7% and self fall 14.8%. Ophthalmic injuries occurred mostly in association with orbital fractures 33.5% followed by Zygomatico maxillary complex fracture 26.8%and Maxillary sinus fractures 24.4%. Periorbital oedema was the most common ophthalmic injury accounting for 46.4%of cases followed by Periorbital ecchymosis 35.4% and Subconjuntival haemorrhage 17.2%. CONCLUSION: Mid facial trauma commonly causes ophthalmic injuries of varying degrees. Prompt ophthalmic examination of all patients with mid facial trauma is mandatory to prevent any blinding complications

Salivary gland disease

2019 ◽  
pp. 69-82
Author(s):  
Johno Breeze ◽  
Sat Parmer ◽  
Niall McLeod
Keyword(s):  
Salivary Gland ◽  
Practical Knowledge ◽  
Maxillofacial Surgery ◽  
Oral And Maxillofacial Surgery ◽  
Senior Clinician ◽  
Assessment And Treatment ◽  
The Subject ◽  
Salivary Gland Disease ◽  
Contemporary Management ◽  
Complex Cases

This chapter contains eight clinical vivas on the subject of salivary gland disease. This will provide candidates sitting the vivas component of the Oral and Maxillofacial Surgery FRCS examination with practical knowledge in the assessment and treatment of obstructive, benign, and malignant salivary gland diseases. It will also provide insight for clinicians in allied specialties, such as otolaryngology and plastic surgery, in how to engage in a debate with a senior clinician in the contemporary management of such complex cases.

scholarly journals The provision of surgical tracheostomies by maxillofacial surgeons in the UK: time for a dedicated tracheostomy team?

2018 ◽  
Vol 100 (2) ◽  
pp. 116-119
Author(s):  
P Chohan ◽  
R Elledge ◽  
MK Virdi ◽  
GM Walton
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Telephone Survey ◽  
Percutaneous Dilatational Tracheostomy ◽  
Maxillofacial Surgery ◽  
University Hospital ◽  
Oral And Maxillofacial Surgery ◽  
Surgical Tracheostomy ◽  
Surgical Teams ◽  
The Uk

Surgical tracheostomy is a commonly provided service by surgical teams for patients in intensive care where percutaneous dilatational tracheostomy is contraindicated. A number of factors may interfere with its provision on shared emergency operating lists, potentially prolonging the stay in intensive care. We undertook a two-part project to examine the factors that might delay provision of surgical tracheostomy in the intensive care unit. The first part was a prospective audit of practice within the University Hospital Coventry. This was followed by a telephone survey of oral and maxillofacial surgery units throughout the UK. In the intensive care unit at University Hospital Coventry, of 39 referrals, 21 (53.8%) were delayed beyond 24 hours. There was a mean (standard deviation) time to delay of 2.2 days (0.9 days) and the most common cause of delay was surgeon decision, accounting for 13 (61.9%) delays. From a telephone survey of 140 units nationwide, 40 (28.4%) were regularly involved in the provision of surgical tracheostomies for intensive care and 17 (42.5%) experienced delays beyond 24 hours, owing to a combination of theatre availability (76.5%) and surgeon availability (47.1%). There is case for having a dedicated tracheostomy team and provisional theatre slot to optimise patient outcomes and reduce delays. We aim to implement such a move within our unit and audit the outcomes prospectively following this change.

Restorative dentistry – what's it all about?

2007 ◽  
Vol 89 (9) ◽  
pp. 327-327
Author(s):  
Paul King
Keyword(s):  
Maxillofacial Surgery ◽  
Oral And Maxillofacial Surgery ◽  
Restorative Dentistry ◽  
The Third ◽  
Complex Problems ◽  
The Uk ◽  
Provision Of Care

The specialty of restorative dentistry encompasses the monospecialties of endodontics, periodontics and prosthodontics, and involves the provision of care and advice for patients with complex problems associated with restoring satisfactory oral and dental function and aesthetics. Restorative dentistry has been recognised within the UK for nearly 25 years, becoming the third dental specialty along with the pre-existing specialties of oral and maxillofacial surgery and orthodontics in 1973.

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