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2. How has COVID-19 affected surgical practice in Oral and Maxillofacial Surgery in the East Midlands, UK?

Author

Asad Ahmed, Sujeev Rajapakse, and Kate Evans

Subjects
medicine.medical_specialty, Maxillofacial, Coronavirus disease 2019 (COVID-19), OMFS, medicine.medical_treatment, Oral Surgical Procedures, Orthognathic surgery, Specialty, Article, Surgical practice, 03 medical and health sciences, 0302 clinical medicine, Surveys and Questionnaires, Personal protective equipment, RCS, Royal College of Surgeons, medicine, Humans, East midlands, Practice Patterns, Physicians', 030223 otorhinolaryngology, Response rate (survey), Infection Control, business.industry, General surgery, Head and neck cancer, OMFS, Oral and Maxillofacial Surgery, COVID-19, Emergency department, medicine.disease, Surgery, Oral, United Kingdom, Coronavirus, Oncology, 030220 oncology & carcinogenesis, Oral and maxillofacial surgery, PPE, Surgery, BAOMs, British Association of Oral and Maxillofacial Surgeons, business, PPE, personal protective equipment
Abstract

The impact on the provision of care within the NHS due to COVID-19 can not be understated. It has created various challenges for Oral and Maxillofacial Surgeons due to the high-risk nature of working within this specialty. The aims of this study were to identify the ongoing clinical activities at the height of pandemic, the guidance issued to staff regarding the use of personal protective equipment and the changes to maxillofacial practice. A prospective analysis was commenced within six Oral and Maxillofacial Surgery units in the East Midlands, UK with data being collected by means of a 10-item questionnaire relating to changes in patient care during this time. The responses were analysed to identify compliance with the national guidance produced by the British Association of Oral and Maxillofacial Surgeons. An 87% response rate was obtained (26 respondents from 30 invitations). 73.1% of participants confirmed all surgical members of staff were offered fit tests for FFP3 masks. All units reported a continuation of Head and Neck cancer and emergency operations with a complete reduction in TMJ and orthognathic surgery. FFP3 masks were the most popular masks used for theatre activity whilst FFP2 and surgical masks were more widely used for examining patients and performing procedures in the emergency department. Changes in maxillofacial practice included the use of local flaps compared to free flaps, use of intermaxillary fixation (IMF) where appropriate for craniofacial trauma and routine COVID-19 testing for all inpatients.

Published
2020

3. Surgical Management: Clearing the Path

Author

Andrew J. Sidebottom and Sujeev Rajapakse

Subjects
medicine.medical_specialty, business.industry, Prolotherapy, medicine.medical_treatment, Range of movement, musculoskeletal system, Autologous blood injection, Surgery, stomatognathic diseases, stomatognathic system, Occlusion, medicine, Thickening, Deep fascia, Botulinum injections, business
Abstract

The hierarchies of management objectives for recurrent TMJ dislocation are to cause no harm, restore function and restore anatomy. More conservative options should be considered prior to surgical intervention such as dextrose prolotherapy, autologous blood injection or botulinum injections described elsewhere in this text. Both stability and range of movement of the TMJ are dictated by: The occlusion (or lack of it) Shape of the glenoid fossa including the slope and size of the articular eminence The TMJ capsule—a thickening of the deep fascia, being strongest laterally The TMJ ligaments—sphenomandibular and stylomandibular

Published
2018
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4. List of Contributors

Author

Khalild Abdel-Galil, Abdul Ahmed, Nabeela Ahmed, Thomas Aldridge, Kavin Andi, Bilal Al-Nawas, Eric Arnaud, Christopher M.E. Avery, Mark Bainbridge, Victoria Beale, William H. Bell, Natasha Louise Berridge, Adam Blancher, Michael S. Block, John N St. J Blythe, Jens Bodem, Paolo Boffano, Farzad Borumandi, Rudolf Robert Maria Bos, Major John Breeze, Peter A. Brennan, James Brown, Rudolf F. Buntic, Heinz Bürger, Brady Burton, Eric R. Carlson, Luke Cascarini, Siwan Cassidy, Alison Chalmers, David Chapireau, Alistair R.M. Cobb, Serryth Colbert, Margaret Jean Coyle, Angelo Cuzalina, Jason E. Dashow, Jag Dhanda, David Drake, Alex D. Ehrlich, Simon Ellis, T. William Evans, Helen Extence, Shahme Ahamed Farook, Jerry N. Farrier, Adekunmi Fasanmade, Rui P. Fernandes, Tim Forouzanfar, Tobias Fretwurst, David E. Frost, Alexander Johann Gaggl Sr., Rishi Kumar Gandhi, Nils-Claudius Bernhard Gellrich, Katherine George, G.E. Ghali, Michael Gilhooly, Daryl R. Godden, Marianela Gonzalez, Jonathan B. Gottlieb, Henry A. Alan Gremillion, Ben C. Green, Elizabeth Anne Gruber, Cesar A. Guerrero, Rishi Jay Gupta, Kevin J. Harrington, Christopher Harris, Andrea M. Hebert, Joseph Helman, Jürgen Hoffmann, Bodo Hoffmeister, Simon Holmes, Dominik Horn, Birgit Jaspers, Gernot Jundt, Julian Eamon Kabala, Leonard B. Kaban, Arshad Kaleem, Anastasios Kanatas, Charles Gerald Kelly, Gary D. Klasser, Beomjune B. Kim, David A. Koppel, Norbert R. Kübler, Ilya Likhterov, Timothy William Lloyd, Richard A. Loukota, Joshua E. Lubek, Andrew Lyons, Col. Neil Mackenzie, Gitta Madani, Michael R. Markiewicz, Nigel Shaun Matthews, Joe McQuillan, Mark McGurk, Divya Mehrotra, Nigel Stuart George Mercer, Louis Gerard Mercuri, Ashraf Messiha, Florencio Monje, Elena V. Mujica, Rachel Anne Mumford, Kenlchiro Murakami, Friedemann Nauck, Hendrik Naujokat, Friedrich-Wilhelm Neukam, Suzan Obagi, Robert A. Ord, Yirae Ort, Ravinder Pabla, Bonnie L. Padwa, Stavan Patel, Chris Neil Penfold, Jon D. Perenack, Michael P. Powers, Wolfgang Puelacher, Faisal A. Quereshy, Jan D. Raguse, Sujeev Rajapakse, Parkash L. Ramchandani, Cory M. Resnick, Janet Mary Risk, Stephen N. Robinson, Eduardo D. Rodriguez, Simon N. Rogers, J.L.N. Roodenburg, Nadeem Saeed, Andrew Graeme Schache, Stephen A. Schendel, Henning Schliephake, Rainer Schmelzeisen, Andrea Maria Schmidt-Westhausen, Riitta Seppänen-Kaijansinkko, Richard J. Shaw, Andrew J. Sidebottom, Mark K. Singh, Rabindra P. Singh, Douglas P. Sinn, Ludi E. Smeele, C. Blake Smith, Brian Sommerlad, Frank Peter Strietzel, Adrian Sugar, Anita Takwale, Clark O. Taylor, William Arthur Townley, Timothy A. Turvey, Mark L. Urken, Simon Van Eeden, Wilfried Wagner, Peter C. Whitfield, Michael J. Will, Jonathan Williams, Jörg Wiltfang, Helen Witherow, Jennifer E. Woerner, Jeffrey S. Wolf, Larry M. Wolford, Wai Lup Wong, Martin Woods, Peirong Yu, and Rüdiger M. Zimmerer

Published
2017
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6. Re: Does the Amount of Screw Fixation Utilized for the Condylar Component of the TMJ Concepts Total Temporomandibular Joint Reconstruction Predispose to Hardware Loss or Postoperative Complications?

Author

Andrew James Sidebottom and Sujeev Rajapakse

Subjects
Temporomandibular Joint, business.industry, Joint Prosthesis, Bone Screws, Mandibular Condyle, Dentistry, 030206 dentistry, Temporomandibular Joint Disorders, Condyle, Screw fixation, Temporomandibular joint, 03 medical and health sciences, 0302 clinical medicine, medicine.anatomical_structure, Postoperative Complications, Otorhinolaryngology, 030220 oncology & carcinogenesis, Component (UML), medicine, Humans, Surgery, Oral Surgery, business
Published
2016

7. Current thinking about the management of dysfunction of the temporomandibular joint: a review

Author

Sujeev Rajapakse, Andrew J. Sidebottom, and Nabeela Ahmed

Subjects
medicine.medical_specialty, Joint replacement, medicine.medical_treatment, Oral Surgical Procedures, Disease, Conservative Treatment, Nice guidance, 03 medical and health sciences, Arthroscopy, 0302 clinical medicine, stomatognathic system, medicine, Humans, Pain Management, Arthroplasty, Replacement, Orthodontics, business.industry, Tmj dysfunction, Arthrocentesis, 030206 dentistry, Temporomandibular Joint Disorders, Combined Modality Therapy, Temporomandibular joint, stomatognathic diseases, medicine.anatomical_structure, Otorhinolaryngology, Physical therapy, Surgery, Oral Surgery, business, 030217 neurology & neurosurgery
Abstract

Increasingly the management of TMJ pathology is becoming a subspecialist interest. The number of patients having TMJ joint replacement had steadily increased over the last decade and there is now NICE guidance on this matter. Whilst the evidence of the management of TMJ disease is limited and there are few randomised controlled trials, the incidence of TMJ pathology has not changed and there is a requirement for guidance on the management. Whilst previously patients with TMJ pain were managed surgically, this is changing, and the vast bulk of initial management is non-surgical/medical. This paper will review the literature on TMD and provide guidance for management.

Published
2016

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