Abstracts of 28th Year Annual Meeting of Turkish Society of Neuroradiology with International Participation, Conrad Istanbul Bosphorus, Istanbul, Turkey, February 15-17, 2019

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Effects of leukocyte- and platelet-rich fibrin alone and combined with hyaluronic acid on early soft tissue healing after surgical extraction of impacted mandibular third molars: a prospective clinical study

In this prospective, randomized, double-blind, controlled study, we evaluated the effects of leukocyte- and platelet-rich fibrin (L-PRF) alone and combined with hyaluronic acid (HA) sponge on early healing of soft tissue after mandibular third molar (M3) surgery.

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Orthognathic Surgery in “Older” Adults with Hemi-Mandibular Elongation: Long-Term Occlusion Outcomes

The purpose of this study was to describe a consecutive series of subjects with HME who underwent orthognathic correction after 26 years of age. The investigators hypothesized that for this group of HME subjects, bimaxillary orthognathic correction would result in a favorable initial and long-term occlusion.

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Development process of traumatic heterotopic ossification of the temporomandibular joint in mice

Heterotopic ossification (HO) means the formation of ectopic bone in muscles, tendons, ligaments, and other soft tissues(Amar et al., 2015). HO is divided into acquired nongenetic HO and inherited genetic HO (Xu et al., 2018). For the rare genetic HO, fibrodysplasia ossificans progressiva (FOP) involves endochondral ossification, while progressive osseous heteroplasia (POH) and Albright hereditary osteodystrophy (AHO) leads to HO through intramembranous ossification(Shore and Kaplan, 2010). Neurogenic trauma-induced HO is a common type of acquired nongenetic HO and occurs through both intramembranous and endochondral ossification(Huang et al., 2018).

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Coincidence of craniocerebral and craniofacial injuries

To determine the incidence of craniocerebral injuries in patients who experienced upper facial or midfacial traumas associated with the disorders of consciousness. To find which types of craniofacial traumas predisposed to craniocerebral injuries. To analyze a relationship between the site of the force application and the type of resultant craniocerebral injury.

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No change in the teaching of oral and maxillofacial surgery to medical students

We read with interest the recent paper by Hamid et al.1 We commend them for publishing an excellent paper that further highlights the lack of teaching about oral and maxillofacial surgery (OMFS) and lack of awareness of the specialty among medical students.2 Their findings echo our own, as we showed that 72% (183/253) of English medical students and 85% (318/374) of Irish medical students3 had no exposure to it. Several years on, it seems that this has remained a trend, with 89% (178/200) of students1 having had no clinical exposure.

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Oncocytic cystadenoma and oncocytic cysts of the parotid gland occurring synchronously with a pleomorphic adenoma

Synchronous tumours that arise ipsilaterally in the parotid gland are rare. We describe what is to our knowledge the first report of both oncocytic cysts and an oncocytic cystadenoma adjacent to a pleomorphic adenoma of the parotid gland.

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Treatment of a calcifying epithelial odontogenic tumour with tube decompression: a case report

Conservative treatment of odontogenic tumours with decompression or marsupialisation is not common, but can be done successfully in those with a cystic pattern. We present a calcifying epithelial odontogenic tumour that was treated by tube decompression and subsequent enucleation.

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Are environmental risk factors for current wheeze in the International Study of Asthma and Allergies in Childhood (ISAAC) Phase Three due to reverse causation?

Abstract

Background

Phase Three of the International Study of Asthma and Allergies in Childhood (ISAAC) measured the global prevalence of symptoms of asthma in children. We undertook comprehensive analyses addressing risk factors for asthma symptoms in combination, at both the individual and the school level, to explore the potential role of reverse causation due to selective avoidance or confounding by indication.

Objective

To explore the role of reverse causation in risk factors of asthma symptoms.

Methods

We compared two sets of multilevel logistic regression analyses, using (i) individual‐level exposure data and (ii) school‐level average exposure (i.e. prevalence), in two different age groups. In individual‐level analyses, reverse causation is a possible concern if individual‐level exposure statuses were changed as a result of asthma symptoms or diagnosis. School‐level analyses may suffer from ecologic confounding, but reverse causation is less of a concern because individual changes in exposure status as a result of asthma symptoms would only have a small effect on overall school exposure levels.

Results

There were 131,924 children age 6‐7 years (2,428 schools, 25 countries) with complete exposure, outcome and confounder data. The strongest associations in individual‐level analyses (fully‐adjusted) were for current paracetamol use (odds ratio = 2.06; 95% confidence interval 1.97‐2.16), early life antibiotic use (1.65; 1.58‐1.73), and open fire cooking (1.44; 1.26‐1.65). In school‐level analyses these risk factors again showed increased risks.

There were 238,586 adolescents age 13‐14 years (2,072 schools, 42 countries) with complete exposure, outcome and confounder data. The strongest associations in individual‐level analyses (fully‐adjusted) were for current paracetamol use (1.80; 1.75‐1.86), cooking on an open fire (1.32; 1.22‐1.43), and maternal tobacco use (1.23; 1.18‐1.27). In school‐level analyses these risk factors again showed increased risks.

Conclusions & clinical relevance

These analyses strengthen the potentially causal interpretation of previously reported individual‐level findings, by providing evidence against reverse causation.

This article is protected by copyright. All rights reserved.

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Opioid analgesic use and patient‐reported pain outcomes after rhinologic surgery

Background

Opioid‐based analgesics are routinely prescribed after elective rhinologic surgery. Balancing appropriate pain management while avoiding overprescription necessitates an evidence‐based approach.

Methods

Patients undergoing elective rhinologic surgery, including endoscopic sinus surgery (ESS), septoplasty, or ESS with septoplasty, were prospectively enrolled. Patients completed demographic and psychometric questionnaires assessing attitudes toward pain, baseline anxiety, and depression before surgery. Postoperatively, patients documented peak pain levels (0‐100 visual analog scale) and daily prescription and nonprescription medication requirements over a 2‐week period.

Results

Of the 42 patients enrolled, 15 underwent ESS, 14 septoplasty, and 13 ESS with septoplasty. Five patients (11.9%) reported a history of chronic pain before surgery. Patients were given a median of 30 opioid pain pills after surgery: acetaminophen with codeine 325/30 mg (10 patients) or oxycodone with acetaminophen 5/325 mg (32 patients). Patients had a median of 27 pills left over at the end of the study period. Median peak pain levels for all procedures were 22 (range, 0‐94) on day 0, 26.5 (range, 0‐86) on day 1, 8.5 (range, 0‐85) on day 3, and 3 (range, 0‐52) on day 7. Median opioid requirements measured in morphine milligram equivalents (MME) over those same days were 6.0, 4.1, 0, and 0, respectively.

Conclusion

Postoperative pain after elective rhinologic surgery appears to peak over the first 3 days and decreases rapidly afterward. Most patients require a few doses of opioid analgesics. Opioid requirements and pain levels did not vary based on surgeon, type and extent of surgery, and demographic factors. Judicious prescribing of opioid medication after rhinologic surgery represents a practical opportunity for rhinologists and otolaryngologists to reduce opioid overprescription and abuse.

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Effects of leukocyte- and platelet-rich fibrin alone and combined with hyaluronic acid on early soft tissue healing after surgical extraction of impacted mandibular third molars: a prospective clinical study

Publication date: Available online 3 December 2018

Source: Journal of Cranio-Maxillofacial Surgery

Author(s): Ibrahim Murat Afat, Emine Tuna Akdoğan, Onur Gönül

Abstract

Purpose

In this prospective, randomized, double-blind, controlled study, we evaluated the effects of leukocyte- and platelet-rich fibrin (L-PRF) alone and combined with hyaluronic acid (HA) sponge on early healing of soft tissue after mandibular third molar (M3) surgery.

Patients and Methods

In total, 60 patients aged 18–30 (mean 22.3), 22 male and 38 female, were included in this study. After surgical extraction of the impacted M3, L-PRF was applied to the socket in the L-PRF group (n = 20), and a combination of L-PRF and HA was applied in the L-PRF+HA group (n = 20). Nothing was applied in the control group (n = 20). The primary outcome variable was healing score for the mucosa over the extraction socket on the 7th, 14th, and 21st days. Secondary outcome variables were frequencies of postoperative complications: hemorrhagic complications, alveolar osteitis (AO), and postoperative wound infection.

Results

Mean healing scores for the mucosa on the 7th, 14th, and 21st days for both the L-PRF group and the L-PRF+HA group were significantly better than those for the control group. The ratio of alveolar osteitis for the control group was 1:20 and the ratio of postoperative wound infection for the control group was 1:20. There were no cases of alveolar osteitis or postoperative wound infection in the L-PRF and L-PRF+HA groups. No hemorrhagic complications were observed in this study.

Conclusion

The results of this study suggest that L-PRF alone and when combined with HA can be an effective way to improve soft tissue healing, and could be used to prevent postoperative alveolar osteitis and infection after M3 surgery. Further studies with larger study groups are necessary.

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