Surgical management of refractory osteoradionecrosis

This is a French single-centre, 10-year experience of 55 surgical resection and reconstruction procedures. They claim an overall effectiveness rate of 92.3%. Thity-six segmental and 19 marginal mandibulectomies were performed. A variety of free flaps were used with soft tissue...

Hierarchy of orthognathic surgical stability

This study was designed as ‘an overview’ of secondary studies and analysed 15 articles. Two procedures were considered highly unstable, a bilateral sagittal split osteotomy for clockwise rotation of the mandible with bi-cortical screw rigid internal fixation, and posterior maxillary...

Bone grafting in orthognathic surgery

This is a systematic review from Belgium and Saudi Arabia of 48 articles. They reviewed the complication, stability, aesthetics and healing of Le Fort I, sagittal split, chin and zygomatic osteotomies. They concluded that there was strong evidence that bone...

Risks of tracheostomy in head and neck cancer

Tracheostomy is an accepted surgical procedure that is one of the oldest ways of securing the airway. It is widely accepted to protect the airway after big cases of head and neck cancer and especially following free flap reconstruction. It...

Soft tissue changes following maxillary osteotomy, comparison of three computer programmes

This small group of seven patients had a Le Fort I advancement maxillary osteotomy with vertical repositioning and alar base cinch sutures. They were assessed with cone beam CTs three months preoperatively and one year postoperatively. A clinical comparison between...

Temporary tracheostomies are not always necessary for head and neck free flap reconstruction

Complex head and neck cancer cases with reconstruction can be challenging due to the risk of loss of airway. Temporary tracheostomies are often used to protect the airway following complex oral and maxillofacial ablative surgery and reconstruction. However, while this...

Plastic surgery trainees’ exposure to cosmetic surgery during training

Cosmetic surgery is an essential component of plastic surgery training and is required in order to CCT. However, the training opportunities in UK are limited. The current operative requirements for plastic surgery trainees are 100 procedures during specialist training, either...

Transgender breast surgery

Most plastic surgeons working outside specialist centres for gender affirmation surgery will have a number of patients within their population wishing to undergo their breast surgery more locally. Surgery for this small minority is informed largely by experience in the...

Transgender facial surgery

In this review article the author outlines the various elements of this subspecialty, with reference to published literature and his own clinical experience in the field. The article does not present new data, and lacks the detail necessary to appeal...

Modified subciliary approach to the orbital floor

Fractures involving the lateral midface and orbital floor are routinely treated by maxillofacial surgeons. The surgical management requires access to the facial skeleton to reposition and free the soft tissues. There are three main approaches to the orbital floor the...

When to treat a fractured mandible?

This is a prospective study from Brisbane of 215 patients with a total of 359 fractures of the mandible. Nine outcome variables were analysed with a further 19 included to adjust for potential confounding. Treatment delay was found not to...

One anastomosis or two

This is a cumulative meta-analysis from Hong Kong reviewing 27 articles and a total of 7389 flaps. The authors, at the outset, acknowledge that the number of anastomoses is not the only factor of venous compromise and flap failure. Nonetheless...