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Oral and Maxillofacial Surgery Clinics of North America

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https://www.readbyqxmd.com/read/28893467/controversies-in-oral-and-maxillofacial-pathology
#1
REVIEW
Zachary S Peacock
Several benign pathologic entities that are commonly encountered by the oral and maxillofacial surgeon remain controversial. From etiology to treatment, no consensus exists in the literature regarding the best treatment of benign lesions, such as the keratocystic odontogenic tumor, giant cell lesion, or ameloblastoma. Given the need for often-morbid treatment to prevent recurrence of these lesions, multiple less-invasive treatments exist in the literature for each entity with little agreement. As the molecular and genomic pathogenesis of these lesions are better understood, directed treatments will hopefully lessen the contention in management...
September 8, 2017: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/28823889/controversies-in-the-management-of-oral-and-maxillofacial-infections
#2
REVIEW
Daniel Taub, Andrew Yampolsky, Robert Diecidue, Lionel Gold
The management and treatment of odontogenic infection, and its frequent extension into the head and neck, remains an important section of oral and maxillofacial surgical practice. This area of maxillofacial expertise is widely recognized by the medical community and an essential component to the hospital referral system. Although the general principles of infection management have not changed, there have been modifications in the timing of treatment sequences and treatment techniques. These modifications are influenced by the development of diagnostic methods and advances in bacterial genetics and antibiotic usage...
August 18, 2017: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/28709538/evaluation-of-the-surgical-margin-an-interdisciplinary-approach
#3
EDITORIAL
Joshua E Lubek, Kelly R Magliocca
No abstract text is available yet for this article.
August 2017: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/28709537/introduction
#4
EDITORIAL
Joseph I Helman
No abstract text is available yet for this article.
August 2017: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/28709536/margin-analysis-has-free-tissue-transfer-improved-oncologic-outcomes-for-oral-squamous-cell-carcinoma
#5
REVIEW
Sean P Edwards
Microvascular reconstruction of ablative defects has become a mainstay of contemporary management of head and neck cancer patients. These techniques offer myriad tissue options that vary in character, volume, and components and have vastly improved the esthetic and functional outcomes achieved in this patient population. Although consensus exists regarding the reliability and functional and esthetic benefits of free tissue transfer, the same cannot be said for oncologic outcomes. The increase in resources required for the routine use of free tissue transfer has led to asking this question-Do vascularized free flaps allow for increased surgical margins and improvements in oncologic outcomes?...
August 2017: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/28709535/surgical-margins-the-perspective-of-pathology
#6
REVIEW
Kelly R Magliocca
Neoplasms of the head and neck constitute a broad spectrum of benign and malignant entities. When treatment involves resection, assessment of the surgical margins represents an important component of the pathologic examination. Margin status is an important indicator of a complete surgical resection. The ability to generalize conclusions such as 'safe distance' measurements from work performed mSCCa or cutaneous malignancy to other types of neoplasms in the head and neck region seems limited. This article reviews conditions and considerations for reliable margin assessment and interpretation...
August 2017: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/28709534/margin-analysis-sarcoma-of-the-head-and-neck
#7
REVIEW
Raafat F Makary, Arun Gopinath, Michael R Markiewicz, Rui Fernandes
Head and neck sarcomas are rare but are associated with significant morbidity/mortality and management difficulties. These tumors are best managed in a multidisciplinary setting. Open or core biopsy is essential for histologic diagnosis and grading. Complete surgical tumor resection with negative margins at the first attempt is the best chance for potential cure. In most patients, except those with small resectable low-grade lesions, adjuvant radiotherapy and chemotherapy are added to maximize local control with variable results...
August 2017: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/28709533/margin-analysis-cutaneous-malignancy-of-the-head-and-neck
#8
REVIEW
Donita Dyalram, Steve Caldroney, Jonathon Heath
This article focuses only on margin analysis of the cutaneous malignancy of the skin. It discusses basal cell carcinoma, squamous cell carcinoma, and cutaneous melanoma. The management of the neck and distant disease are beyond the scope of this article, but it answers what is the appropriate surgical margin when excising these skin tumors, whether frozen sections are accurate for the analysis of these tumors, and treatment algorithm and rationale for a positive resection margin.
August 2017: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/28709532/margins-for-benign-salivary-gland-neoplasms-of-the-head-and-neck
#9
REVIEW
Eric R Carlson, James Michael McCoy
The proper ablation of any neoplasm of the head and neck requires the inclusion of linear and anatomic barrier margins surrounding the neoplasm. Extirpative surgery of the major and minor salivary glands is certainly no exception to this surgical principle. To this end, the selection and execution of the most appropriate ablative surgical procedure for a major or minor benign salivary gland neoplasm is an essential exercise in oral and maxillofacial surgery. Of equal importance is the intraoperative identification and preservation of the pseudocapsule surrounding the benign neoplasm...
August 2017: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/28709531/bone-margin-analysis-for-osteonecrosis-and-osteomyelitis-of-the-jaws
#10
REVIEW
Mohammed Qaisi, Lindsay Montague
Bone margin analysis in cases of osteomyelitis, osteoradionecrosis, and medication-related osteonecrosis of the jaw is a controversial topic. There is little evidence to guide treatment and the interpretation of bone margin results. This article examines the significance of margin status and any possible effect on progression of the disease process. A review of various treatment adjuncts used for intraoperative margin analysis during removal of affected tissue is provided. Literature on the role of imaging is also discussed with regards to treatment planning for surgical resection...
August 2017: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/28709530/margin-analysis-squamous-cell-carcinoma-of-the-oropharynx
#11
REVIEW
Felix W Sim, Hong D Xiao, R Bryan Bell
Because of the common shared risk factors of smoking and heavy alcohol consumption, literature involving oropharyngeal squamous cell carcinoma (OPSCC) is often combined with oral squamous cell carcinoma. Human papilloma virus is now confirmed to be a major risk factor of OPSCC with its distinct epidemiology and favorable treatment outcome. The impact of adjuvant chemoradiation in the setting of positive surgical margins remains unclear but is likely influenced by tumor biology. This article reviews the tumor biology of OPSCC and summarizes recent findings on outcomes following surgical treatment of OPSCC...
August 2017: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/28709529/margin-analysis-squamous-cell-carcinoma-of-the-oral-cavity
#12
REVIEW
Michael Shapiro, Andrew Salama
This article primarily focuses on defining terms including negative margin, close margin, and positive margin. Furthermore, this review delineates the current role of frozen section analysis and adjuvant therapy in treating oral squamous cell carcinoma with respect to surgical margin status.
August 2017: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/28558942/bone-margin-analysis-for-benign-odontogenic-tumors
#13
REVIEW
Eric Ringer, Antonia Kolokythas
With the potential exception of the case of ameloblastoma, information relevant to the exact tumor-bone interface and extent of bone invasion by the commonly encountered odontogenic tumors is lacking. These tumors are rare. Treatment rendered varies significantly. Although commonly accepted practices are recommended, scientific evidence is relatively lacking. Prospective multicenter studies from tertiary treatment centers are required for evidence-based guidelines. Until studies are available, the proposed linear bone resection margin for odontogenic tumors and the evaluation of its adequacy in tumor eradication will be based on the limited data available...
August 2017: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/28551338/evaluation-of-the-bone-margin-in-oral-squamous-cell-carcinoma
#14
REVIEW
Joshua E Lubek, Kelly R Magliocca
Squamous cell carcinoma is the most common cancer within the oral cavity. Bone invasion involving the maxilla or mandible is reported in up to 50% of tumors on initial presentation. Although conflicting data exist, true bone invasion is thought to negatively affect risk of recurrence and long-term prognosis. The ultimate goal is to accurately identify bone invasion preoperatively and intraoperatively, because it affects the treatment plan. This article focuses on methods of evaluation of the bone margin in the preoperative and intraoperative setting, discussing the implications for prognostic, staging, and reconstructive methods...
August 2017: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/28551337/margin-analysis-malignant-salivary-gland-neoplasms-of-the-head-and-neck
#15
REVIEW
Robert A Ord, Naseem Ghazali
There are no established protocols for the optimum surgical margin required for salivary gland malignancies. Factors including histologic diagnosis and TNM stage have been shown to be important in prognosis and survival outcome and mandate special consideration of margin size. Salivary cancers are treated differently at different anatomic sites, and different histologic types show a propensity for major or minor glands. Low-grade malignancies are treated with soft tissue margins of 1 cm or less. The facial nerve is preserved unless infiltrated and encased...
August 2017: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/28528739/understanding-the-surgical-margin-a-molecular-assessment
#16
REVIEW
David J ClarK, Li Mao
The inclusion of molecular characteristics into surgical margin analysis may not only yield a more sensitive and accurate assessment of the cells in these margins, but may also provide insight into their impacts on patients' postoperative prognosis. This concept of the "molecular surgical margin" is advantageous, as it integrates recent advances in our understanding of head and neck carcinogenesis, while also retaining the established methodology of histopathology. This multidisciplinary approach may facilitate the development of a uniform criterion for defining the surgical margin, which will likely result in a reduced recurrence rate and improved overall patient survival...
May 18, 2017: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/28417895/preface
#17
EDITORIAL
David W Todd, Jeffrey D Bennett
No abstract text is available yet for this article.
May 2017: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/28417894/quality-improvement-and-reporting-systems-what-the-oral-and-maxillofacial-surgeon-should-know
#18
REVIEW
Justine S Moe, Shelly Abramowicz, Steven M Roser
Health care is an inherently dangerous environment, and patient safety should be an explicit goal of oral and maxillofacial surgery. Important components of a safety program include a nonpunitive safety culture, the implementation of patient safety practices, standardized incident reporting and adverse event analysis, regular self-assessment, and internal and external benchmarking. Implementation of a safety program requires the strong commitment of leadership and the engagement and empowerment of all employees...
May 2017: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/28417893/equipment-safety-maintenance-and-inspection-what-the-oral-surgeon-needs-to-know
#19
REVIEW
Katherine A Keeley
Many oral and maxillofacial surgical procedures are done in an office-based setting, with many oral and maxillofacial surgeons involved in oversight of equipment maintenance. Goals in equipment management are to prevent harm to patients and staff, stay compliant with current regulations, and increase equipment longevity. This article covers the safety, maintenance, and inspection related to electrical equipment used in the treatment of patients, autoclaves, radiograph machines, nitrous oxide and oxygen medical gases, and required back-up power and lighting...
May 2017: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/28417892/discharge-criteria-impact-of-the-patient-and-the-procedure-what-the-oral-surgeon-should-know
#20
REVIEW
Kyle J Kramer
This article is a concise review of discharge criteria following sedation or anesthesia relevant to the oral and maxillofacial surgeon. Topics covered include a general overview of the need for objective discharge criteria, a review of standardized criteria, and a brief discussion on specific anesthetic, patient, and surgical factors that can impact the safety of the immediate postoperative recovery and postdischarge periods.
May 2017: Oral and Maxillofacial Surgery Clinics of North America
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