Biomedical subjects
Publications and source records attributed to G H Irvine.
A case is reported of a 26-year-old man, who after sustaining a fracture involving the nasal complex and left infra-orbital margin developed orbital cellulitis and a sub-periosteal abscess. This resulted in complete loss of vision in that eye. A pre-existing sinusitis was the source of the infection.
Castleman's disease is a rare condition usually presenting as a localized mass of lymphoid tissue in the thorax. We report the CT and MRI appearances of a case of cervical Castleman's disease.
101 fine needle aspirations of 82 head and neck masses in 72 patients performed in one maxillofacial unit over a 5-year period were studied retrospectively. Satisfactory reports were obtained for 69 masses. Fifty six (81.2%) were confirmed histologically and 13 (18.8%) by clinical follow up of at least 6 months' duration. The sensitivity was 96.7% and specificity 100% with a positive predictive value of 100%. No complications were recorded. Provided the unsatisfactory specimens are correctly recognised this technique provides a useful aid in the management of head and neck masses.
A simple method to facilitate good access to the palate of the adult patient using the Dingman gag is described.
Neck surgery on 100 consecutive patients in a unit with an established antibiotic policy was studied. An infection rate of 3% was recorded, comparing well with previously published studies. There were no major sequelae in the infected cases. A policy of no perioperative antibiotics for 'clean' surgery for benign disease, cefuroxime for 'clean' surgery for malignant disease and cefuroxime plus metronidazole for 'clean contaminated' surgery is vindicated.
Intra-oral carcinoma can present in a variety of ways. Whilst carcinoma classically presents as an irregular, indurated, painless mass or ulcer, it is also recognised as being a great 'mimic' of benign lesions. A series of four cases of intra-oral squamous cell carcinoma is presented in which the initial presentation suggested a lesion of benign or dental origin. Factors which raise the index of suspicion are discussed.
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A useful but underused technique of mandibular fixation is described. Its main advantages over more traditional techniques are that it is easily and rapidly applied, suitable for both children and adults, and generally well tolerated. The method can be employed where only a few teeth are present and in displaced fractures together with an intraosseous buccal plate wire. It is a method that can be recommended for use in nonmaxillofacial units and in areas where only basic equipment and facilities are available.
Temporomandibular joint pain and dysfunction is a common complaint and a frequent cause of referral to oral and maxillofacial surgeons. The importance of considering malignant disease in the differential diagnosis is illustrated by the following cases of parotid gland neoplasia which were referred as temporomandibular joint dysfunction.
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Neurological damage following the sagittal split osteotomy is a commonly recognised complication. The results of 38 osteotomies in 19 patients following a minimum post-operative period of 2 years is presented. Subjective evaluation demonstrated normal sensation in 73.7% of osteotomy sides. However, objective evaluation demonstrated normal sensation in only 34.2% of sides. The remainder had a variable degree of sensory loss.
A series of 15 mandibular keratocysts is presented. Criteria and methods of treatment are outlined, in particular radical enucleation and bone packing.
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A review of 41 patients in whom rib grafts were used has shown that this is a relatively simple, reliable and safe procedure for obtaining autogenous bone. The incidence of pneumothorax was significantly lower than that previously reported.