Diagnostics and Management in Oral and Maxillofacial Medicine

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Medical Imaging and Theranostics".

Deadline for manuscript submissions: 30 November 2024 | Viewed by 695

Special Issue Editor


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Guest Editor
Department of Oral Medicine, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.
Interests: beam computed tomography (CBCT); periapical dental lesions; artificial intelligence; oral and maxillofacial radiology

Special Issue Information

Dear Colleagues,

The field of oral and maxillofacial medicine demands precision and accuracy in diagnostics. Like in any field of medicine, the diagnostics encompass a comprehensive range of techniques, including clinical examination, radiological imaging, blood work and biopsies when needed. These methods provide crucial insights into the diseases affecting the mouth, jaws and facial structures. An accurate diagnosis lays the foundation for effective management strategies, ranging from conservative treatments to surgical interventions. The evolving techniques in diagnostics continue to enhance our understanding of oral and maxillofacial conditions, enabling earlier detection and improved patient outcomes.

Prof. Dr. Mel Mupparapu
Guest Editor

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Keywords

  • oral and maxillofacial medicine
  • diagnostics
  • clinical examination
  • radiological imaging
  • blood work
  • biopsies
  • earlier detection

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Published Papers (1 paper)

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Research

11 pages, 243 KiB  
Article
Facial Nerve Injury after Extracapsular Dissection for Benign Parotid Tumors with and without Intraoperative Monitoring: A Retrospective Study of a Single Center
by Maria Giulia Cristofaro, Walter Colangeli, Francesco Ferragina, Giuseppe Tarallo, Angelo Ruggero Sottile, Maria Grazia Ioppolo, Antonella Arrotta and Ida Barca
Diagnostics 2024, 14(18), 2017; https://doi.org/10.3390/diagnostics14182017 - 12 Sep 2024
Viewed by 384
Abstract
Background: Facial nerve injury (FNI) is the most common complication of parotid surgery and manifests as FN paralysis. The use of intraoperative facial nerve monitoring (IFNM) is becoming an established intraoperative aid for surgeons, assisting in the identification of the location and dissection [...] Read more.
Background: Facial nerve injury (FNI) is the most common complication of parotid surgery and manifests as FN paralysis. The use of intraoperative facial nerve monitoring (IFNM) is becoming an established intraoperative aid for surgeons, assisting in the identification of the location and dissection of the facial nerve trunk or branches. The postoperative outcomes of parotid surgery with and without monitoring have been addressed in only a limited number of studies. Objective: The objective of this study is to evaluate the incidence of postoperative paralysis in patients undergoing extracapsular dissection (ED) for benign parotid tumors concerning the use or non-use of IFNM. Materials and Methods: The retrospective study was conducted at the Maxillo-Facial Department of the Magna Graecia University of Catanzaro. The patients were divided into two groups: Group 1 consisted of patients who underwent surgery without IFNM (1 January 2015 to 31 December 2018); Group 2, on the other hand, consisted of patients who underwent surgery with IFNM (1 January 2019 to 31 December 2022). Group 2 employed the Nerve Integrity Monitor (Medtronic’s NIM®). To classify the FN function, we employed the modified House–Brackmann classification system. To evaluate the dependence between the “use of IFNM” and “postoperative paralysis”, a descriptive analysis was conducted, including applying the Chi-squared test and calculating the Pearson correlation. Subsequently, a binary logistic regression model was applied to further evaluate the correlation between the latter. The level of statistical significance was set at p < 0.05. Results: A total of 276 patients were included in the study: 120 subjects were assigned to Group 1 (43.5%, comprising 60 men and 60 women) and 156 subjects were assigned to Group 2 (56.5%, comprising 93 men and 63 women). In 91.7% of the cases (n. 253, precisely 105 in Group 1 and 148 in Group 2), no FNI occurred. In 8.33% of the cases (n. 23, specifically 15 in Group 1 and 8 in Group 2), postoperative paralysis was observed. Of these subjects, only two in Group 1 had permanent paralysis (8.69%); therefore, 91.31% had transient paralysis. As a result, 91.31% of the subjects exhibited transient paralysis. In the case of FNI, 78% of the cases involved the marginal mandibular branch (n. 18), 13% involved the temporo-zygomatic branch (n. 3), and 7% involved more than one branch (n = 2). The results of the multivariable binary logistic regression analysis demonstrated that the use of IFNM was a statistically significant influencing factor, with an estimated reduction in postoperative paralysis of approximately 62% (OR 0.378; 95% CI: 0.155–0.92). In Group 2, the occurrence of transient complications was significantly reduced (OR 0.387; 95% CI: 0.149–1.002 with p < 0.05). Discussion and Conclusions: The use of IFNM in the ED for benign parotid tumors significantly reduces the rate of FNI and, consequently, postoperative FN paralysis. On the other hand, the use of monitoring systems must not replace the experience and anatomical knowledge of the surgeon. Full article
(This article belongs to the Special Issue Diagnostics and Management in Oral and Maxillofacial Medicine)
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