Oral and Maxillofacial Surgery - Conference Papers

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Browsing Oral and Maxillofacial Surgery - Conference Papers by Author "Adeyemi, M.O."

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    Open Access
    Necrotizing fasciitis: A five years review of cases seen at the Lagos University Teaching Hospital
    (FDS, CMUL 2019, 2019-10-09) James, O.; Anorue, E.I.; Adamson, O.O.; Adeyemi, M.O.; Adekunle, A.A.; Ladeinde, A.L.; Ogunlewe, M.O.; Adeyemo, W.L.
    Background: Cranio-facial necrotizing (CFN) fasciitis of the head and neck is a bacterial infection characterized by spreading along fascia planes and subcutaneous tissue. This results in tissue necrosis and may lead to death. It is commonly triggered by odontogenic or pharyngeal infections. Aim: To retrospectively review cases seen in our center to determine the factors that might affect the outcome Patient and methods: This was a five years retrospective study of patients presenting with necrotizing fasciitis, treated at the Department of Oral and Maxillofacial Surgery, LUTH from 2014 to 2018. The medical records were reviewed for: aetiology, trigger factors and sites of infection, clinical manifestations, underlying medical condition, type of surgical treatment, medical and surgical complications, length of hospital stay and outcome of treatment. Results: Twenty –three patients with head and neck necrotizing fasciitis were treated during the study period. There were 11 males and 12 females in this group. The average age was 43 years, with age range between 22 and 84 years. Triger factor in most cases was odontogenic infection (18, 78.3%) while the upper part of the neck was the most prevalent site of presentation. Clinical presentations were a rapidly progressing painful neck swelling, fever, ulceration and trismus. Sixteen patients (69.5%) had no significant comorbidity. The other 7 patients (30.4%) had at least one significant comorbidity: diabetes (5 patients, (21.7%), malnutrition (2, 8.7%), alcoholism (2, 8.7%). All cases received early and aggressive medical treatment followed by serial surgical debridement. Sixteen cases were treated on outpatient bases. The duration of hospital stay for those admitted ranged from 4 to 34 days . Conclusion: Maintaining a high index of suspicion is crucially important for diagnosing CNF. Early diagnosis, timely resuscitation, and aggressive surgical debridement are the key to a successful clinical Necrotizing fasciitis requires early diagnosis and management to improve prognosis. Keywords: Necrotising, fasciitis, odontogenic, infection
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    Open Access
    Neurosensory deficits of inferior alveolar nerve following impacted mandibular third molar extraction: comparison of a two stage versus one stage surgical technique
    (Unilag Press, 2019, 2019-08-21) James, O.; Oyeneyin, A.O.; Adeyemi, M.O.; Adeyemo, W.L.
    Background: Surgical extraction of impacted mandibular third molar (3M) may be associated with post-operative complications. Inferior alveolar nerve (IAN) neurosensory deficits in form of paraesthesia of lower lip and gingivae is a common complications which impacts negatively on the quality of life of the patients. Landi et al has proposed two stage surgical extraction as an alternative surgical procedure to reduce this complication. However, few published studies on staged partial coronectomy are only case reports and case series. Aim and Objectives: To compare neurosensory deficits of inferior alveolar nerve following impacted mandibular third molar extraction using either a two stage or one stage surgical technique. Material and methods: This randomized controlled study was conducted at the Department of Oral and Maxillofacial Surgery, Lagos University Teaching Hospital (LUTH) Idi Araba, Lagos State, Nigeria between April 2016 and September 2018. Subjects with mesioangular or horizontal impacted 3M with intimate relationship with inferior alveolar canal who met the inclusion criteria were recruited for the study and informed consent obtained. Surgical extraction was done under local anaesthesia using buccal guttering technique. Subjects were divided into 2 groups (one-stage technique and two-stage technique). The subjects were evaluated for the presence of IAN neurosensory deficit and recovery, as well as the relationships of IAN neurosensory deficits with gender, age and type of impaction. Results: A total of 68 subjects who satisfied the inclusion criteria participated in the study with 34 subjects in each group. There were 33 (48.5%) males and 35 (51.5%) females. The age range of participants was 18-57years with a mean age of 28.07 ± 8.37. There was not statistically significant difference in the age and gender distribution between the 2 groups. Neurosensory deficit of IAN was observed in 6 subjects, comprising of 5 (14.7%) in group A and 1 (3.33%) in group B. This difference was not statistically significant (p=0.23). Temporary nerve deficit was observed in 5 cases while permanent nerve deficit was seen in one patient. Similarly, relationships between the incidence of IAN neurosensory deficit and age, gender, type; position; and class of impaction, and the relationship between the proximity of the root with IAN were found not to be related to the neurosensory deficit outcomes age, gender and type of impaction in both groups were not statistically significant. Conclusion: This study shows that two-stage surgical extraction technique of impacted 3M was associated with lower incidence of IAN injury when compared with conventional one stage technique. The difference was however, not statistically significant. Two-stage surgical technique may be a suitable alternative to one stage surgical extraction technique of impacted 3Ms at risk of IAN injury especially when cost of treatment is taken into consideration.
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    Open Access
    Retrospective study of the clinicopathologic factors of recurrent Ameloblastoma of the jaws
    (2019-10-09) James, O.; Adamson, O.O.; Fashina, A.A.; Adeyemi, M.O.; Agbogidi, F.O.; Adekunle, A.A.; Adeyemo, W.L.; Ladeinde, A.L.; Ogunlewe, M.O.
    Background: Ameloblastomas are benign, locally aggressive, polymorphic neoplasms of proliferating odontogenic epithelial origin. Clinically, ameloblastoma appears as an aggressive odontogenic tumour, often asymptomatic and slow growing, with no evidence of swelling. Aim: To retrospectively review recurrent ameloblastomas cases during a 10-year period and to determine the recurrence rate of ameloblastoma and clinicopathologic factors involved in recurrence. Methodology: Records of clinicopathologically diagnosed and treated cases of recurrent ameloblastoma for a period of 10 years (2008 –2018) were obtained from the Department of Oral and Maxillofacial surgery, LUTH. Information derived include patients’ demographics, initial diagnosis, previous surgery done, year of recurrence, localisation of tumor and histologic diagnosis of recurrent tumor. Results: During the period of this study (2009-2018), 247 ameloblastoma cases were treated during the of which 32 (12%) were recurrent cases. 19 (59.4%) were females while 13 (40.6%) were males. Male to female ratio is 1:1.5. The ages ranges from 11- 60 with a mean of 37.03±12.57. Recurrence was more observed in the mandible 26 (81.3%) than the maxilla 4 (12.5%) and craniofacial region 2 (6.3%). The number of years for recurrence to occur ranges from 1-30 years with median of 4 years and interquartile range of 7.75. Most recurrence occurs between 3-5 years (40.6%) followed by 1-2 years (25%) of initial surgery. Conclusion: The recurrence rate after conservative treatment was higher than that after radical treatment. The choice of treatment should be adapted to the macroscopic and histological characteristics of each tumour.