Maxillofacial Tumors Research Articles

Neutrophil Extracellular Traps in Oral Diseases.

To summarize the current knowledge of the neutrophil extracellular traps (NETs) and its critical role in various oral diseases. We reviewed the recent research on NETs through PubMed and Web of Science. An analysis of recent research results was summarized from three aspects: NETs induction and formation, functions of NETs, and NETs in oral diseases. The relationship between neutrophils and NETs is critical to the body's defense against microbial invasion. NETs can effectively combat pathogens with an anti-inflammatory effect and meanwhile it can contribute to inflammation. Moreover, it can synergize with other immune cells to respond to stimuli, such as pathogens, host-derived mediators, and drugs. It was revealed that NETs play different roles to influence various oral diseases like periodontitis, endodontic infection, oral mucosal diseases, maxillofacial tumors, and many other oral diseases. The balance between the protective and potentially harmful effects of NETs is a key factor in determining the outcome of infections and inflammatory responses. The role of NETs in oral diseases needs to be further studied to enable better understanding of its role in the different oral diseases.

Assessment of different shielding materials for radiation therapy of maxillofacial tumors – An in vitro study

Aim: Since the advent of radiotherapy, the success rate of head and neck cancer treatment has increased significantly. However, when the tissue tolerance level is exceeded, unnecessary and uncontrolled exposure to radiation is considered detrimental. Such problems remain difficult to prevent and manage. The aim of the study to evaluate and compare the degree of attenuation of therapeutic radiation using four different radiation shielding materials of varying thickness. Study Setting and Design: In vitro experimental study. Materials and Methods: The samples were divided into four groups based on the different radiation shielding materials of thickness 3mm and 5mm. The materials are Lead (Pb), Silver-tin alloy (Ag-Sn) with Polyvinylsiloxane (PVS), Polymethylmethacrylate (PMMA) with Barium sulphate (BaSO4), and a combination of Ag-Sn with PVS and PMMA with BaSO4 which was exposed to radiation. The radiation dose measurements were recorded and the radiation attenuation properties of the shielding materials were evaluated. Among all of the shielding materials the most efficient material under consideration is determined. Statistical Analysis Used: One-way ANOVA followed by post hoc test was used to compare the means of all four groups. Results: A statistically significant difference between groups was found by a one-way ANOVA with a P = 0.001. In the post hoc test, statistically significant findings were obtained with a P = 0.05 when comparing the variation values of 3mm and 5mm thickness between each group and other groups. Conclusion: The shielding materials results in significant reductions in radiation dosage. It was concluded that the combinations of Ag-Sn alloy with PVS, and PMMA with BaSO4 of thickness 5 mm had a good shielding effect.

Comprehensive analysis of risk factors for flap necrosis in free flap reconstruction of postoperative tissue defects in oral and maxillofacial tumors

Free flap reconstruction for postoperative tissue defects in oral and maxillofacial tumors is a critical component of reconstructive surgery. Identifying risk factors for flap necrosis is essential for improving surgical outcomes and patient quality of life. A retrospective study was conducted on patients who underwent free flap reconstruction between January 2020 and December 2023. Patients were included if they had comprehensive medical records and at least a six-month follow-up. We excluded those with a history of flap necrosis, uncontrolled systemic diseases, non-adherence to postoperative care, or concurrent malignancy treatments. Data on demographics, comorbidities, flap characteristics, and operative details were collected and analyzed using univariate analysis and logistic regression tests. Univariate analysis did not find a significant correlation between flap necrosis and factors such as hyperlipidemia, lymph node metastasis, or flap type. However, diabetes mellitus, oral infections, and albumin levels below 35 g/L were significantly associated with flap necrosis. Multivariate logistic regression showed diabetes mellitus increased the odds of flap necrosis by approximately ninefold, and oral infection increased it by over tenfold. Diabetes mellitus, oral infection, and low albumin levels are significant risk factors for flap necrosis in free flap reconstruction after oral and maxillofacial surgery. Prompt identification and management of these factors are crucial to mitigate the risk of flap necrosis.

Current status and influencing factors of fear of surgery in patients with oral and maxillofacial tumors.

This study aimed to investigate the incidence and severity of surgical fear in patients with oral and maxillofacial tumors. The survey participants were composed of patients with oral and maxillofacial tumors, who were scheduled to undergo surgery. A general information questionnaire, the Surgical Fear Questionnaire (SFQ), the Patient Health Questionnaire (PHQ)-9, and the Generalized Anxiety Disorder (GAD)-7 score were used for the investigation. A total of 203 patients were investigated. Among them, 85.22% had fear of surgery. The median score of SFQ was 20, and the quartile was (6, 36). The patients were categorized into none, mild, moderate, and severe groups according fear level. Gender, diabetes, obvious discomfort before surgery, PHQ-9, and GAD-7 scores were the variables with statistical difference in each fear level. Multifactor analysis showed that women were more likely to have moderate and severe fear than men (OR=2.19, P=0.03; OR=2.72, P=0.01), patients with obvious preoperative discomfort symptoms were more inclined to have no fear (OR=4.73, P=0.02), and patients with diabetes were more likely to have severe fear (OR=3.33, P=0.02). The incidence rates of depression and anxiety were 31.03% and 24.63%, respectively. The incidence of anxiety and depression in patients with severe fear was 40.00%. Surgical fear was moderately positively correlated with anxiety (r=0.491, P<0.001) and depression (r=0.514, P<0.001). The fear of surgery in patients with oral and maxillofacial tumors is common and distributed in all levels. Medical staff can screen and assess patients with moderate and severe fear of surgery in accordance with the influencing factors and implement targeted interventions to reduce fear of surgery, anxiety, and depression on the basis of the source of fear.

Impact of various nutritional interventions on the physical and mental state of patients undergoing surgery for oral and maxillofacial tumor: guiding patients' informed choices.

To compare the effects of oral nutritional supplements (ONS), parenteral nutrition (PN), and enteral nutrition (EN) on the recovery of patients who underwent oral and maxillofacial surgery. The shared decision-making process assigned 37, 56, and 35 patients to the ONS, PN, and EN groups, respectively. Details such as demographic data, duration of hospitalization, cost of nutritional therapy, nutritional assessments, patients' satisfaction, and compliance, Hamilton Anxiety Rating Scale (HAM-A) score, and relevant biochemical indices were systematically recorded and compared between the groups. Patients with healthier biochemical indices and physical states at baseline, including a higher body mass index, preferred ONS. Patients using dentures and those with medical insurance often chose EN, while patients with recurrent disease preferred PN. Patients receiving EN had a similar duration of hospitalization to patients receiving ONS and also had the lowest nutritional costs. Patients receiving ONS had higher lymphocyte counts and levels of hemoglobin, albumin, and C-reactive protein. Patients in the PN group had elevated levels of serum potassium, chlorine, and sodium, while those receiving EN reported higher HAM-A scores, indicating greater anxiety than their counterparts. Predischarge surveys showed higher satisfaction and compliance in the PN and ONS groups than in the EN group. The PN group reported more adverse symptoms. At 7days post-discharge, patients with EN reported a greater feeling of well-being. ONS is the optimal choice for patients in good preoperative conditions, while PN is preferred during disease recurrence or when financially feasible. EN is suitable for patients using dentures or those with limited finances despite its potential psychological discomfort. Future studies with increased sample sizes and longer follow-up duration are necessary to corroborate our findings. The Trial Registration Number is ChiCTR2100049547. The date of registration isAugust 2, 2021.

Comparison of the Efficacy of Indwelling Gastric Tubes in Preoperative and Postoperative Patients With Oral and Maxillofacial Malignancies

PurposeTo explore the optimal plan for the timing of indwelling gastric tube placement in oral and maxillofacial malignant tumor patients. DesignA prospective randomized controlled trial. Methods80 patients with oral and maxillofacial tumor were selected, and 40 patients were Pre-operative group. The remaining 40 patients were the control group, called Postoperative group. The body weight and hospital stay of the two groups were observed before and after surgery. Blood samples were taken before surgery and 1, 3 and 7 days after surgery to detect hemoglobin and plasma albumin. FindingsThe number of postoperative hospitalization days in the pre-operative group was significantly lower than that in the post-operative group; postoperative hemoglobin and plasma albumins were lower in both groups compared with the preoperative level. ConclusionsPreoperative nasogastric tube ensured early postoperative administration of gastrointestinal nutrition, promoted postoperative plasma albumin recovery, and shortened the days of hospitalization.

Effects of acute normovolemic hemodilution and allogeneic blood transfusion on postoperative complications of oral and maxillofacial flap reconstruction: a retrospective study

ObjectivePatients undergoing oral and maxillofacial flap reconstruction often need blood transfusions due to massive blood loss. With the increasing limitations of allogeneic blood transfusion (ABT), doctors are considering acute normovolemic hemodilution (ANH) because of its advantages. By comparing the differences in the (Δ) blood indices and postoperative complications of patients receiving ABT or ANH during the reconstruction and repair of oral and maxillofacial tumor flaps, this study’s purpose was to provide a reference for the clinical application of ANH.MethodsThe clinical data of 276 patients who underwent oral and maxillofacial flap reconstruction from September 25, 2017, to October 11, 2021, in the Department of Oral and Maxillofacial Surgery, Sun Yat-sen Memorial Hospital, were retrospectively analyzed. According to the intraoperative blood transfusion mode, the patients were divided into two groups: ABT and ANH. The differences in the (Δ) blood indices and the incidence of postoperative complications between the groups were analyzed.ResultsAmong the 276 patients who had ANH (124/276) and ABT (152/276), there were no differences in (Δ) Hb, (Δ) PT, or (Δ) FIB (P > 0.05), while (Δ) WBC, (Δ) PLT, (Δ) APTT and (Δ) D-dimer were significantly different (P < 0.05). The blood transfusion method was not an independent factor for flap crisis (P > 0.05). The wound infection probability in patients with high post-PTs was 1.953 times greater than that in patients with low post-PTs (OR = 1.953, 95% CI: 1.232 ∼ 3.095, P = 0.004). A normal or overweight BMI was a protective factor for pulmonary infection, and the incidence of pulmonary infection in these patients was only 0.089 times that of patients with a low BMI (OR = 0.089, 95% CI: 0.017 ∼ 0.462). Moreover, a high ASA grade promoted the occurrence of pulmonary infection (OR = 6.373, 95% CI: 1.681 ∼ 24.163). The blood transfusion mode (B = 0.310, β = 0.360, P < 0.001; ANH: ln hospital stay = 2.20 ± 0.37; ABT: ln hospital stay = 2.54 ± 0.42) improved the length of hospital stay.ConclusionPreoperative and postoperative blood transfusion (Δ) Hb, (Δ) PT, and (Δ) FIB did not differ; (Δ) WBC, (Δ) PLT, (Δ) APTT, and (Δ) D-dimer did differ. There was no difference in the effects of the two blood transfusion methods on flap crisis, incision infection or lung infection after flap reconstruction, but ANH resulted in a 3.65 day shorter average hospital stay than did ABT.

Exploiting BRAF mutations in the therapeutic approach towards oral and maxillofacial tumors

Oral and maxillofacial tumors pose a significant clinical challenge due to their tendency to recur, despite advancements in surgical removal techniques. The jaw's intricate structure further complicates treatments and affects patient quality of life. Consequently, emphasis has shifted towards pharmacological interventions, to potentially reduce invasive surgical procedures. One promising approach targets BRAF mutations, specifically the common V600E mutation. BRAF, a critical protein kinase, regulates cell growth and differentiation via the RAS-RAF-MEK-ERK-MAP kinase pathway. A specific nucleotide change at position 1799, swapping Thymine (T) for Adenine (A), results in the V600E mutation, causing unchecked cell growth. This mutation is common in certain oral and maxillofacial tumors like ameloblastoma. A recent neoadjuvant therapy targeting BRAF, involving the use of dabrafenib and trametinib, has showcased a promising, safe, and effective strategy for organ preservation in the treatment of mandibular ameloblastoma. This convergence of molecular insights and targeted therapies holds the key to managing BRAF-mutated oral and maxillofacial tumors effectively, promising improved patient outcomes.

The H2O2 Self-Sufficient 3D Printed β-TCP Scaffolds with Synergistic Anti-Tumor Effect and Reinforced Osseointegration.

Tumor recurrence and massive bone defects are two critical challenges for postoperative treatment of oral and maxillofacial tumor, posing serious threats to the health of patients. Herein, in order to eliminate residual tumor cells and promote osteogenesis simultaneously, the hydrogen peroxide (H2O2) self-sufficient TCP-PDA-CaO2-CeO2 (TPCC) scaffolds are designed by preparing CaO2 or/and CeO2 nanoparticles (NPs)/chitosan solution and modifying the NPs into polydopamine (PDA)-modified 3D printed TCP scaffolds by rotary coating method. CaO2 NPs loaded on the scaffolds can release Ca2+ and sufficient H2O2 in the acidic tumor microenvironment (TME). The generated H2O2 can further produce hydroxyl radicals (·OH) under catalysis effect by peroxidase (POD) activity of CeO2 NPs, in which the photothermal effect of the PDA coating enhances its POD catalytic effect. Overall, NPs loaded on the scaffold chemically achieve a cascade reaction of H2O2 self-sufficiency and ·OH production, while functionally achieving synergistic effects on anti-tumor and bone promotion. In vitro and in vivo studies show that the scaffolds exhibit effective osteo-inductivity, induced osteoblast differentiation and promote osseointegration. Therefore, the multifunctional composite scaffolds not only validate the concept of chemo-dynamic therapy (CDT) cascade therapy, but also provide a promising clinical strategy for postoperative treatment of oral and maxillofacial tumor.

Use of Fine Needle Aspiration Biopsy in Diagnosis Oral and Maxillo-Facial Tumors

The Technique of fine needle aspiration biopsy (F.N.A.B.) was evaluated in the field of maxillofacial surgery. For this purpose comparison of cyt ological results with the conventional histo pathological results were take place. Seventy-two specimens were obtained by F.N.A.B. from 60 patients with age range from 3-84 years of both sexes, 11.7% of the patients had previous history of diagnosed malignant tumors. Cytological results show 40 cases(55.5%) were benign tumor, 27 cases (37.5 %) were malignant, 3 cases (4.2 %) unsatisfactory for diagnosis and 2 cases (2.8 %) were suspicious to be malignant. The statistical analysis showed that F.N.A.B. had sensitivity (92.6%), specificity (100%), positive predictive value (92.3%), and accuracy rate (96%).

Clinical Enigma of Maxillofacial Tumors: Hyperparathyroidism-related Brown Tumors

Clinical Enigma of Maxillofacial Tumors: Hyperparathyroidism-related Brown Tumors

Fluoride Application in Patients Undergoing Radiotherapy: An Overlooked Protocol for Preserving Radiant Smiles

Abstract This case report focuses on the rising incidence of oral and maxillofacial tumors, requiring multimodal therapy involving surgery and radiotherapy. Radiotherapy, integral to cancer treatment, poses oral health challenges, notably radiation-related caries. Severe complications such as mucositis, xerostomia, and osteoradionecrosis highlight the critical role of optimal oral hygiene practices in managing these conditions. The presented case involves a 38-year-old male with a history of verrucous carcinoma, undergoing composite resection, modified neck dissection, and pectoralis major myocutaneous flap reconstruction. Adjuvant radiotherapy requires a comprehensive approach to minimize complications. Here, the focus is on fluoride treatment, specifically Fluoritop SR Dental Varnish, to prevent radiation-related caries. A multidisciplinary approach, including fluoride application, vigilant monitoring, patient education, and collaboration, is crucial for minimizing complications in oral malignancy radiotherapy. Emphasizing fluoride’s significance in preventing radiation-related caries, this care plan contributes to awareness and improves oral health outcomes in this patient population.

Epidemiological profile of patients attending the maxillofacial prosthodontics unit at Ibn Sina University Hospital in Rabat, Morocco: a cross-sectional study.

the present study aimed to establish an epidemiological profile of patients consulting the unit of maxillofacial prosthodontics in Rabat. Results deriving from this study will help enhance the quality of patient care in our center and can also serve as a comparison tool with other maxillofacial teams around the world. during 11 months all patients consulting the unit of maxillofacial prosthodontics in our center were included. We opted for a questionnaire with 3 variables: socio-demographics, clinical examination data, and the type of prosthetic treatment adopted. The study was conducted in the Department of Removable Prosthodontics in the Center of Consultation and Dental Treatment of Rabat Morocco (CCDTR) from September 2020 to July 2021. the study population consisted of 91 patients, with a majority of male patients at 53% (n=48). During our study period, the proportion of patients under one-year-old was predominant, accounting for 38.4% (n=35) of the total sample. Among the patients in the sample, 72.5% (n=66) had no profession, while 66% (n=60) had a low income. Regarding medical insurance, the majority of our patients, 85.5% (n=78), were covered by Public Health Insurance for the Low-income Population (PHILP). Among the total sample, 57.1% (n=52) consulted for a combination of pain function and aesthetics. Additionally, 61.5% (n=56) were referred by teaching hospitals. For the type of oro-facial defect, 52.7% (n=48) of the sample consisted of newborns with congenital facial cleft. Out of the 91 patients, 36 had maxillofacial tumors, with 47.6% (n=17) of them presenting squamous cell carcinoma. Furthermore, 63.7% (n=58) of the prosthetic treatments adopted involved presurgical orthopedic treatments for newborns with facial cleft. the study on the epidemiological profile of patients attending the maxillofacial prosthodontics unit at Ibn Sina University Hospital in Rabat, Morocco provides important insights. The findings highlight the predominance of male patients and the prevalence of oro-facial defects in newborns. Socioeconomic factors, such as low income and lack of profession, are significant considerations. The majority of patients are covered by the PHILP, indicating the importance of medical insurance. These findings contribute to improving healthcare planning and specialized care for this patient population.

Application Prospect of Monopolar Low-temperature Plasma Knife in Oral and Maxillofacial Surgery

Oral and maxillofacial surgery is primarily responsible for the treatment of oral and maxillofacial tumors, jaw fractures, maxillary sinusitis, and other temporomandibular joint diseases using surgical techniques. With improvements in living conditions and dietary changes, the demand for diagnosis and treatment in oral and maxillofacial surgery has been steadily increasing. Simultaneously, both patients and healthcare providers have higher expectations for intraoperative effectiveness and postoperative recovery. With the advancement of technology, surgical knives in oral and maxillofacial surgery have gradually transitioned from traditional physical blades to high-frequency electric scalpels. However, high-frequency electric scalpels have drawbacks, including substantial tissue damage, the generation of intraoperative smoke, electrode adhesion, imprecise cutting, and reliance on traditional surgical blades. This paper proposes the idea of using a monopolar low-temperature plasma knife in oral and maxillofacial surgery, with a focus on research utilizing the monopolar low-temperature plasma surgical system produced by Jingyi Medical (Host Model: PSG-60A; Electrode Model: PS-01) as an example. This equipment disrupts tissue molecular bonds through the low-temperature plasma layer formed around the knife tip, allowing for tissue cutting and separation. This approach significantly reduces tissue damage compared to traditional surgical blades and high-frequency electric scalpels, while also simplifying surgical procedures, improving cutting precision, and enhancing postoperative recovery. Through this research, it can be observed that the monopolar low-temperature plasma knife has significant potential for widespread application in oral and maxillofacial surgery.

Commissurotomy Using Carbon Dioxide Laser in 67 Dogs.

Commissurotomy is a surgical technique whereby the lip commissure is incised. Indications for commissurotomy include cheiloplasty, partial commissurectomy, or access to the caudal portion of the maxilla or mandible for oral surgery. Carbon dioxide (CO2) laser was used for commissurotomy in dogs for partial commissurectomy (n = 7) or access for oral surgery (n = 60). All dogs had oral or maxillofacial neoplasms that required resective surgery. The CO2 laser was used to perform commissurotomy or commissurectomy, as indicated. Commissurotomy healing was evaluated at 2 weeks with longer-term follow-up of a minimum of 6 weeks (104.6 ± 99.2 weeks) postoperatively. Postoperative complications related to commissurotomy (n = 6) included mucosal dehiscence (n = 3) less than 1.5 cm, lip margin dehiscence (n = 2) less than 1.0 cm, and complete commissurotomy wound dehiscence (n = 1). Two wound dehiscence cases, including the complete wound dehiscence, had uncomplicated healing following revision surgery. Minor marginal and mucosal dehiscence cases healed by the second intention. Periwound edema ranged from mild to severe and resolved by the 2-week postoperative examination. Statistical analysis showed that complications associated with commissurotomy/commissurectomy were independent of the type of surgical procedure, tumor type, and surgical margin evaluation when using the CO2 laser. Commissurotomy using CO2 laser provided rapid and unimpeded exposure with minimal hemorrhage of the caudal maxilla and mandible for resective oral and maxillofacial surgery.

Types, prevalence, management, and outcome of maxillofacial tumors

Maxillofacial tumors constitute a diverse group of pathologic disorders with various histological types and clinical behaviours. The causes of head and neck tumors involve a combination of environmental factors and genetic predisposition. Although less frequent in children and adolescents, they still represent approximately 3% to 10% of head and neck tumor cases worldwide. Accurate diagnosis and management are crucial for favourable outcomes. The tumors can be categorized into epithelial, soft tissue, odontogenic, hematologic, and bone tumors, each with distinct characteristics and treatment approaches. The prevalence of these tumors varies based on location, age, and gender. A multidisciplinary approach, including surgery, medical treatments, radiation therapy, and palliative care, is often required for managing these tumors. Prognosis and outcomes depend on tumor type, stage, and individual factors, with early diagnosis and appropriate management contributing to better results. Regular follow-up is essential to detect potential recurrence or metastasis early and provide timely intervention. Individualized evaluation and treatment by qualified medical professionals are vital due to the uniqueness of each case. This review discusses the classification, clinical features, histopathological characteristics, radiographic presentations, treatment options, and prognosis of maxillofacial tumors.

Safety and Aesthetics of Autologous Dermis-Fat Graft after Parotidectomy: A Multidisciplinary Retrospective Study.

(1) Background: In surgical procedures for maxillofacial tumours, it is challenging to preserve functional and cosmetic properties in the affected patients. The use of fat grafting is considered as a valuable alternative to overcome postoperative aesthetic asymmetry problems. (2) Methods: In this study, we enrolled thirty patients with parotid gland tumours in which a partial or complete parotidectomy was performed with positioning in the parotid bed of autologous dermis-fat grafts. We evaluated the satisfaction rate of the patients and the objective efficacy in solving the deformity by comparing MRI data before and after surgery. (3) Results: Twenty-six patients showed a satisfying cosmetic result with proper facial symmetry between the affected side and the healthy one. Two patients presented mild postsurgical complications such as haematomas, and two patients reported temporary weakness of the facial nerve related to the parotidectomy. (4) Conclusions: Based on the imaging data obtained via MRI before and after surgery, we can assess that the employment of fat grafts in parotidectomy surgical procedures gives good cosmetic results and does not affect the post operative management and follow up of oncologic patients.

Facial Reanimation After Peripheral Facial Nerve Paralysis: A Single-institution Surgical Experience.

Facial nerve trauma occasionally develops during oral and maxillofacial surgery. This study was aimed at enhancing the available knowledge on facial nerve reanimation correlated to surgery and proposing our surgical algorithm. We retrospectively analyzed medical records of patients who underwent facial reanimation surgery at our hospital. The inclusion criterion was surgery for facial reanimation from January 2004 to June 2021. We included 383 eligible patients who underwent facial reanimation surgery. Trauma or maxillofacial neoplasms were noted in 208 of 383 and 164 of 383 cases, respectively. In 238 of 383 cases, nerve branches were likely more vulnerable. Facial nerve anastomosis was performed in 256 patients. Sixty-eight patients received nerve grafts. In 22 patients, distal facial nerve transfer to the masseteric nerve, sublingual nerve, or contralateral facial nerve was performed. Twenty-five patients received static surgery; in most cases, the temporalis fascia flap (20/25) was used. The nerve function outcomes were HB grade I (n=17), Grade Ⅱ (n=108), Grade Ⅲ (n=118), Grade Ⅳ (n=94), and Grade V (n=46). The mean follow-up time was 4.88 ± 3.93 years. Facial paralysis caused by trauma ( P =0.000), branch injury ( P =0.000), and the primary reconstruction of facial nerve ( P =0.000) were predictive of favorable treatment outcomes. Although facial nerve injury caused by trauma was more likely, cases of interference in facial expression could be limited, and so did the injury to branches. Nerve anastomosis was prioritized if a tension-free suture was possible. Maintaining the integrity of the nerve and shortening the duration of mimetic muscular denervation were crucial.

Application of Midline Catheter Placed Under Ultrasound Guidance in Intravenous Therapy for Oral and Maxillofacial Tumor

To examine the application effect of ultrasound-guided placement of midline catheter and to select the appropriate placement method of intravenous catheter for patients with oral and maxillofacial tumors. We retrospectively analyzed the general data and venous catheter-related information of 143 oral and maxillofacial tumor patients who received treatment between June 2019 and December 2021. There were two patient groups, a control group of patients with inserted peripheral venous catheters (PVC) and an observation group of patients with midline catheters placed under ultrasound guidance. We made a comparative analysis of the incidence of catheter-related complications, including bleeding at the insertion site, phlebitis, catheter blockage, extravasation, etc., in the two groups. When the baseline data from the two groups were not balanced, we used propensity score matching (PSM) to match the general data before comparing the complication incidence between the two groups. There were 71 patients who underwent 215 times of PVC placement in the control group and 72 patients who underwent 72 times of midline catheter placement in the observation group. There was no significant difference between the patients in the two groups in terms of age, sex, diagnosis, or the use of anticoagulant medication ( P>0.05) . The observation group had longer average length-of-stay than the control group did ( P<0.01). The cost of catheter placement in the observation group was 1080 yuan per set, with the average daily cost being about (56.27±20.23) yuan. Patients in the control group had PVC placement for an average of (3.03±0.93) times. The cost for PVC placement was 96 yuan per time and the average daily cost was about (19.94±7.50) yuan. There was significant difference in the average daily cost between the observation group and the control group ( P<0.01). PSM was performed for the two groups. Before PSM, the incidence of catheter-related complications in the observation group (8.3%, 6/72) was lower than that of the control group (30.2%, 65/215) and the difference was statistically significant ( P<0.01). After PSM, 72 times of catheter placement from each group were included in comparative analysis. The incidence of catheter-related complications in the observation group (8.3%, 6/72) was lower than that of the control group (54.2%, 39/72) and the difference was statistically significant ( P<0.01). Patients have low incidence of catheter-related complications when they have midline catheter placed under ultrasound guidance, which helps reduce the pain of repeated venous insertion that patients incur and the workload of clinical nurses. The use of midline catheters is appropriate for and should be popularized among patients with oral and maxillofacial malignant tumors, especially patients who have poor peripheral venous conditions and those who are undergoing repair and reconstruction surgeries.

Factors Associated To Diagnostic Delay Of Oromaxillofacial Cancers

Introduction: It is not uncommon in developing countries for patients to consult specialists for extended maxillofacial tumours, known as "historic". Purpose: To identify the socio-demographic and clinical characteristics associated with the delay in establishing the diagnosis of oromaxillofacial cancers in Brazzaville. Patients and Methods: This was an analytical cross-sectional study with prospective data collection, conducted at the maxillofacial surgery and stomatology department of the Brazzaville Hospital Center, over a period of 24 months from January 2020 to December 2021, out of 37 oromaxillofacial cancers. Results: The study involved 37 patients: 23 men and 14 women with a sex ratio of 1.65. The mean age at the time of diagnosis was 45.7±2 years. 79.40% were diagnosed at advanced stages. The diagnostic delay, whether specialized or cumulative, was essentially related to the socioeconomic level (p= 0.04). Those with a low socioeconomic level were 3 times more likely to be diagnosed late than patients with an acceptable socioeconomic level (OR=3). The level of education did not influence the delay (p=0.30). Conclusion: The responsibility for the delay in diagnosis was found with the patient, the provider of nonspecialized care and the organization of the health system. These delays were influenced by many factors including the low socioeconomic level for all three components, the follow-up by Brazzaville providers for the delay in providing care.