Intravenous opiates and benzodiazepine sedation.
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Biomedical subjects
Publications and source records attributed to R P Ward-Booth.
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The reproducibility of radiographs taken in the natural head position was compared with and found similar to those taken in a standard cephalostat. Between three and six films were taken for each patient. The natural head position was found to be not as reproducible as has been suggested by others. Reasons for this finding have been examined, and some proposals made concerning a rational approach to cephalometric radiographs.
Anatomical variants of the common carotid artery are rarely reported. Two different congenital anomalies of the common carotid artery, encountered during radical neck dissection, are documented and their surgical significance discussed.
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Ultrasound has until recently found little application in oral and maxillofacial surgery despite wide use in other specialties. Ultrasound imaging uses the reflection of pulses of high frequency sound to display soft tissues and to differentiate between tissue types, particularly solid and cystic. A case of branchial (lymphoepithelial) cyst is presented to illustrate the use of ultrasound, and the aetiology and histogenesis of this controversial lesion is discussed. Ultrasound as a safe, painless, non-invasive technique is recommended as an additional investigation for neck swellings, particularly in view of the high incidence of malignancy claimed to occur in this region.
Bicoronal flaps have been used in neurosurgery to gain access to the anterior cranium for over a century. A previous paper by Henderson and Jackson (1973) described the good access afforded by the flap for Le Fort II osteotomies. This paper reviews the morbidity of the procedure in 24 patients in whom bicoronal flaps were raised for access to the mid and upper facial skeleton.
The stability of Le Fort I advancement osteotomies using 4 "Champy" stainless steel mini plates without bone grafts was studied. Eleven consecutive patients, 3 of whom had cleft lips and palates were evaluated retrospectively. Seven patients had bimaxillary procedures. Cephalometric radiographs were taken preoperatively, immediately after operation and at least six months later. The mean maxillary advancement in the horizontal direction was 3.7 mm. The radiographs were traced and the results were subjected to a statistical analysis. No significant relapse was found.
One hundred and forty-seven patients with unstable fractures of the zygoma are discussed. Complications encountered during the treatment of such patients with antral packs and external pins are compared. These results are evaluated.
Solitary bone cysts, also known as haemorrhagic, traumatic or simple bone cysts, of the jaws are a well-recognised entity, being found primarily in the mandible, occasionally in the maxilla and rarely in the zygoma. In this report, routine investigative measures confused the diagnosis of the lesion.
A variety of procedures are available for the correction of the secondary cleft deformity. In this study of the use of the Le Fort II osteotomy, hard and soft tissue changes are documented using 40 discrete hard and soft tissue points on each lateral cephalogram. These were compared in the pre-operative, immediate post-operative and follow-up cephalograms. Some of the possible causes for relapse were identified.
Ultrasound scanning is a simple investigation that is recommended for preoperative diagnosis of cervical swellings. Its clinical utility has been demonstrated by use in four cases: a parotid cyst, an abscess, a lymph node metastasis, and a branchial cyst.
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Thirty three healthy patients (ASA 1) who required the removal of impacted third molars were included in a double-blind cross-over trial to compare the amnestic and anxiolytic efficacy of diazepam and midazolam. The anxiolytic properties of the two drugs were assessed objectively by the measurement of changes in blood pressure, pulse rate, plasma cortisol levels, and subjectively by a patient assessment using a visual analogue scale for anxiety. The amnestic properties were evaluated by patient's ability to recall two visual stimuli they were shown. The first drug given was titrated to clinical sedation and the second drug was given in an "equipotent" ratio of 1.0 midazolam to 2.86 diazepam. There was a statistically significant fall in anxiety and good levels of amnesia achieved using both drugs. No statistical differences were detected between the two drugs.