Gary Walton

A “star” retractor in head and neck surgery

he Lone Star RetractorTM (Lone Star Medical Products, tafford, UK) has its origins in anorectal surgery as a specially esigned, single use retractor ring using elastic stays that rovide optimal exposure while taking up the minimum of oom.1 The specially designed stays come in a number of ifferent ergonomic designs including a “rake”, “blunt hook”, nd “sharp hook” (Fig. 1). They were designed for the friable nal mucosa and are gentle enough to use in the head and eck. We have found in our surgical practice, and particuarly in neck dissections, that these hooks provide ideal

Psychiatric outcomes in operatively compared with non-operatively managed patients with facial trauma: Is there a difference?

Abstract Patients who sustain facial injury and who require an operation may be at greater risk for developing psychological distress and maladaptive coping. The purpose of this study was to examine psychological responses in adult victims of facial trauma after operation. A consecutive group of adult patients attending specialist outpatient clinics after facial trauma were evaluated for psychological distress. The subjects were divided into two groups based on whether their facial injuries were managed operatively or conservatively. The primary predictor variable in this study was surgical intervention. The main outcome variable was Hospital Anxiety and Depression Scale (HADS) scores. Chi-squared, Mann Whitney U-test, and multiple regression analysis were used to analyse data. The sample consisted of 102 subjects; 71 patients had been managed operatively and 31 patients treated non-operatively. Psychometric scores suggestive of anxiety were present in 21% (n = 15) of the operatively managed group compared with 13% (n = 4) of the non-operatively managed group of patients. The prevalence of depression was comparable between both groups (14% compared with 13%). The median anxiety subscale scores for the operatively managed group when compared with the conservatively managed group of patients were significantly higher (6.6 compared with 4.4, p = 0.02); however, differences in the depression subscale scores did not reach statistical significance (6.2 compared with 4.6, p = 0.06). This study shows an association between anxiety disorders and operative interventions in patients with facial trauma (HADS-A, β = 2.2, p = 0.04). Similar rates of depression were found in the surgically and conservatively managed patients.

Going for Gold: British Medical Olympians 1908–2008

The modern Olympic Games began in 1896. Baron Pierre de Coubertin, founder of the International Olympic Committee (IOC), is commonly considered to be the father of these Games. The modern Olympics are often viewed as a revival of the Games of antiquity, which were held on a four-yearly cycle.

Recurrent sclerosing dysplasia of bone: report of a case.

a c d D enetic disorders of bone homeostasis are uncomon; however, knowledge of their clinical features nd management are important for the maxillofacial urgeon. A variety of genetic abnormalities may give ise to excessive bone. The pathogenic mechanisms nderlying these conditions include: disorders of one resorption (eg, osteopetrosis), excessive bone eposition (eg, van Buchem disease or sclerostosis), nd a disturbed balance between bone resorption and ormation (eg, juvenile Paget’s disease). Progress in enetic mapping and the human genome project have nraveled the abnormalities behind many of these onditions and allowed the function of the affected enes to be described. The LRP5 gene and the SOST gene are implicated in he etiology of several conditions that have excessive one formation in the craniomaxillofacial region. an Buchem disease and autosomal dominant osteoclerosis (ADO) are such conditions, and craniomaxllofacial manifestations are responsible for the major-