Z. Sadiq

Oral and maxillofacial surgery: “publication hot spots” in the United Kingdom

We aimed to evaluate the number of articles in the British Journal of Oral and Maxillofacial Surgery (BJOMS) written by consultants and trainees within deaneries in the UK. We reviewed the authorship of articles published between January 2010 and July 2011, and subdivided them by deanery and first author. In total, 76 full length articles were published (30 written by consultants and 46 by trainees), and half came from the London, Wessex, and Mersey deaneries. Technical notes were mostly written by trainees; 5 of the 22 published came from London. A total of 38 short communications were published; most were from the Wessex (21%), Yorkshire and Humber (29%), and Mersey (13%) deaneries, and in 32% a consultant was first author. A league table of all publications showed that most came from Wessex (n=25), Mersey (n=23), and Yorkshire and Humber (n=23). Most publications by trainees came from Wessex (n=20), followed by Yorkshire (n=18) and London (n=11). The study shows that the amount of published material varies considerably between oral and maxillofacial surgery (OMFS) units in the UK. To realise their ambitions, potential trainees with an interest in research and publications may consequently find the best support in these deaneries.

Use of surgical loupes among oral and maxillofacial surgery specialist trainees/registrars in United Kingdom

Introduction of magnification has transformed contemporary surgery. A magnified surgical field assists the operator to navigate around micro anatomical structures with greater precision, assurance and ease. The use of magnification in oral and maxillofacial surgery (OMFS) varies according to the type of surgery involved and individual preference. OMFS has been identified as a specialty which uses magnification regularly, where the use of loupe magnification is more frequent than microscopes. Despite this, no studies have been undertaken to catalogue the use of surgical loupes among trainees. We therefore carried out a national survey to determine the perceived need and patterns for loupes-assisted surgery amongst OMFS trainees in the United Kingdom (UK). One hundred fifty-three OMFS units were contacted by telephone using a pro-forma and 51 specialist Trainees/registrars participated in the survey. Average age of the trainee was 35 years (31–46) and male to female ratio was 3:1. Most trainees (60%) use loupes and on average have been using magnification for 3.25 years (0.5–10 years). Majority (73%) started wearing loupes in hospital posts and 76% cited a desire to improve surgical technique and outcome as a driver. Magnification of 2.5 was popular (81%) and 65% opted for the “through the lens” variety. Price (53%) and magnification (22%) were the important factors which governed their purchase. An accessory light source was not a popular choice (13%). Use of loupes was higher among senior trainees and variations were noted in relation to the type of surgery involved. Majority of the trainees did use loupes for raising free flaps (87%), parotid surgery (78%) and in facial aesthetic surgery (68%) with a minority of the trainees (14%) opted to use loupes in Orthognathic surgery. Among the non-loupe users, most (70%) are considering purchasing loupes and “through the lens” variety was a popular choice (67%). Many (71%) wanted to use loupes to improve surgical outcome but any future purchase would be governed heavily by price (46%) and magnification (27%). OMFS is a specialty which can benefit from magnification to aid intricate techniques to manipulate tissue in the head and neck region. Such procedures include microvascular anastomosis of blood vessels of 1.0 mm or greater in diameter, pedicle manipulation or flap dissection and fine suturing methods. Studies have confirmed that experienced clinicians can perform free-flap surgery under loupe magnification with successful patency similar to that with microscopes and can save time with no significant difference in complication rates. Loupes can offer magnification of up to six times that of the unaided human eye and can provide the user with greater freedom. Greater affinity for loupes was noted among senior trainees. This reflects well with their increased exposure to complex surgeries that can involve meticulous skin incisions and closure, or procedures incurring a greater risk of nerve damage, such as parotid surgery. A minority (14%) did use loupes during Orthognathic surgery possibly for identification or repair of the inferior dental nerve. *Correspondence to: Mr. Shahme A. Farook, M.B.Ch.B., B.D.S., B.Sc. (Hons), M.R.C.S., M.F.D.S., Specialist Registrar, Department of Oral and Maxillofacial Surgery, London North West Healthcare NHS Trust, Northwick Park Hospital, Watford Road, Harrow, HA1 3UJ, United Kingdom. E-mail: safarook@hotmail.com and shahme.farook@nhs.net Received 8 December 2014; Revision accepted 29 December 2014; Accepted 9 January 2015 Published online 29 January 2015 in Wiley Online Library (wileyonlinelibrary.com). DOI: 10.1002/micr.22383

Response to: Publication hot spots and oral and maxillofacial surgery: an alternative interpretation

e thank Mr Kanatas for his interest and comments on our ecent recent publication.1 He makes a very good point. Idelly, we would like to have presented the data by Deanery n relation to the number of trainees in post. The aim of ur paper was really to pinpoint areas where trainees might e supported in research and publication activity. With the ncreasing numbers of OMFS trainees wishing to take up nterface fellowships, a research portfolio is likely to become ssential in competition for these posts. Trainees in the other ead and neck specialties often have a higher research degree hich they have undertaken prior to entry to specialist trainng. At the present time there are 125 whole time equivalent pecialty trainees in post. Consequently, with the data that we nalysed, one could possibly expect that over an 18 month eriod, a third of trainees would publish a full length artile, about 10% will publish a technical note and 20% a short ommunication in our Journal. There are currently no requireents for publications or research to be undertaken during MFS specialty training, but if these figures are extrapolated