ELHT Evidence Hub
  • Home
  • Meet the Team
  • Library Facilities
  • Library News
  • FAQS
  • Evidence Search Request
Picture

Morbidity related to the lip-split mandibulotomy approach: a systematic and narrative review.

5/7/2022

0 Comments

 
Authors: Hedayat F;  Jerry Htwe KK;  Vassiliou LV et al.
Source:Source: The British journal of oral & maxillofacial surgery [Br J Oral Maxillofac Surg] 2022 May; Vol. 60 (4), pp. 430-436. Date of Electronic Publication: 2021 Nov 27.
Abstract:
The lip-split mandibulotomy (LSMA) is an access procedure that has been used in head and neck (H&N) surgery as an aid to surgical resection of inaccessible tumours of the postertior oral cavity and oropharynx. Anecdotal evidence suggests that it has significant morbidity. Voices of concern within the H&N surgical community suggest that it has been abandoned in favour of technological advances such as robotic surgery. We report here the first (to our knowledge) registered systematic review of its kind, documenting the safety and efficiency of LSMA in H&N surgery. We performed a PRISMA-guided systematic review (PROSPERO-registered) and identified reports using a search algorithm in MEDLINE/EMBASE. LSMA-related surgical complications were recorded using the Clavien-Dindo classification. Secondary outcomes included swallowing dysfunction, facial cosmesis, and patient satisfaction recorded in health-related quality of life questionnaires (HRQoL). From 125 studies identified, 54 met the inclusion criteria (3872 patients). The LSMA mortality rate was 0%; we did not identify a single case of perioperative death. The median rate of osteoradionecrosis was 5.4%, whereas fistula formation was 5.7%. Malunion was noted in 4.9%. Other complications (surgical site infection, plate exposure) were around 5%. There was significant between-study variation with regards to swallowing assessment tools, but overall there was no significant difference in outcomes. This was also the case for the HRQoL questionairres. LSMA is a safe procedure with an acceptable rate of complications, and should definitely remain in the armamentarium of H&N surgery.

Request this item

0 Comments



Leave a Reply.

    The following databases were searched:
    EMBASE,  MEDLINE, PsycINFO, BNI, CINAHL, 
    to find  ELHT staff publications

    Specialties

    All
    ANAESTHETICS
    CAMHS
    CARDIOLOGY
    COVID 19
    DEMENTIA
    DERMATOLOGY
    DIABETES
    DIETETICS
    EMERGENCY CARE
    ENDOCRINOLOGY
    EVIDENCE BASED MEDICINE
    GASTROENTEROLOGY
    GYNAECOLOGY
    HAEMATOLOGY
    MATERNITY
    MAXILLOFACIAL
    NEONATOLOGY
    NEUROLOGY
    NURSING
    OBSTETRICS
    ONCOLOGY
    ORTHOPAEDICS
    PAEDIATRICS
    PHARMACY
    PHYSIOTHERAPY
    RADIOLOGY
    RESPIRATORY
    RHEUMATOLOGY
    STROKE
    SURGERY
    UROLOGY
    VASCULAR SURGERY

    RSS Feed

    Archives

    August 2022
    July 2022
    May 2022
    April 2022
    March 2022
    December 2021
    November 2021
    October 2021
    September 2021
    August 2021
    July 2021
    June 2021
    May 2021
    April 2021
    March 2021
    February 2021
    December 2020
    November 2020
    October 2020
    September 2020
    August 2020
    July 2020
    June 2020
    May 2020
    April 2020
    March 2020
    February 2020
    January 2020
    December 2019
    November 2019
    October 2019

Learning Centre Library
Royal Blackburn Teaching Hospital
01254 734312 or Ext 84312
library.blackburn@elht.nhs.uk
​Find us
​​Mackenzie Library
Burnley General Teaching Hospital
01282 803114 or Ext. 13114
library.burnley@elht.nhs.uk

Find us
​Staffed Opening Hours
Mon     08:30-16:30
Tue      08:30-16:30
Wed     08:30-16:30
Thu      08:30-16:30
Fri        08:30-16:00
24/7 access to both libraries is available - please see library staff
View our Quality Standards and Performance
Picture
Picture
  • Home
  • Meet the Team
  • Library Facilities
  • Library News
  • FAQS
  • Evidence Search Request