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Classifications and Lists in
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Oral and Maxillofacial Surgery
is book contains a concise collection of the most important oral and maxillofacial surgery classications and lists. Such classications help to describe diseases in a comprehensible, measurable, validated and reproducible manner and are the rst step towards a systematic approach for treating specic conditions. Elsewhere in this book, lists provide clinical guidance on key subspecialty topics.
Using subdivisions such as trauma, head and neck cancer, and orthognathic surgery, this is a succinct and easy-to-use guide for the head and neck clinician.
Used as a reference tool, this book will be a valuable resource for the surgical trainee, those working in ward rounds and outpatient clinics, or before surgery.
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Classifications and Lists in
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Oral and Maxillofacial Surgery
Alexander M.C. Goodson
BSc (Hons), MBBS, BDS, PhD, FRCS, DOHNS
Consultant Maxillofacial, Head & Neck Surgeon
Queen Alexandra Hospital, Portsmouth, United Kingdom
Mohammad S. Sarwar
MB ChB, BSc (Hons), MRCS (Edin), DOHNS-1
Graduate Entry Dental Student, King’s College London
Clinical Fellow (locum) Oral and Maxillofacial Surgery
Queen Victoria Hospital, East Grinstead, United Kingdom
Umar Rehman
BMBS, BSc (Hons), PGCME, MRCS (Eng), MSc (Dist)
Clinical Research Fellow and PhD Candidate
UCL Division of Surgery and Interventional Science
UCL, London, United Kingdom
MB BS, MD, PhD FRCS (Eng), FRCSI, Hon FRCS (Glasg), FFST(Ed), FDSRCS
Consultant Oral and Maxillofacial Surgeon, Honorary Professor of Surgery
Department of Oral and Maxillofacial Surgery, Queen Alexandra Hospital
Peter A. Brennan
Portsmouth, United Kingdom
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Cover image: Shutterstock ID. 2049471578
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First edition published 2024 by CRC Press 2385 NW Executive Center Drive, Suite 320, Boca Raton FL 33431
and by CRC Press 4 Park Square, Milton Park, Abingdon, Oxon, OX14 4RN
CRC Press is an imprint of Taylor& Francis Group, LLC
© 2024 Alexander M.C. Goodson, Mohammed S. Sarwar, Umar Rehman and Peter A. Brennan
is book contains information obtained from authentic and highly regarded sources. While all reasonable eorts have been made to publish reliable data and information, neither the author[s] nor the publisher can accept any legal responsibility or liability for any errors or omissions that may be made. e publishers wish to make clear that any views or opinions expressed in this book by individual editors, authors or contributors are personal to them and do not necessarily reect the views/opinions of the publishers. e information or guidance contained in this book is intended for use by medical, scientic or health-care professionals and is provided strictly as a supplement to the medical or other professional’s own judgement, their knowledge of the patient’s medical history, relevant manufacturer’s instructions and the appropriate best practice guidelines. Because of the rapid advances in medical science, any information or advice on dosages, procedures or diagno ses should be independently veried. e reader is strongly urged to consult the relevant national drug formu­lary and the drug companies’ and device or material manufacturers’ printed instructions, and their websites, before administering or utilizing any of the drugs, devices or materials mentioned in this book. is book does not indicate whether a particular treatment is appropriate or suitable for a particular individual. Ultimately it is the sole responsibility of the medical professional to make his or her own professional judgements, so as to advise and treat patients appropriately. e authors and publishers have also attempted to trace the copyright holders of all material reproduced in this publication and apologize to copyright holders if permission to pub lish in this form has not been obtained. If any copyright material has not been acknowledged please write and let us know so we may rectify in any future reprint.
Except as permitted under U.S. Copyright Law, no part of this book may be reprinted, reproduced, transmitted, or utilized in any form by any electronic, mechanical, or other means, now known or hereaer invented, includ ing photocopying, microlming, and recording, or in any information storage or retrieval system, without writ­ten permission from the publishers.
For permission to photocopy or use material electronically from this work, access www.copyright.com or con­tact the Copyright Clearance Center, Inc. (CCC), 222 Rosewood Drive, Danvers, MA 01923, 978-750-8400. For works that are not available on CCC please contact mpkbookspermissions@tandf.co.uk
Trademark notice: Product or corporate names may be trademarks or registered trademarks and are used only for identication and explanation without intent to infringe.
ISBN: 9780367742720 (hbk) ISBN: 9780367701055 (pbk) ISBN: 9781003156895 (ebk)
DOI: 10.1201/9781003156895
Typeset in Minion by Apex CoVantage, LLC
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The authors wish to dedicate this book to their families,
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friends and colleagues who have supported their clinical
and academic pathways in the specialty of oral and
maxillofacial surgery.
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Contents
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Preface xv Authors xvii Acknowledgements xix Human Factors Analysis and Classification System
(HFACS) Adapted for Surgery xxi List of Abbreviations xxiii
1 Airway 1
Difficult Airway Society (DAS) Intubation Guidelines 1 Indications for Submental Intubation 2 Intubation Guidelines in Trauma 2 Laryngotracheal Injury Classification ‘Groups’ as per
Schaefer Classification 2 Mallampati Score 3 Further Reading 3
2 Facial Trauma 5
Frontal Sinus 5 Naso-Orbital-Ethmoid (NOE) 6 Orbit 7 Midface 7 Maxilla and Zygoma 8 Mandible 9 Nerves and Soft Tissue Injuries 13 Further Reading 15
vii
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viii Contents
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3 Jaw Deformity 19
Orthognathic 19 Further Reading 21 Temporomandibular Joint (TMJ) 22 Further Reading 26 Facial Pain 27 Fibromyalgia 27 Further Reading 29
4 Head and Neck Oncology 31
Anneroth Grading Score (Correlates with Lymph
Node Involvement Risk) 31 Brown Classification of Mandibular Defects 32 Brown Classification of Maxillary Defects 33 Chyle Leak Management 34 Criteria for Successful Non-Vascularised Block
Bone Graft 34 Features of Positive Nodes on Imaging 34 Grades of Chondrosarcoma 35 Global Stage Grouping in H&N Cancer Overall 35 How Does Treatment of Oropharyngeal Cancer Differ
from Oral Cancer? 36 Hypopharynx TNM 36 Indications for Adjuvant External Beam Radiation
Therapy (DXT) in Oral Cancer 37 Indications for Adjuvant Chemo-Radiotherapy in
OralCancer 37 Indications for Radical Neck Dissection 37 Investigations for a Carcinoma of Unknown
Primary(CUP) Origin 38 Lip Defect Types and Reconstruction Options 38 Lymphoma Staging 39 Mathes and Nahai Classification of Muscular Flaps 39 Node Staging 40 Oral (and Oropharyngeal) Cancer Tumour, Node,
Metastasis (TNM) 40 Osteoradionecrosis (ORN) Grades by Notani 40 ORN Stages by Marx 41
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Contents ix
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ORN Types by Lyons et al. 41 Response Evaluation Criteria in Solid Tumours
(RECIST) 42 Residual Tumour Classification 42 Shamblin’s Classification of Carotid Body Tumours 42 Sino-Nasal TNM 42 Sino-Nasal Tumour Management 43 When to Use PET-CT 43 When to Use Frozen Section – Three Points 44 Further Reading 44
5 Salivary Gland Disease 47
Sjögren’s Diagnosis Criteria – American-European
Consensus Group (AECG) 2002 47 Sjögren’s Diagnosis Criteria – American College of
Rheumatology (ACR) 2012 48 Surgery for Salivary Malignancy 48 TNM of Salivary Gland Cancer 49 Further Reading 49
6 Oral Medicine and Pathology 51
Behcet’s International Diagnostic Criteria 51 Burning Mouth Syndrome Criteria 52 Montandon Classification of Noma Defects 52 Medicine-Related Osteoradionecrosis of the Jaw
(MRONJ) Staging by Ruggiero 52 Oral Pre-Malignant Lesions and Conditions 53 Oral Submucous Fibrosis (OSMF) Grouping by
Khanna and Andrade 54 OSMF Stages 54 OSMF Treatment 54 Further Reading 55
7 Conditions of Skin and Facial Cutaneous Surgery 57
Actinic Keratosis Grading by Olsen 57 Fitzpatrick Sun-Reactive Types for Skin 58 Non-Melanotic Skin Cancer (NMSC) Follow-Up 58 Criteria of High-Risk NMSC 58 NMSC Staging 59
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x Contents
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Cases for the Multidisciplinary Team (MDT) 59 Indications for Mohs Micrographic Surgery 60 Neck Treatment in NMSC 60 Melanoma Breslow Thickness (Measured from
Granular Layer Down) versus Clark Scale 60 Melanoma Follow-Up 61 Melanoma Modified Glasgow Criteria for
Urgent Referral 61 Melanoma TNM 62 Further Reading 63
8 Facial Aesthetic Surgery and Restoration of Form
and Function 65
Changes in Skin with Decades of Age 65 Classification of Ptosis 65 Classification of Levator Function 66 Dedo Facial Profile 66 Ellenbogen’s Criteria for Ideal Brow Position 66 Ellenbogen and Karlin’s Criteria for a YouthfulNeck 67 Facial Nerve Palsy Grading by House-Brackmann 67 Facial Nerve Palsy Management Algorithm (Facial
Reanimation) 68 Photo-Aging Classification by Glogau 69 Pinch-Test Points (Graded 0–5 in Terms of Laxity –
Lemperle Scale) 69 Soft Tissue Values 70 Further Reading 70
9 Cleft Lip and Palate Surgery 73
Alveolar Bone Graft (ABG) Success Using Bergland Scale 73 ABG Success Grading by Kindelan 73 Modified Kriens’ LAHSAL (Recommended by Royal
College of Surgeons, 2005) 74 Veau Classification 74 Kernahan and Elsahy Classification (Modified by Millard) 74 Nyberg Classification of Antenatal Ultrasound
CleftFindings 75 Speech Testing Standards for Cleft Treatment 75 Timing of Cleft Treatment in the UK 76 Further Reading 76
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