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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 classications and lists. Such
classications help to describe diseases in a comprehensible,
measurable, validated and reproducible manner and are the
rst step towards a systematic approach for treating specic
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
eorts 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 reect the views/opinions of the publishers. e information or
guidance contained in this book is intended for use by medical, scientic 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 veried. 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 hereaer invented, includ
ing photocopying, microlming, 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 identication 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
OralCancer 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 YouthfulNeck 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
CleftFindings 75
Speech Testing Standards for Cleft Treatment 75
Timing of Cleft Treatment in the UK 76
Further Reading 76
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