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ABSTRACT: Our aim was to develop a way of measuring trismus and evaluating it in terms of reliability and validity for use by nurses who care for patients with head and neck cancer. We developed a method from existing resources and tested it for interoperator reliability and validity against a "gold standard". We showed that within the variables outlined, nursing staff could use it after minimal training to identify patients broadly as being "at risk", "low risk", or having "normal mouth opening". Interexaminer reliability was poor. There was a trend towards a group of people having reasonable interexaminer reliability, and this same group showed consistency towards the gold standard. Nurses' accuracy and consistency in using a simple method of assessing trismus depends on more than the method used, and neither validity nor reliability can be assumed. The accurate assessment of trismus for comparison across studies is complex, and future research must define exactly what method was used.
British Journal of Oral and Maxillofacial Surgery 09/2011; 49(6):430-7. · 1.95 Impact Factor
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ABSTRACT: We describe the outcome of 46 patients 12 months after partial or total replacement of the temporomandibular joint (TMJ) using the Christensen implant system (TMJ Implants Inc, Golden, CO, USA). The study group comprised 35 women and 11 men; the women were slightly older than the men at the time of operation. We studied three diagnostic groups in detail: patients who had ankylosis, internal derangement, and osteoarthritis. Those with ankylosis were slightly older than the others. Pain decreased over time in all three groups. There was a significant reduction between preoperative pain and that recorded 1 month postoperatively. After this point the pain decreased slowly, and by year 1 it had decreased significantly with respect to preoperative scores. Women reported worse preoperative pain than men, but not significantly so.
British Journal of Oral and Maxillofacial Surgery 09/2011; 49(6):455-8. · 1.95 Impact Factor
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ABSTRACT: Lugol's iodine is currently under investigation as a technique to detect dysplasia, carcinoma in situ and invasive carcinoma at resection margins, plus further afield. Lugol's iodine is inexpensive and easy to use. We present two cases where the technique revealed abnormal mucosa (one carcinoma, one squamous cell carcinoma in situ) at distant sites from the tumour being treated within oral cavity and oropharynx.
British Journal of Oral and Maxillofacial Surgery 07/2011; 49(5):409-11. · 1.95 Impact Factor
