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Jenkinson AO, Fell M, Eshete M, Patel V, Demissie Y, Abate F, McGurk M. The impact of complex facial surgery provided on a short-term surgical mission. Int J Oral Maxillofac Surg 2021; 50:1649-1652. [PMID: 34059404 DOI: 10.1016/j.ijom.2021.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 03/27/2021] [Accepted: 05/12/2021] [Indexed: 10/21/2022]
Abstract
The long-term consequences of performing facial surgery on patients living in rural Ethiopia are largely unknown. A review of 36 patients who had been treated on a short-term surgical mission (STSM) in the previous 2 years was conducted to evaluate the outcomes of the surgical interventions performed. There was a significant reduction in social isolation following a surgical intervention. Improvements in postoperative self-reported changes were found for facial appearance, facial function, and quality of life. Positive outcomes can be achieved when surgical treatment is performed on a STSM.
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Affiliation(s)
| | - M Fell
- Department of Plastic and Reconstructive Surgery, North Bristol NHS Trust, Bristol, UK
| | - M Eshete
- Department of Surgery, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia; Department of Plastic and Reconstructive Surgery, Yekatit 12 Hospital Medical College, Addis Ababa, Ethiopia.
| | - V Patel
- Oral Surgery Department, Guy's Hospital, Guy's and St Thomas' Foundation Trust, London, UK
| | - Y Demissie
- Department of Plastic and Reconstructive Surgery, Yekatit 12 Hospital Medical College, Addis Ababa, Ethiopia
| | - F Abate
- Department of Plastic and Reconstructive Surgery, Yekatit 12 Hospital Medical College, Addis Ababa, Ethiopia
| | - M McGurk
- Department of Oral and Maxillofacial Surgery, University College London Hospitals NHS Foundation Trust, London, UK
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de Berker H, Patel V, Honeyman C, Yonis E, Eshete M, Martin D, McGurk M. 724 Improving the Lives of Patients with Large Amelobastomas In Ethiopia: Long-Term Outcomes of Mandibular Reconstruction for Ameloblastoma Using Non-Vascularised Rib Grafts. Br J Surg 2021. [DOI: 10.1093/bjs/znab135.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Background
Ameloblastomas are odontogenic tumours that often require radical excision and mandibular reconstruction. This is challenging in resource-limited settings where access to microsurgery is limited. Non-vascularised rib-grafts can be used as an alternative, however robust long-term outcomes are lacking.
Method
Adult patients with large ameloblastomas underwent hemimandibulectomy and autologous rib graft reconstruction on short-term surgical missions to Ethiopia between 2012 and 2015. Long-term follow-up was conducted over a two-week period in rural Ethiopia in 2017.
Results
Follow-up was possible for seven patients (58% of those treated). Mean post-operative follow-up time was 42.9 months (SD 11.7; range 24-60 months). Early complications were four superficial surgical site infections. Late complications were two cases of wire extrusion and one of keloid scarring. There were no graft failures. Patients reported reduced social stigma (p = 0.04), excellent function and 100% satisfaction.
Conclusions
When situational factors preclude the use of microsurgery, bundle rib-grafts offer a reliable alternative for partial or total mandibular reconstruction for patients after ameloblastoma resection. Mild complications were experienced by most patients, but these were straightforward to manage and the bundle rib-grafts still took well, being surprisingly resistant to infection. Importantly, this technique is associated with long-term improvements in social stigma and quality of life for patients.
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Affiliation(s)
- H de Berker
- Department of Burns and Plastic Surgery, Royal Manchester Children's Hospital, Manchester, United Kingdom
| | - V Patel
- Oral Surgery Department, Guys Dental Institute, Guys & St Thomas NHS Foundation Trust, London, United Kingdom
| | - C Honeyman
- Canniesburn Plastic Surgery and Burns Unit, Glasgow Royal Infirmary, Glasgow, United Kingdom
| | - E Yonis
- No Affiliation, London, United Kingdom
| | - M Eshete
- Department of Surgery, Addis Ababa University, Addis Ababa, Ethiopia
| | - D Martin
- Department of Plastic and Reconstructive Surgery, University of Bordeaux, Bordeaux, France
| | - M McGurk
- Department of Head and Neck Surgery, University College London Hospital, London, United Kingdom
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Bradley D, Honeyman C, Patel V, Zeolla J, Lester L, Eshete M, Demissie Y, Martin D, McGurk M. Smartphones can be used for patient follow-up after a surgical mission treating complex head and neck disfigurement in Ethiopia: Results from a prospective pilot study. J Plast Reconstr Aesthet Surg 2020; 74:890-930. [PMID: 33189622 DOI: 10.1016/j.bjps.2020.10.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2020] [Revised: 08/29/2020] [Accepted: 10/24/2020] [Indexed: 10/23/2022]
Affiliation(s)
- D Bradley
- Oral and Maxillofacial Surgery Department, University Hospitals Coventry and Warwickshire, Clifford Bridge Road, Coventry, CV2 2DX, United Kingdom.
| | - C Honeyman
- Department of Plastic and Reconstructive Surgery, Ninewells Hospital, Dundee, United Kingdom
| | - V Patel
- Oral Surgery Department, Guys Dental Institute, Guys & St Thomas NHS Foundation Trust, London, United Kingdom
| | - J Zeolla
- Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom
| | - L Lester
- Department of Plastic and Reconstructive Surgery, Queen Alexandra Hospital, Portsmouth, United Kingdom
| | - M Eshete
- Department of Surgery, School of Medicine, College of Health Sciences Addis Ababa University, Addis Ababa, Ethiopia
| | - Y Demissie
- Department of Surgery, School of Medicine, College of Health Sciences Addis Ababa University, Addis Ababa, Ethiopia
| | - D Martin
- 35 avenue des pins 13013, Marseille, France
| | - M McGurk
- Department of Head and Neck Surgery, University College London Hospital, London, United Kingdom
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Gowans LJJ, Adeyemo WL, Eshete M, Mossey PA, Busch T, Aregbesola B, Donkor P, Arthur FKN, Bello SA, Martinez A, Li M, Augustine-Akpan EA, Deressa W, Twumasi P, Olutayo J, Deribew M, Agbenorku P, Oti AA, Braimah R, Plange-Rhule G, Gesses M, Obiri-Yeboah S, Oseni GO, Olaitan PB, Abdur-Rahman L, Abate F, Hailu T, Gravem P, Ogunlewe MO, Buxó CJ, Marazita ML, Adeyemo AA, Murray JC, Butali A. Association Studies and Direct DNA Sequencing Implicate Genetic Susceptibility Loci in the Etiology of Nonsyndromic Orofacial Clefts in Sub-Saharan African Populations. J Dent Res 2016; 95:1245-56. [PMID: 27369588 DOI: 10.1177/0022034516657003] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Orofacial clefts (OFCs) are congenital dysmorphologies of the human face and oral cavity, with a global incidence of 1 per 700 live births. These anomalies exhibit a multifactorial pattern of inheritance, with genetic and environmental factors both playing crucial roles. Many loci have been implicated in the etiology of nonsyndromic cleft lip with or without cleft palate (NSCL/P) in populations of Asian and European ancestries, through genome-wide association studies and candidate gene studies. However, few populations of African descent have been studied to date. Here, the authors show evidence of an association of some loci with NSCL/P and nonsyndromic cleft palate only (NSCPO) in cohorts from Africa (Ghana, Ethiopia, and Nigeria). The authors genotyped 48 single-nucleotide polymorphisms that were selected from previous genome-wide association studies and candidate gene studies. These markers were successfully genotyped on 701 NSCL/P and 163 NSCPO cases, 1,070 unaffected relatives, and 1,078 unrelated controls. The authors also directly sequenced 7 genes in 184 nonsyndromic OFC (NSOFC) cases and 96 controls from Ghana. Population-specific associations were observed in the case-control analyses of the subpopulations, with West African subpopulations (Ghana and Nigeria) showing a similar pattern of associations. In meta-analyses of the case-control cohort, PAX7 (rs742071, P = 5.10 × 10(-3)), 8q24 (rs987525, P = 1.22 × 10(-3)), and VAX1 (rs7078160, P = 0.04) were nominally associated with NSCL/P, and MSX1 (rs115200552, P = 0.01), TULP4 (rs651333, P = 0.04), CRISPLD2 (rs4783099, P = 0.02), and NOG1 (rs17760296, P = 0.04) were nominally associated with NSCPO. Moreover, 7 loci exhibited evidence of threshold overtransmission in NSOFC cases through the transmission disequilibrium test and through analyses of the family-based association for disease traits. Through DNA sequencing, the authors also identified 2 novel, rare, potentially pathogenic variants (p.Asn323Asp and p.Lys426IlefsTer6) in ARHGAP29 In conclusion, the authors have shown evidence for the association of many loci with NSCL/P and NSCPO. To the best of this knowledge, this study is the first to demonstrate any of these association signals in any African population.
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Affiliation(s)
- L J J Gowans
- Department of Biochemistry and Biotechnology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana Cleft Clinic, Komfo Anokye Teaching Hospital, Kumasi, Ghana Department of Pediatrics, University of Iowa, Iowa City, IA, USA Department of Oral Pathology, Radiology and Medicine, University of Iowa, Iowa City, IA, USA
| | - W L Adeyemo
- College of Medicine, University of Lagos, Lagos, Nigeria
| | - M Eshete
- Addis Ababa University, Addis Ababa, Ethiopia
| | - P A Mossey
- Department of Orthodontics, University of Dundee, Dundee, Scotland
| | - T Busch
- Department of Oral Pathology, Radiology and Medicine, University of Iowa, Iowa City, IA, USA
| | - B Aregbesola
- Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigeria
| | - P Donkor
- Cleft Clinic, Komfo Anokye Teaching Hospital, Kumasi, Ghana Department of Surgery, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - F K N Arthur
- Department of Biochemistry and Biotechnology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - S A Bello
- Department of Oral and Maxillofacial Surgery, State House Hospital, Abuja, Nigeria
| | - A Martinez
- Department of Oral Pathology, Radiology and Medicine, University of Iowa, Iowa City, IA, USA
| | - M Li
- Department of Oral Pathology, Radiology and Medicine, University of Iowa, Iowa City, IA, USA
| | - E A Augustine-Akpan
- Department of Oral Pathology, Radiology and Medicine, University of Iowa, Iowa City, IA, USA
| | - W Deressa
- Addis Ababa University, Addis Ababa, Ethiopia
| | - P Twumasi
- Department of Biochemistry and Biotechnology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - J Olutayo
- College of Medicine, University of Lagos, Lagos, Nigeria
| | - M Deribew
- Addis Ababa University, Addis Ababa, Ethiopia
| | - P Agbenorku
- Cleft Clinic, Komfo Anokye Teaching Hospital, Kumasi, Ghana Department of Surgery, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - A A Oti
- Cleft Clinic, Komfo Anokye Teaching Hospital, Kumasi, Ghana Department of Surgery, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - R Braimah
- Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigeria
| | - G Plange-Rhule
- Cleft Clinic, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - M Gesses
- Yekatit 12 Hospital Medical College, Addis Ababa, Ethiopia
| | - S Obiri-Yeboah
- Cleft Clinic, Komfo Anokye Teaching Hospital, Kumasi, Ghana Department of Surgery, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - G O Oseni
- Department of Burns and Plastic Surgery, Ladoke Akintola University of Technology Teaching Hospital, Osogbo, Nigeria
| | - P B Olaitan
- Department of Burns and Plastic Surgery, Ladoke Akintola University of Technology Teaching Hospital, Osogbo, Nigeria
| | - L Abdur-Rahman
- Division of Pediatric Surgery, Department of Surgery, University of Ilorin, Ilorin, Nigeria
| | - F Abate
- Yekatit 12 Hospital Medical College, Addis Ababa, Ethiopia
| | - T Hailu
- Yekatit 12 Hospital Medical College, Addis Ababa, Ethiopia
| | - P Gravem
- Haukeland University Hospital Bergen, Bergen, Norway
| | - M O Ogunlewe
- Department of Burns and Plastic Surgery, Ladoke Akintola University of Technology Teaching Hospital, Osogbo, Nigeria
| | - C J Buxó
- School of Dental Medicine, University of Puerto Rico Medical Science Campus, San Juan, Puerto Rico
| | - M L Marazita
- Department of Oral Biology, University of Pittsburgh, Pittsburgh, PA, USA
| | - A A Adeyemo
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
| | - J C Murray
- Department of Pediatrics, University of Iowa, Iowa City, IA, USA
| | - A Butali
- Department of Oral Pathology, Radiology and Medicine, University of Iowa, Iowa City, IA, USA
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