Objectives: There has been a notable surge in cycling injuries during the COVID-19(SARS-CoV-2 virus) pandemic. Cycling in general increased during lockdown as a leisure & fitness activity along with reduction in the use of public transport for commuting. We investigated the bicycle-related maxillofacial injuries & associations presenting through our emergency department(ED) which covers more than 1.6 million of London population. Study Design/Methods: A retrospective observational study was undertaken in the Barnet General Hospital (“hub”) which receives all maxillofacial referrals from 6 “spoke” hospitals & other urgent primary/community care practices in North London area between 16 March 2020 & 16 July 2020. All data corresponding to cycling injuries during the lockdown period was analyzed with the aid of trauma database/trust-wide electronic patient records. Results: Twenty-two patients (6.7%) with cycling-related injuries out of a total of 322 patients who attended during the 4 months study period with maxillofacial emergencies were identified. Average age of patient cohort was 35.4 years, mainly consisting of adult males (77%). Seven patients had minor head injury and 1 patient suffered traumatic brain injury. About 59% patients did not wear a protective helmet & 3 patients had heavy alcohol/recreational drug intoxication during the accidents. Four patients needed inpatient admission and treatment under general anesthesia. Conclusions: Based on our humble study, we advocate the need for robust road & personal safety measures with mandatory government legislations, policing of drug intoxication & encouragement of physical & mental health improvement measures during these unprecedented times & beyond.

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Introduction It is not uncommon to note patients with painful orofacial lesions presenting via the emergency department to the on-call team. However, during the COVID-19 pandemic, we saw a surge in these attendances, prompting a review of our emergency database. Methods The maxillofacial emergency database was retrospectively reviewed in the period between March 2020 and October 2021 (19 months). Data including relevant variables were collected in a standard spreadsheet database and analysed by two clinicians. Results Between March 2020 and October 2021, 34 patients attended with oral ulceration and non-odontogenic neck swellings, out of which nine patients had subsequent diagnosis of oral/oropharyngeal cancer (mean age: 64.2 years). All patients were grouped as stage IV cancers and only one patient was deemed suitable for ablative surgery, which is the primary mode of treatment in oral cancers. Three patients were deemed to have progressive/recurrent disease despite active treatment and two patients unfortunately passed away due to the disease. Conclusion The impact of the COVID-19 pandemic on head and neck cancer diagnoses and management suffered significantly. We present our experience dealing with this vulnerable cohort in the emergency department and their subsequent journey.

Knife crimes and facial injuries Sir, knife crimes are on a steady rise in the UK producing deleterious effects on the victim, family and community. More than 5,000 recorded hospital consultations in England were noted in 2017-18 related to assault by sharp weapons (14% rise compared to 2016-17). Disturbingly, 10-17-year-olds accounted for 21% of all offensive weapon possessions. 1 The increase in the number of female offenders involved in Offensive Weapons Related Crimes (OWC) in recent years is alarming. A 23-year-old Asian female was brought in via ambulance after being stabbed with a knife on the left side of her face by another female assailant after an argument. She had also been hit with a bottle on her head during the same episode. On examination, she had a large variably deep wound of the left cheek with ragged edges measuring approximately 12 cm in length (Fig. 1). The facial nerve appeared to be intact with no global neurological deficit. The patient was admitted for a formal exploration of the facial wounds including assessment of the parotid duct. The wound was found to be just short of the duct. The area was thoroughly debrided and closed primarily. Facial injuries are a common presentation in the emergency department and quite often COMMENT