Objectives: This study aimed to investigate the efficacy of postoperative submucosal injection of hyaluronidase (HUD) for reducing sequelae and quality of life (QOL) after mandibular third molar (M3M) surgery. Materials and Methods: Participants with bilateral impacted M3M underwent surgical extraction with a split-mouth randomized controlled study design. M3M were removed by the same surgeon in 2 sessions, one a control and the other experimental. Submucosal injection of HUD was performed in the experimental session and submucosal injection of saline in the control session. Mouth opening, facial swelling, and pain intensity were measured before surgery, and then 2 and 7 days after surgery. The QOL of participants following surgery was evaluated by means of a patient-centered outcome questionnaire (PCOQ). Results: A total of 36 patients was included in the final data analysis. There was a significant reduction in the maximal mouth opening and postoperative pain in the experimental side at the 2 and 7 days after surgery (P<0.05), and a remarkable difference in facial swelling was reported on the experimental side 7 days after surgery (P<0.05). The PCOQ demonstrated that participants reported less pain and swelling on the experimental side. Conclusion:The present study provides clinical evidence that submucosal administration of HUD immediately after M3M surgery reduced postoperative discomfort and improved patients' QOL.

Background: The number, location, and pattern of perforators in anterolateral thigh(ALT) flap vary and predicting them preoperatively will aid in reconstructing complex head and neck defects. This article suggests guidelines for utilizing CTA imagery to predict perforators of ALT-free flaps. Methods: We retrospectively analyzed 53 Korean patients who underwent reconstruction with ALT flap in our department from March 2021 to July 2022. The location, course, origin, and pedicle lengths predicted in CTA and confirmed in the operation field were recorded and compared. Results: Among the 85 intraoperatively-found perforators, 79 were also identified in CTA. Six perforators unidentified in CTA were newly found intraoperatively. The positive predictive value of CTA for the perforator was 100%, with a sensitivity of 79/85 = 92.9%. Of the 79 perforators depicted by the CTA for the flap, CTA and intraoperative findings for the course were consistent in 52 cases, a 9.6 mm median discrepancy being noted between the actual location and CTA. Conclusions: The overall pattern or location of perforation was not significantly different between the two, although some differences were observed. It is suggested that the addition of Doppler imaging, in conjunction with CTA, can aid in perforator detection and help minimize such discrepancies.

To survey the advantages, future prospects, and cases using robotic systems in oromaxillofacial surgery.Background: With the accumulation of advances in minimally invasive surgery in the entire body area, robot-assisted surgeries have become very common in operating rooms, despite of their short history. Thus, advances in robotic surgery are accelerating rapidly, particularly with respect to the maxillofacial region. In this regard, researchers reviewed the literatures using the keywords given below, including systematic metaanalysis.Methods: The report follows the format of the "narrative review" and reviewed literatures extracted from the PubMed database since 1980 when 'Robotic surgical procedures', 'neck dissection' and 'oral surgery' were searched.Conclusions: Robotic surgery in the oral and maxillofacial region allows the incision to hide the scar by making the incision line far from the surgical field, resulting in fewer intra-operative and post-operative complications, such as amount of drainage or hospital days. Furthermore, recent studies show similar or superior results in terms of oncologic safety of robot assisted surgeries compared to conventional surgeries.Robotic surgery is likely to extend throughout the oral and maxillofacial region once it becomes capable of manipulating bone such as in osteotomies, particularly as robotic systems become smaller. When combined with artificial intelligence technology, the surgical robot will become more useful and powerful in relieving human suffering.

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By comparing the surgical outcomes of free-flap reconstruction using the retroauricular approach (RA) and transcervical approach (TA), we show that free-flap reconstruction is sufficiently available via RA