This longitudinal study highlights the psychological and functional problems that can result from maxillofacial trauma. This is the first study to report outcome at one year. A total of 147 patients admitted for surgery following facial trauma were recruited over a seven-month period. Three questionnaires were used to record patient-derived levels of dysfunction: the Hospital Anxiety Depression scale, a modified University of Washington Quality of Life questionnaire and five non-validated facial trauma items. At one year 46 patients (31%) responded. Although there were significant improvements in scores from pre-operatively to one year, with all patients being discharged from outpatient follow-up, there was a substantial level of subjective symptomatology. Most notable was the level of anxiety and depression, which were present in 30% of the sample at both time points. Health-care professionals tend to underestimate the long-term effects of maxillofacial trauma. To improve patient care, greater appreciation of these problems is required at the time of initial management.
Infiltrating lipomatosis of the face has been described as a congenital disorder in which mature lipocytes invade adjacent tissues in the facial region. The presentation is always unilateral with hypertrophy of hard and soft structures on the affected side of the face. We present a case of a 27-year-old female who reported with a complaint of recurrent unilateral facial swelling with history of two previous resections, the histopathology or details of these surgeries were not available. The patient underwent resection of tumour and the histopathology confirmed it to be infiltrating lipomatosis. The surgery resulted in a definite improvement in the facial asymmetry and the patient is being closely followed up with no evidence of recurrence. The pathogenesis of the condition is unclear, though it has been postulated that the condition is at one end of a spectrum of overgrowth syndromes with classic Proteus syndrome on the other extreme. Management of this condition involves resection of the tumour which in most cases is subtotal to reduce the risk of damage to facial nerve. There is a controversy regarding both timing and extent of resection in the literature and we think the subtotal resection of tumour in an adolescent or older patient can give good aesthetic outcome without compromising facial nerve function. However, the patients should be informed about high rate of recurrence and increase risk of complications with any subsequent surgery.
Myiasis-the feeding of fly larvae on living mammals, may have various clinical presentations depending on the tissues or organs involved. Myiasis is a common travel associated skin disorder as a consequence of short visits to developing countries. It is the fourth most common travel associated disease. The most common clinical manifestations of fly larvae infestation include inflammatory and allergic reactions. Ear, eye and respiratory tract infestations are not uncommon and the human botfly Dermatobia hominis is the most recognised causative organism. We present an unusual case report of a myiasis in the upper lip of a patient admitted under the maxillofacial team at South Manchester Hospital.
A retrospective five-year review of upper labial frenectomies in a hospital in the east of England. AIMS Determine how many patients underwent surgery; indications for surgery; assess awareness of practitioners to local guidelines; compare the results to set standards and recommend change to our practice. METHOD A sample of 41 patients has been reviewed, ranging between 3–48 years old. Female-to-male ratio is 4:1. Children aged 11 years or under represented 20% of the sample. RESULTS The rationale for upper labial frenectomy was varied, possibly owing to a lack of consensus among practitioners regarding the timing of frenectomy. The majority of patients (73%) were between 12–16 years old, of whom 81% were females. 59% of patients were referred for orthodontic reasons and 78% of these had an orthodontic opinion. 88% of referring practitioners were not aware of any guidelines for upper labial frenectomy. CONCLUSIONS National guidelines based on a consensus view will streamline the referral pattern.
Errors in surface code have typically been decoded by Minimum Weight Perfect Matching (MWPM) based method. Recently, neural-network-based Machine Learning (ML) techniques have been employed for this purpose. Here we propose a two-level (low and high) ML-based decoding scheme, where the first level corrects errors on physical qubits and the second one corrects any existing logical errors, for different noise models. Our results show that our proposed decoding method achieves ∼ 10× and ∼ 2× higher values of pseudo-threshold and threshold respectively, than for MWPM. We show that usage of more sophisticated ML models with higher training/testing time, do not provide significant improvement in the decoder performance. Finally, data generation for training the ML decoder requires significant overhead hence lower volume of training data is desirable. We have shown that our decoder maintains a good performance with the train-test-ratio as low as 40 : 60.
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