A recent Oral & Maxillofacial Surgery digest,
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Study Type: Systematic review (COSMIN methodology) of PROM measurement properties.

Key Question: Which patient-reported outcome measures used after third molar surgery have robust, well-validated measurement properties suitable for clinical or research use?

Key Findings:

• 18 studies identified, describing 13 distinct PROMs, most designed for general (non-specific) use rather than third molar surgery specifically.
• Only 4 PROMs achieved "category A" status (very good content validity) per COSMIN criteria.
• Measurement properties were inconsistently assessed and often incompletely reported across studies, limiting comparability.

Clinical Relevance: UK OMFS units increasingly need validated PROMs to demonstrate patient-centred outcomes for third molar surgery (e.g., for NHS commissioning, audit, and consent discussions), but current instrument choice should be guided cautiously given limited validation evidence.

Limitations: Substantial heterogeneity in study methods and outcome reporting precluded meta-analysis and limits confidence in ranking PROMs, as overall certainty of evidence was low.

Study Type: Technical note (descriptive report of a surgical technique; not original clinical research)

Key Question: How can virtual surgical planning (VSP) be used to correct for the triangulation-related measurement error affecting intraoperative maxillary vertical positioning during splint-based orthognathic surgery?

Key Findings:

• Large anteroposterior maxillary movements distort standard medial canthus–incisor caliper measurements due to a triangulation effect, reducing vertical positioning accuracy.
• The authors propose measuring the medial canthus–incisor distance on identical landmarks pre- and post-movement in VSP, then using the calculated difference as the intraoperative caliper target.
• No clinical or cadaveric validation data, case outcomes, or accuracy metrics are reported.

Clinical Relevance: Offers UK OMFS units a low-cost, VSP-integrated workflow to improve translation of planned vertical maxillary movements into theatre, potentially reducing postoperative vertical malposition without additional intraoperative navigation equipment.

Limitations: This is a conceptual/technical description without clinical validation, so accuracy and reproducibility of the method remain unproven.

Study Type: Cadaveric anatomical study (gross dissection and histology)

Key Question: Are the depressor septi nasi, incisivus labii superioris, nasalis, and orbicularis oris anatomically discrete muscles, and how does their true relationship explain nasal changes after Le Fort I osteotomy?

Key Findings:

• Across 38 sides from 19 cadavers, gross and histological analysis showed continuous, multilayered muscle architecture rather than separate, discrete muscles.
• The orbicularis oris superior fibres extended into the philtral dermis/medial crus without direct septal cartilage attachment.
• The incisivus labii superioris arose from the anterior maxilla, blending inferiorly with orbicularis oris and superiorly with the alar/transverse nasalis, with no clear intermuscular borders—forming a single "incisive muscle–orbicularis oris" complex with depressor septi nasi and nasalis.

Clinical Relevance: This refined muscular anatomy helps explain postoperative alar base widening, nasal tip depression, and philtral changes after Le Fort I osteotomy, informing muscle-preserving closure techniques to improve aesthetic outcomes in UK orthognathic practice.

Limitations: Findings are based on formalin-fixed cadaveric specimens, which may not fully reflect in vivo muscle behaviour or dynamic postoperative soft-tissue changes.

Study Type: Retrospective case series (n=106)

Key Question: What are the clinicopathological features, optimal surgical approaches, and outcomes for primary parapharyngeal space (PPS) tumours?

Key Findings:

• Salivary gland tumours (45.3%) and neurogenic tumours (42.5%) were the predominant histological types; malignancy was present in only 9.4% of cases.
• The transcervical-transparotid approach was used most frequently (50.9%), with vertical ramus osteotomy reserved for larger/deeper tumours to improve exposure with minimal added morbidity.
• Surgical resection achieved low recurrence and mortality rates overall, supporting its role as first-line management.

Clinical Relevance: Provides UK OMFS teams with a large single-centre dataset supporting individualised approach selection (based on size, location, vascular proximity, malignancy risk) for these technically demanding, low-incidence tumours often managed in tertiary head and neck MDT settings.

Limitations: Single-centre retrospective design without comparative outcome data (e.g., cranial nerve morbidity rates by approach) limits generalisability and strength of approach-specific conclusions.

Study Type: International cross-sectional survey

Key Question: How much variation exists internationally in perioperative management of primary cleft palatoplasty?

Key Findings:

• 72/297 (24.2%) surgeons responded; mean age at repair was ~10.8–10.9 months for hard and soft palate closure.
• Significant regional variation was found in timing of surgery, duration of antibiotic prophylaxis (P = 0.024), postoperative feeding protocols (P < 0.05), and inpatient stay length (P < 0.001).
• A trend was identified away from prolonged postoperative antibiotics towards short-course or single-shot prophylaxis.

Clinical Relevance: Highlights the lack of standardised perioperative protocols in cleft surgery internationally, relevant to UK cleft networks (e.g., CSAG-aligned MDT centres) considering antimicrobial stewardship and enhanced recovery pathways in paediatric palatoplasty.

Limitations: Low response rate (24.2%) and self-reported survey data limit generalisability and risk selection/recall bias.

Study Type: Case report (technical description of a novel surgical approach)

Key Question: Can a fully remote-access, subclavicular robotic technique (MiRA pneumoneck) safely achieve lateral neck dissection without visible cervical scarring?

Key Findings:

• In one patient with floor-of-mouth squamous cell carcinoma, robotic selective neck dissection (levels I–III) was completed via four subclavicular ports using CO2 insufflation and the Da Vinci Xi system, with major neurovascular structures preserved.
• Postoperative course was uneventful, with early mobilisation and discharge on day 4, no major complications reported.
• The Asson assistant port system maintained pneumoneck stability and reduced gas leakage, facilitating instrument use.

Clinical Relevance: This early proof-of-concept technique may offer UK OMFS units an avenue toward scarless robotic neck dissection, relevant as robotic head and neck surgery services expand within selected NHS tertiary centres.

Limitations: Findings are based on a single case, with no data yet on oncologic safety, reproducibility, or long-term outcomes.

Study Type: Pilot validation study (prospective cohort, n=10)

Key Question: How accurately do patient-specific cutting guides, PSI chin plates, and β-TCP gap implants reproduce the virtually planned genioplasty position?

Key Findings:

• Translational deviations of the bony chin, PSI plate, and β-TCP gap-PSI were all <0.5 mm across anteroposterior, vertical, and lateral directions.
• Rotational deviations were <1° for pitch, yaw, and roll, except β-TCP gap-PSI pitch (1.7°).
• Measurement reproducibility between observers/sessions was moderate to excellent (intraclass correlation coefficients).

Clinical Relevance: Supports the feasibility of fully digital, patient-specific genioplasty workflows using β-TCP spacers as an alternative to titanium plates/autologous grafts, relevant to UK units adopting virtual surgical planning and 3D-printed guides for orthognathic care.

Limitations: Small sample size (n=10) with short-term (4-week) follow-up, precluding assessment of long-term β-TCP graft integration and clinical outcomes.

Study Type: Narrative review

Key Question: How can cell lines, patient-derived organoids, and in vivo transplantation models be integrated into a stepwise preclinical framework for OSCC translational research?

Key Findings:

• Cell lines offer reproducible, low-cost platforms for mechanistic studies and initial drug screening but poorly capture tumour heterogeneity.
• Patient-derived organoids better preserve tumour heterogeneity and enable patient-specific drug response testing.
• Orthotopic in vivo models reproduce local invasion, metastasis, and tumour microenvironment interactions; integrating AI-based imaging and multi-omics may enhance translational value across all platforms.

Clinical Relevance: A structured stepwise preclinical pipeline could accelerate development of more effective, personalised drug therapies for OSCC, a disease with persistently poor outcomes despite optimal surgical and adjuvant management in UK OMFS practice.

Limitations: As a narrative (non-systematic) review, it lacks standardised methodology and quantitative synthesis, limiting the strength of its conclusions.