Research Articles (Maxillo-Facial & Oral Surgery)
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Item Solitary fibrous tumour of the parapharyngeal space – a case report(Elsevier, 2025) Melariri,H; Opperman, Johan; Mukhtar, AWe present a case of a female patient with solitary fibrous tumour (SFT) originating in the parapharyngeal space which was successfully resected using an open transoral approach. The patient presented with a worsening airway obstruction, obstructive sleep apnoea, and dysphagia for three years. Rhinolaryngoscopy revealed a right nasopharynx and oropharynx lateral pharyngeal wall submucosal mass. Histopathological analysis was consistent with an SFT. This uncommon site of a rare tumour often presents diagnostic challenges or leads to overt misdiagnosis. We interrogated the literature in respect of the diagnostic and therapeutic approaches for this rare condition.Item Cemento-osseous dysplasia: a multi-centre analysis of surgical management(Springer Science and Business Media Deutschland GmbH, 2025) Titinchi, Fadi; Alturki, Naser; Morkel, JeanPurpose: Cemento-osseous dysplasia (COD) is a fibro-osseous lesion whose management is highly controversial in the literature. Due to scarcity of comprehensive studies on its management, the aim of this study was to analyse its management and develop a treatment protocol. Methods: A multi-centre retrospective cohort analysis was conducted at two tertiary referral hospitals on 124 patients diagnosed with COD from 2005 to 2023. Demographic, clinical, and radiological data were analysed and correlated with treatment methods. Post-operative complications such as osteomyelitis or pathological fracture were documented along with follow-up visits to evaluate the need for further treatment. Data was analysed using Student’s t-test and Fisher’s exact test. Statistical significance was set at P < 0.05. Results: The patients’ ages ranged from 22 to 78 years (mean: 48.5 years), with majority being females (90.4%) and of African descent (95.9%). Radiopaque CODs presented significantly higher rate of symptoms compared to radiolucent or mixed lesions (p = 0.02). The majority of incidental CODs were managed through observation (72%), while six incidental CODs underwent biopsy due to suspicion of more sinister lesions. Symptomatic lesions were mainly treated by curettage (29.7%) or local excision (48.6%), while only one symptomatic case was managed with observation and antibiotics (p = 0.0001). Conclusion: Biopsy of asymptomatic COD should only be reserved for cases with inconclusive clinico-pathological features. The decision to surgically treat COD should be based on the presence of symptoms and infection. Early curettage or excision of infected COD is the most effective approach to eradicate the disease and prevent progression into osteomyelitis. Clinical trial number: : Not applicable.Item Exodontia block course evaluation: a review of the learning outcomes, content, and assessment practices at a dental faculty in South Africa(John Wiley and Sons Inc, 2025) Behardien, Nashreen; Brijlal, Priscilla; Roman, Nicolette VanessaIntroduction: Regular curriculum renewal ensures relevant and responsive curricula. Skills development courses, such as for dental extraction procedures, require the same rigorous review, as this skill demands both technical proficiencies and a high level of cognition. In South Africa, the high burden of dental disease, in particular pain and sepsis, relies on competent graduate exodontia (tooth extraction) abilities. However, research on evidence-based instruction in this field is limited. This action research study emanated from the goal of enhancing the Exodontia Block Course by integrating a teaching and learning strategy proven to develop psychomotor skills. The first step in the broader research study involved evaluating the traditional course. This study thus aimed to evaluate a traditional exodontia block course, gaining insight into its curricular components prior to redesigning it. Materials and Methods: An interpretive qualitative study employed appreciative inquiry for data collection. A purposive sampling strategy was employed. Six focus group discussions were conducted with homogeneous groups of undergraduate dental students (n = 13), clinical teachers (n = 10), and dentist practitioners (n = 7). Audio recordings were transcribed, and data underwent coding and thematic analysis. Results: This paper presents the findings pertaining to three curricular elements, namely the objectives, content, and assessment. The larger study identified four main themes: integration of skills and knowledge, block course structure, challenges, and recommendations for improvement. The study found that overall the students were satisfied with the content presented in the course. Recommendations to improve the course, however, were to include the use of elevators as a learning outcome of the course and the inclusion of an additional practical assessment. Challenges associated with the course related to the duration of the course and the presentation of non-relevant content. The course content revealed discrepancies between the material covered and the intended learning outcomes, with students noting insufficient focus on elevator/luxator use in extractions. Concerns were raised about including non-exodontia content, including a call for standardised terminology and locally developed teaching materials. Assessment methods were largely well received, but issues emerged regarding unlimited assessment attempts potentially reducing student accountability. Suggestions included limiting assessment opportunities and incorporating OSCE formats for preclinical evaluation to enhance rigour and student learning. Conclusions: The evaluation highlighted the strengths of the course as well as areas requiring reflection and emendation. Whilst the course was adequate to meet its objectives, areas for redress included instrumentation adaptations such as the combined use of elevators and luxators in intra-alveolar (simple, or non-surgical) extractions. A call for standardised terminology, locally developed teaching materials, and a broader array of assessment types was recommended. Additionally, issues emerged regarding unlimited assessment attempts potentially reducing student accountability. The need for future initiatives that focus on developing a nationally standardised competency-based curriculum was also foregrounded. Follow-up research would be required to investigate the impact of the implementation of the revised course.Item Advanced tumour-induced osteomalacia secondary to sinonasal phosphaturic mesenchymal tumour(AOSIS (pty) Ltd, 2024) van Wijk, Monica; Opperman, Johan F.; Afrogheh, Amir H.Phosphaturic mesenchymal tumours (PMT) are rare, benign lesions and the most common tumour to cause tumour-induced osteomalacia (TIO), a paraneoplastic syndrome. Patients frequently exhibit severe osteomalacia, accompanied by multiple fractures, which significantly impair their quality of life. Complete surgical resection is curative. Contribution: A rare case of sinonasal PMT is presented, with a focus on the imaging findings and role of the radiologist and nuclear physician.Item intra-osseous maxillary myofibroma: case report and review of literature(department of maxillo-facial and oral surgery, university of the western cape, 2023) gounden t; morkel ja; mdlalose l; adam rzItem management of residual cysts of the jaws: an analysis of a large case series(department of maxillo-facial & oral surgery, university of the western cape, 2023) titinchi f; morkel jaItem Mucoepidermoid bronchial tumor in a child masqueradingas tuberculosis(SAGE Publications, 2024) Opperman, Johan; Goussard, Pierre; Gie, AndréBackground: Endobronchial primary tumors are rare in children and are difficult to diagnose, often leading to a delay in the diagnosis. In the developing world, there are other more common causes of luminal airway obstruction and tumors are not always considered. An 11-year-old HIV-negative boy presented with a fever and cough. His condition deteriorated during the next 2 days, and he needed high-flow oxygen. On examination, there were no signs of chronic lung disease, but he had reduced chest expansion on the left, was dull to percussion over the entire left side of the chest, had markedly reduced air entry on the left, and his trachea deviated to the left. The chest X-ray at the time of admission demonstrated left basal opacity with volume loss, displacement of the cardio mediastinal shadow to the left and compensatory expansion of the right lung across the midline (Figure 1A).