Oral and maxillofacial surgery (OMFS or OMS) specializes in surgery of the face, mouth, and jaws. Oral and Maxillofacial Surgery is an internationally recognized surgical specialty. Consultants in oral and maxillofacial Surgery (OMFS) deal with the diagnosis and treatment of patients with diseases affecting the mouth, jaws, face and neck.
Oral and maxillofacial surgeons work with patients of all ages from newborn babies to elderly people. They treat children who are born with or develop deformities of their skull or face including cleft lip/palate. Much of their work with young adults involves surgery following an injury or accident. In the older population they often treat oral cancer and skin tumors of the face and head.
Common to all surgical specialties, OMFS procedures range from the relatively minor through to complex major surgery. The more straight-forward procedures include dento-alveolar surgery which is the surgical treatment of disorders of the teeth and their supporting hard and soft tissues. For example, a dentist may refer a patient with impacted wisdom teeth to an OMFS consultant.
Alternatively, a general medical practitioner might refer a patient with a basal cell carcinoma on their nose. These conditions may be treated via the outpatient clinic without the need for general anesthesia. Instead a local anesthetic perhaps with conscious sedation is used.
Major complex surgery in OMFS is exciting, and often collaborative. It includes:
- craniofacial surgery for congenital problems
- cancer and injuries involving the skull base (working with neurosurgeons)
- facial surgery for cancer (working with oncologists, ENT surgeons, and dental specialists)
- skin cancer surgery (working with dermatologists)
- Procedures undertaken by oral and maxillofacial surgeons include:
surgical treatment of facial injuries – complex craniofacial fractures, fractures of the lower jaw, upper jaw, cheekbone, nose, and orbit (sometimes all of these together) and soft tissue injuries of the mouth, face and neck:
- removal of head and neck benign and malignant tumors
- reconstructive surgery – including micro-vascular free tissue transfer
- removal of impacted teeth and complex buried dental roots
- removal of jaw tumors and cysts
- cosmetic surgery such as face lifts, eyelid and brow surgery and correction and reconstruction of the nose (rhinoplasty)
- temporomandibular (jaw) joint surgery
- salivary gland surgery – for benign and malignant lesions
- surgical treatment of cleft lip and palate and other congenital facial deformities
- surgery of skin lesions of the head and neck
A) Dentoalveolar surgery: Dentoalveolar surgery is surgery of the tooth-bearing part of the jaws, including impacted teeth, complex tooth extractions, cysts and lesions of the oral mucous membranes.
B) Oral medicine: Ulcers, infections and diseases of the mouth. The diagnosis and medical treatment of a wide range of conditions of the oral mucosa is carried out in the department.
C) Orthognathic surgery / facial deformity: This involves surgically moving the jaws and correction of anomalies of the face and mouth. Treatment planning is carried out in conjunction with our orthodontic colleagues, who prepare the dental arches prior to surgery. Craniofacial deformity, cleft lip and palate and post traumatic deformities are managed in a multidisciplinary environment.
E) Trauma: The treatment of facial fractures including orbital fractures, lacerations, craniofacial trauma and post traumatic deformity.
F) Oral and facial cancers: There is a multidisciplinary approach to head and neck cancer according to NICE guidance. Combined clinics are held with Maxillofacial Surgery, ENT Surgery, Radiotherapy, Radiology, Histopathology and MacMillan Nurse input. Following assessment and treatment planning, patients are treated as appropriate. Radiotherapy +/- chemotherapy is provided where indicated.
G) Treatment of neck lumps
H) Salivary gland diseases: Salivary gland obstruction (stones/strictures), inflammatory diseases, mucoceles/ranulas, benign and malignant tumors, parotid surgery and ‘minimally invasive techniques’ are provided.
I) Facial pain: A service for the diagnosis and treatment of facial pain is provided.
J) Jaw joint disorders: Treatment, including surgery for disorders of the temporomandibular (TM) joints. Most patients are seen on an outpatient basis in the Maxillofacial Unit, but surgery under general anesthesia is sometimes required.
K) Secondary cleft lip and palate deformities: Management of cleft lip and palate patients follows the established international protocol. Primary cleft treatment is performed by the plastic surgeon. Secondary bone-grafting of the cleft and subsequent orthognathic surgery is performed by the maxillofacial team.
L) Medically compromised patients: The management of medically compromised patients requiring dental surgery is an expanding area, with the increase in long-term management of cardiac patients (e.g. patients on anticoagulants), transplants and immuno-compromised patients.