Oral surgery Health Dictionary

Relating to the mouth. The area with the mouth opening.... oral

See MINIMALLY INVASIVE SURGERY (MIS).... keyhole surgery

See RECONSTRUCTIVE (PLASTIC) SURGERY.... plastic surgery

That branch of medicine involved in the treatment of injuries, deformities or individual diseases by operation or manipulation. It incorporates: general surgery; specialised techniques such as CRYOSURGERY, MICROSURGERY, MINIMALLY INVASIVE SURGERY (MIS), or minimal access (keyhole) surgery, and stereotactic sugery (see STEREOTAXIS); and surgery associated with the main specialties, especially cardiothoracic surgery, gastroenterology, GYNAECOLOGY, NEUROLOGY, OBSTETRICS, ONCOLOGY, OPHTHALMOLOGY, ORTHOPAEDICS, TRANSPLANTATION surgery, RECONSTRUCTIVE (PLASTIC) SURGERY, and UROLOGY. Remotely controlled surgery using televisual and robotic techniques is also being developed.

It takes up to 15 years to train a surgeon from the time at which he or she enters medical school; after graduating as a doctor a surgeon has to pass a comprehensive two-stage examination to become a fellow of one of the ?ve recognised colleges of surgeons in the UK and Ireland.

Surgery is carried out in specially designed operating theatres. Whereas it used to necessitate days and sometimes weeks of inpatient hospital care, many patients are now treated as day patients, often under local anaesthesia, being admitted in the morning and discharged later in the day.

More complex surgery, such as transplantation and neurosurgery, usually necessitates patients being nursed post-operatively in high-dependency units (see INTENSIVE THERAPY UNIT (ITU)) before being transferred to ordinary recovery wards. Successful surgery requires close co-operation between surgeons, physicians and radiologists as well as anaesthetists (see ANAESTHESIA), whose sophisticated techniques enable surgeons to undertake long and complex operations that were unthinkable 30 or more years ago. Surgical treatment of cancers is usually done in collaboration with oncologists. Successful surgery is also dependent on the skills of supporting sta? comprising nurses and operating-theatre technicians and the availability of up-to-date facilities.... surgery

Surgery done in a clinic or a hospital without an overnight stay either before or after the operation. Improvements in surgery – especially the introduction of MINIMALLY INVASIVE SURGERY (MIS) – as well as more e?ective methods of ANAESTHESIA have simpli?ed many procedures and reduced the physical and mental stress on patients. Patients undergoing day surgery should be accompanied home by a friend or relative. Occasionally a patient may develop complications that require a post-operative stay in hospital.... day surgery

Open-heart surgery permits the treatment of many previously inoperable conditions that were potentially fatal, or which made the patient chronically disabled. CORONARY ARTERY VEIN BYPASS GRAFTING (CAVBG), used to remedy obstruction of the arteries supplying the heart muscle, was ?rst carried out in the mid1960s and is now widely practised. Constricted heart valves today are routinely dilated by techniques of MINIMALLY INVASIVE SURGERY (MIS), such as ANGIOPLASTY and laser treatment, and faulty valves can be replaced with mechanical alternatives (see VALVULOPLASTY).

Heart transplant Replacement of a person’s unhealthy heart with a normal heart from a healthy donor. The donor’s heart needs to be removed immediately after death and kept chilled in saline before rapid transport to the recipient. Heart transplants are technically demanding operations used to treat patients with progressive untreatable heart disease but whose other body systems are in good shape. They usually have advanced coronary artery disease and damaged heart muscle (CARDIOMYOPATHY). Apart from the technical diffculties of the operation, preventing rejection of the transplanted heart by the recipient’s immune system requires complex drug treatment. But once the patient has passed the immediate postoperative phase, the chances of ?ve-year survival is as high as 80 per cent in some cardiac centres. A key di?culty in doing heart transplants is a serious shortage of donor organs.... heart surgery

A contraceptive taken by mouth (see CONTRACEPTION). It comprises one or more synthetic female hormones, usually an oestrogen (see OESTROGENS), which blocks normal OVULATION, and a progestogen which in?uences the PITUITARY GLAND and thus blocks normal control of the woman’s menstrual cycle (see MENSTRUATION). Progestogens also make the uterus less congenial for the fertilisation of an ovum by the sperm.... oral contraceptive

An operation to remove a cancer, plus adjacent tissue and lymph nodes.... radical surgery

Surgery using a rigid endoscope passed into the body through a small incision. Further small openings are made for surgical instruments so that the operation can be performed without a long surgical incision. Minimally invasive surgery may be used for many operations in the abdomen (see laparoscopy), including appendicectomy, cholecystectomy, hernia repair, and many gynaecological procedures. Knee operations (see arthroscopy) are also often performed by minimally invasive surgery.... minimally invasive surgery

See rehydration therapy.... oral rehydration therapy

An operation to correct deformity of the jaw and the severe malocclusion that is invariably associated with it. The bones of the jaw are repositioned under general anaesthesia, and often require splinting (see splinting, dental) until they heal.... orthognathic surgery

More popularly called ‘keyhole surgery’, MIS is surgical intervention, whether diagnostic or curative, that causes patients the least possible physical trauma. It has revolutionised surgery, growing from a technique used by gynaecologists, urologists and innovative general surgeons to one regularly used in general surgery, GYNAECOLOGY, UROLOGY, thoracic surgery, orthopaedic surgery (see ORTHOPAEDICS) and OTORHINOLARYNGOLOGY.

MIS is commonly carried out by means of an operating laparoscope (a type of ENDOSCOPE) that is slipped through a small incision in the skin. MIS now accounts for around 50 per cent

of all operations carried out in the UK. A small attachment on the end of the laparoscope provides an image that can be magni?ed on a screen, leaving the surgeon’s hands free to operate while his assistant operates the laparoscope. Halogen bulbs, ?breoptic cables and rod lenses have all contributed to the technical advancement of laparoscopes. Operations done in this manner include extracorporeal shock-wave LITHOTRIPSY for stones in the gall-bladder, biliary ducts and urinary system; removal of the gall-bladder; appendicectomy; removal of the spleen and adrenal glands; and thoracic sympathectomy. MIS is also used to remove cartilage or loose pieces of bone in the knee-joint.

This method of surgery usually means that patients can be treated on a day or overnight basis, allowing them to resume normal activities more quickly than with conventional surgery. It is safer and lessens the trauma and shock for patients needing surgery. MIS is also more cost e?ective, allowing hospitals to treat more patients in a year. Surgeons undertake special training in the use of MIS, a highly skilled technique, before they are permitted to use the procedures on patients. The use of MIS for hernia repair, colon surgery and repairs of duodenal perforations is under evaluation and its advantages will be enhanced by the development of robotic surgical techniques.... minimally invasive surgery (mis)

Perform surgery to the mouth and face. This not only includes removal of buried teeth but also treatment for fractured facial bones, removal of cancers and the repair of missing tissue, and the cosmetic restoration of facial anomalies such as CLEFT PALATE or large or small jaws.... oral and maxillo-facial surgeons

The optimal state of the mouth and normal functioning of the organs of the mouth without evidence of disease.... oral health

This is the essential initial treatment for DIARRHOEA, and is particularly valuable for dehydrated children in developing countries ill with diseases such as CHOLERA. A litre of water containing one teaspoonful of salt and eight of sugar, taken by mouth, is readily absorbed. It replaces salts and water lost because of the diarrhoea and usually no other treatment is required.

In developed countries ORT is useful in treating gastroenteritis. There are a number of proprietary preparations, often dispensed as ?avoured sachets, including Dioralyte® and Rehydrate®.... oral rehydration therapy (ort)

Giving a remedy by mouth. Such a route leads to its passage through the mucous membrane lining the intestines and from there into the bloodstream. ... oral administration

An operation to repair arteries that are narrowed, blocked, or weakened. Arterial reconstructive surgery is most often performed to repair arteries that have been narrowed by atherosclerosis. It is also used to repair aneurysms and arteries damaged as a result of injury. (See also angioplasty, balloon; coronary artery bypass; endarterectomy.)... arterial reconstructive surgery

Reconstructive surgery on the skin and underlying tissues that have been damaged or lost as a result of disease or injury. Congenital malformations are also remedied using reconstructive surgery. Surgeons graft healthy skin from another part of the body to repair skin damaged or destroyed by burns or injuries. New techniques are under development for growing new skin in the laboratory to be used in reconstructive surgery. Surgeons also repair damage using skin ?aps prepared in another part of the body – for example, a skin ?ap from the arm may be used to repair a badly injured nose or face. Reconstructive surgery is also used to repair the consequences of an operation for cancer of, say, the neck or the jaw. Plastic surgeons undertake cosmetic surgery to improve the appearance of noses, breasts, abdomens and faces.... reconstructive (plastic) surgery

Surgery performed to remove excess fat, skin, or both, from various parts of the body, especially the abdomen, thighs, and buttocks. Abdominal wall reduction, also known as abdominoplasty, involves removing excess skin and fat from the abdomen. With all of these procedures there is a risk of complications, and the wound may become infected.

In suction lipectomy (liposuction), a rigid hollow tube is inserted through a small skin incision and use to break up large areas of fat, which can then be sucked out through the instrument.

Minor irregularities and dimpling of the skin commonly occur after surgery.... body contour surgery

A type of mammoplasty.... breast enlargement surgery

The branch of surgery concerned with the heart and blood vessels.

Cardiovascular surgery includes operations to prevent or repair damage caused, for example, by congenital heart disease (see heart disease, congenital), atherosclerosis, or a myocardial infarction (heart attack).

Procedures include heart valve surgery, coronary artery bypass, and heart transplant.... cardiovascular surgery

Removal of the lens from the eye, performed to restore sight in people whose vision is impaired by a cataract. The lens is usually replaced with a plastic implant during the operation, although for young people and those with other eye disorders, a contact or spectacle lens fitted after the operation may be preferable.... cataract surgery

An operation performed to improve appearance rather than to cure or treat disease.

Cosmetic surgery techniques include the removal of skin blemishes or dermabrasion; rhinoplasty to alter the shape or size of the nose; face-lifts; mammoplasty to reduce or enlarge the breasts; body contour surgery to remove excess body fat and tissue; hair transplants; blepharoplasty to remove excess skin on the eyelids; and mentoplasty to alter the size or shape of the chin.

All cosmetic surgery carries the risk of side effects from the anaesthetic, as well as of complications of the procedure itself.... cosmetic surgery

See otorhinolaryngology.... ear, nose, and throat surgery

See otorhinolaryngology.... ent surgery

Any operation that is carried out to investigate or examine part of the body to discover the extent of known disease or to establish a diagnosis. Advances in imaging techniques, such as MRI, have reduced the need for exploratory surgery.... exploratory surgery

See blepharoplasty.... eyelid surgery

See oral hygiene.... hygiene, oral

A group of antidiabetic drugs that are used to lower blood glucose.

Too high a dose may provoke the onset of hypoglycaemia.... hypoglycaemics, oral

See minimally invasive surgery.... minimal access surgery

An operation to correct a heart valve defect or to remove a diseased or damaged valve. A heart valve may have to be repaired, widened, or replaced because it is either incompetent (leaky) or stenotic (narrowed). Widening of a valve may involve valvotomy or valvuloplasty. A damaged valve can be replaced by a mechanical one (fashioned from metal and plastic), a valve constructed from human tissue, a pig valve, or a valve taken from a human donor after death. A heart–lung machine is used during replacement.After heart-valve surgery, symptoms such as breathlessness may take weeks to improve and require medication to be continued. Some people need longterm treatment with anticoagulant drugs to prevent the formation of blood clots around the new valve.... heart-valve surgery

Any operation on the heart in which it is stopped temporarily and its function taken over by a mechanical pump. The main forms of open heart surgery are correction of congenital heart defects (see heart disease, congenital), surgery for narrowed or leaky heart valves (see heart-valve surgery), and coronary artery bypass surgery. Once the pump is connected, the heart is opened, and the defects repaired. Surgical hypothermia is used to keep the heart cool and help prevent damage to the heart muscle from lack of oxygen (see hypothermia, surgical).... open heart surgery

A group of oral drug preparations containing one or more synthetic female sex hormones, taken by women in a monthly cycle to prevent pregnancy. “The pill” commonly refers to the combined or the phased pill, which both contain an oestrogen drug and a progestogen drug, and the minipill, which contains only a progestogen. Oestrogen pills include ethinylestradiol; progestogens include levonorgestrel and norethisterone. When used correctly, the number of pregnancies among women using oral contraceptives for one year is less than 1 per cent. Actual failure rates may be 4 times higher, particularly for the minipill, which has to be taken at precisely the same time each day.

Combined and phased pills increase oestrogen and progesterone levels. This interferes with the production of two hormones, luteinizing hormone (LH) and follicle-stimulating hormone (FSH), which in turn prevents ovulation. The minipill works mainly by making the mucus lining of the cervix too thick to be penetrated by sperm.

Oestrogen-containing pills offer protection against uterine and ovarian cancer, ovarian cysts, endometriosis, and irondeficiency anaemia. They also tend to make menstrual periods regular, lighter, and relatively pain-free. Possible side effects include nausea, weight gain, depression, swollen breasts, reduced sex drive, increased appetite, leg and abdominal cramps, headaches, and dizziness. More seriously, there is a risk of thrombosis causing a stroke or a pulmonary embolism. These pills may also aggravate heart disease or cause hypertension, gallstones, jaundice, and, very rarely, liver cancer. All oral contraceptives can cause bleeding between periods, especially the minipill. Other possible adverse effects of the minipill include irregular periods, ectopic pregnancy, and ovarian cysts. There may be a slightly increased long-term risk of breast cancer for women taking the combined pill.

Oestrogen-based pills should generally be avoided in women with hypertension, hyperlipidaemia, liver disease, migraine, otosclerosis, or who are at increased risk of a thrombosis. They are not usually prescribed to a woman with a personal or family history of heart or circulatory disorders, or who suffers from unexplained vaginal bleeding. The minipill or a lowoestrogen pill may be used by women who should avoid oestrogens. Combined or phased pills may interfere with milk production and should not be taken during breast-feeding. Certain drugs may impair the effectiveness of oral contraceptives. (See also contraception.) ... oral contraceptives

Measures to keep the mouth and teeth clean and reduce the risk of tooth decay (see caries, dental), gingivitis and other gum disorders, and halitosis. Oral hygiene includes regular, thorough toothbrushing and flossing (see floss, dental) to remove plaque. Disclosing agents help to reveal build-up of plaque. Dentures are brushed on all surfaces and soaked in cleansing solution.

Professional treatment to remove calculus and stubborn plaque by scaling and polishing is usually carried out by a dentist or dental hygienist during a routine check-up.

In periodontal disease, treatment may be needed more often.... oral hygiene

See arterial reconstructive surgery; plastic surgery.... reconstructive surgery

See rehydration therapy.... rehydration, oral

Brain operations carried out by inserting delicate instruments through a surgically created hole in the skull and guiding them, with the aid of CT scanning, to a specific area.

Stereotaxic procedures can be used to treat pituitary tumours; for a brain biopsy; or to destroy small areas of the brain to treat disabling neurological disorders.... stereotaxic surgery

A surgical speciality concerned with operations on organs within the chest cavity. Sometimes, thoracic surgery is combined with heart surgery, in which case it is known as cardiothoracic surgery.... thoracic surgery

Replacement of a diseased organ or tissue with a healthy, living substitute. The organ is usually taken from a person who has just died. Some kidneys are transplanted from a patient’s living relatives (see organ donation). The results of surgery have also been improved by testing for histocompatibility antigens and tissue-typing.

Rejection is a major problem. However, a combination of a corticosteroid drug and ciclosporin are given in order to suppress this response.

Every patient who undergoes an organ transplant operation must take immunosuppressant drugs indefinitely. (See also heart transplant; heart–lung transplant; liver transplant; kidney transplant.)... transplant surgery

See traumatology.... trauma surgery

surgery performed for the purpose of weight loss in obese patients. Most procedures are restrictive, being designed to promote feelings of fullness and satiety after meals (see gastric banding; stomach stapling). See also gastric bypass surgery; jaw wiring.... bariatric surgery

(image-guided surgery, surgical navigation) a technique by which a virtual image or map of the patient is created from CT scans, MRI scans, X-rays, or ultrasound scans and loaded into a computer. Special instruments connected to the computer are then applied to certain reference points on the patient. The computer can then produce a picture of the location of the instrument within the patient.... computer-assisted surgery

surgical procedures that can be performed in a single day, without the need to admit the patient for an overnight stay in hospital. Modern techniques of surgery and anaesthesia now enable many surgical cases of minor and intermediate degrees of severity to be treated in this way: examples include many breast lesions, dilatation and curettage, and operations for hernia and varicose veins. Special units are established in many hospitals.... day-case surgery

(DOAC) a relatively recently introduced class of drugs that reduce coagulation of the blood by inhibition of one of the coagulation factors (Factor Xa). They may be used as an alternative to *warfarin in many (but not all) cases, their advantage being that regular blood tests are not required for dose adjustment. Examples include, apixaban, dabigatran, edoxaban, and rivaroxaban.... direct oral anticoagulant

(ESS) surgery of the *paranasal sinuses using endoscopes. Functional endoscopic sinus surgery (FESS) clears inflamed tissue from routes of sinus drainage and aeration to allow the other sinuses to return to normal.... endoscopic sinus surgery

(FGCS) surgery to alter the size or shape of the *vulva and/or vagina when these are a cause of significant distress or sexual dysfunction. FGCS includes labioplasty (reduction or alteration of the labia), clitoral hood reduction (excision of excess skin in the fold surrounding the clitoris), and hymenoplasty (partial or complete reconstruction of the hymen).... female genital cosmetic surgery

(FESS) see endoscopic sinus surgery.... functional endoscopic sinus surgery

any of several procedures of *bariatric surgery that allow food to bypass parts of the gut in order to reduce absorption of nutrients and calories. Such operations often lead to greater weight loss than restrictive procedures, such as *gastric banding and *stomach stapling, but there are significant long-term complications relating to chronic malabsorption and patients must remain under long-term specialist follow-up.... gastric bypass surgery

see computer-assisted surgery.... image-guided surgery

a surgical technique used for removing primarily high-risk nonmelanoma skin cancers, particularly basal cell carcinoma. The technique allows the surgeon to see beyond the visible tumour as the specimen is removed and the histology checked in stages. At each stage, if the tumour involves the margins, further tissue is resected until they are clear. There is an extremely high cure rate. [F. E. Mohs (1910–2002), US surgeon]... mohs’ micrographic surgery

the mouth.... oral cavity

(oral antihyperglycaemic drug) one of the group of drugs that reduce the level of glucose in the blood and are taken by mouth for the treatment of type 2 *diabetes mellitus. They include the *sulphonylurea group (e.g. glibenclamide, gliclazide), metformin (a *biguanide), *alpha-glucosidase inhibitors, *meglitinides, *thiazolidinediones, *DPP-IV inhibitors, and *SGLT-2 inhibitors.... oral hypoglycaemic drug

see stomatology.... oral medicine

the procedure of rebuilding a dentition that has been mutilated as a result of disease, wear, or trauma.... oral rehabilitation

any surgical procedure that has as its primary objective the correction of any refractive error. It includes such procedures as clear lens extraction, *LASIK, *LASEK, and photorefractive *keratectomy.... refractive surgery

a type of laparoscopic surgery in which the operating surgeon controls the instruments via a robot. The surgeon sits at a console away from the patient and controls the robot’s operating arms.... robotic surgery

(TORS) a form of robot-assisted surgery used for treating difficult-to-access tumours of the pharynx and larynx.... trans-oral robotic surgery