Magister Scientiae Dentium - MSc(Dent) / Aim To analyze the demographic profile, clinical data and radiographs of patients who had third molar surgery under general anaesthesia at the Faculty of Dentistry at the University of the Western Cape over a 10 year period. Introduction Minor oral surgical procedures are carried out by Maxillofacial and Oral Surgeons daily. The surgical removal of third molars is a large part of Minor Oral Surgery which is common throughout the world. The general impression of third molar surgery performed by experienced professionals is the ease of the operation, however no-matter how experienced one may be, a simple procedure should never be underestimated (Carvalho and Do Egito Vasconselos, 2011). New surgical techniques, as well as extensive training, skill and experience have led to the evolution of oral surgery and allowed this procedure to be carried out in a less traumatic manner. Certain factors precipitate third molar surgery to be performed in theatre as opposed to the dental clinic setting. These factors will be discussed in this research report.

Benign paroxysmal positional vertigo (BPPV) is a condition characterized by brief spinning episodes that occur with a rapid change in head position. Although considered benign, BPPV can have many personal, social, health, and financial implications. Yet, providers in a variety of settings are frequently mismanaging the condition leading to incomplete resolution of symptoms, decreased quality of life, reduced productivity, and increased healthcare spending. This study sought to better understand why providers fail to follow current evidence-based BPPV guidelines and the impact BPPV-specific education could have on improving their practices. Questionnaires assessing BPPV-specific knowledge as well as inquiring about provider barriers to following guidelines were distributed to 11 providers in a rural Colorado mountain town. A 45-minute education session was then presented to providers in order to update them on current recommendations. Following the education, similar questionnaires reassessing provider knowledge of BPPV guidelines were disseminated. Results showed an improvement in provider knowledge as evidenced by an increase in the percentage of correct response scores following the education session compared to pre-education. Additionally, providers identified difficulty in interpreting nystagmus patterns as well and remembering how to perform the various maneuvers as major barriers to guidelines adherence. Future BPPV education should focus on these two barriers to ensure better guidelines adherence. In order to evaluate long-term practice changes following the intervention, a 16-month retrospective chart analysis was performed in a small rural emergency department where three of the participating providers from the education session worked. Results from the chart analysis were inconclusive due to a scarcity of patient encounters during the post-intervention period. Future studies should be performed with a larger participation pool and longer analysis period to better evaluate the effectiveness of BPPV-specific education on improving provider practices. The ultimate goals of providing BPPV education are to promote a quicker resolution of patient’s symptoms, improve their quality of life, reduce unnecessary healthcare spending, while still allowing for appropriate provider compensation.

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Benign paroxysmal positional vertigo (BPPV), characterized by a history of brief attacks of intense positional vertigo and rotary nystagmus, results from otoconial migration into the semicircular canals, making the sensory structures in the canal gravity sensitive. Treatment methods include positioning maneuvers, which return the otoconia back into the otolith, and typically include a variety of activity limitations for the subsequent 24-48 hours. Previous studies suggest BPPV treatment can be successful without any limitations of the patient post- therapy. The purpose of this study was to determine the necessity of post-maneuver restrictions on BPPV patients treated with the Canalith Repositioning Maneuver. Twenty participants were identified as having BPPV of the posterior canal and treated with the Canalith Repositioning Maneuver. During post-maneuver instruction, the ten participants assigned to the restricted group were provided with typical instructions. Ten participants assigned to the non-restricted group were given no post-maneuver restrictions. At the one-week post-treatment follow-up, all patients were free of vertigo and/or nystagmus. Results indicated that given two groups of subjects matched for age, gender, and symptoms, post-maneuver restrictions are not necessary for successful outcome using the CRM to treat posterior-canal BPPV.

Professional research project (Au.D.)--University of South Florida, 2002. / Title from PDF of title page. / Document formatted into pages; contains 24 pages. / Includes bibliographical references. / Text (Electronic thesis) in PDF format. / ABSTRACT: The purpose of this study was to examine the prevalence of nystagmus found in healthy individuals during the positional testing subtest of the standard vestibular test battery. Positional testing involves moving the patient's head, and sometimes the entire body, into a variety of positions while observing eye movement. The hypothesis of the current study was that a relatively low percentage of participants would display nystagmus during positional testing used routinely in clinical diagnostic procedures. The findings were then compared to those of an earlier study in which 82% of normal, healthy individuals were reported to exhibit nystagmus during this testing. Twenty-five participants were selected that had no known otologic disease and who reported normal hearing sensitivity. / ABSTRACT: In addition, the participants affirmed they had not consumed any alcohol or taken any medications that are known to affect nystagmus. They were then observed in nine different positions. Forty-eight percent of the participants experienced nystagmus in at least one position. Although this percentage was considerably lower than that reported in the earlier study, methodological differences appear to account for the discrepancy. Specifically, the criterion for determining the presence/absence of nystagmus potentially explains the difference in full. / System requirements: World Wide Web browser and PDF reader. / Mode of access: World Wide Web.

Benign paroxysmal positional vertigo (BPPV) is a specific type of short-duration vertigo that is provoked by changes in head position and usually lasts less than one minute. It is a common vestibular pathology that can have significant effects on patient safety, quality of life, and medical costs. Therefore, it is crucial that medical students are educated and trained to facilitate and coordinate care of patients who may have undiagnosed BPPV. Because there is evidence to suggest that physicians—specifically primary care physicians—may not be properly equipped in their education to manage patients with BPPV, the purpose of this study was to investigate medical students’ evaluations of their preparedness to provide evidence-based care in the diagnosis and treatment of BPPV. An anonymous survey was administered via email to medical students in their fourth and final year of medical school at East Tennessee State University’s Quillen College of Medicine. This survey includes statements about the evidence-based Clinical Practice Guideline on BPPV provided by the American Academy of Otolaryngology. Respondents rated the degree to which they agreed or disagreed with how prepared they felt to address each item using a 5-point response scale from “strongly disagree” to “strongly agree.” Of the 70 students in the current fourth year class, 41 (59%) completed the survey. Students felt prepared for some aspects of diagnosing and treating BPPV, especially with regard to their general knowledge of BPPV, its impact on patients’ lives, and the options available to manage it. They felt less prepared to know when or if it is appropriate to recommend additional testing, imaging, or medication. They did not feel confident in their ability to perform the maneuvers to diagnose and treat BPPV. Overall, these results suggest medical students have a good foundation in their knowledge of BPPV. These results also propose topics to support more specialized training during their residencies to build upon the foundational knowledge obtained during their didactic training and optimize diagnosis and management of BPPV.

The purpose of this study was to examine the prevalence of nystagmus found in healthy individuals during the positional testing subtest of the standard vestibular test battery. Positional testing involves moving the patient's head, and sometimes the entire body, into a variety of positions while observing eye movement. The hypothesis of the current study was that a relatively low percentage of participants would display nystagmus during positional testing used routinely in clinical diagnostic procedures. The findings were then compared to those of an earlier study in which 82% of normal, healthy individuals were reported to exhibit nystagmus during this testing. Twenty-five participants were selected that had no known otologic disease and who reported normal hearing sensitivity. In addition, the participants affirmed they had not consumed any alcohol or taken any medications that are known to affect nystagmus. They were then observed in nine different positions. Forty-eight percent of the participants experienced nystagmus in at least one position. Although this percentage was considerably lower than that reported in the earlier study, methodological differences appear to account for the discrepancy. Specifically, the criterion for determining the presence/absence of nystagmus potentially explains the difference in full.

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