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Article ; Online: The effect of the COVID-19 pandemic on the diagnosis and progression of oral cancer.

Cwintal, M / Shih, H / Idrissi Janati, A / Gigliotti, J

International journal of oral and maxillofacial surgery

2024

Abstract: The COVID-19 pandemic placed a significant burden on healthcare resources, limiting care to emergent and essential services only. The objective of this study was to describe the effect of the COVID-19 pandemic on the diagnosis and progression of oral ... ...

Abstract	The COVID-19 pandemic placed a significant burden on healthcare resources, limiting care to emergent and essential services only. The objective of this study was to describe the effect of the COVID-19 pandemic on the diagnosis and progression of oral cancer lesions in Montreal, Canada. A retrospective analysis of health records was performed. Patients presenting for a new oncology consultation for an oral lesion suspicious for cancer between March 2018 and March 2022, within the Department of Oral and Maxillofacial Surgery of the McGill University Health Center, were included. Data was collected on sociodemographic characteristics, oral cancer risk behaviors of study participants, oral cancer delays, tumor characteristics, and clinical management. A total of 190 patients were included, 91 patients from the pre-pandemic period and 99 from the pandemic period. The demographic characteristics of the patients in the two periods were comparable. There was no significant difference in the patient, professional, or treatment delay between the two periods. There was a non-significant increase in pathologic tumor size during the pandemic, but the pathologic staging and postoperative outcomes were comparable to those of the pre-pandemic cohort. The results indicate that emergent care pathways for oral cancer treatment were efficiently maintained despite the pandemic shutdown of services.
Language	English
Publishing date	2024-02-22
Publishing country	Denmark
Document type	Journal Article
ZDB-ID	353721-3
ISSN	1399-0020 ; 0901-5027
ISSN (online)	1399-0020
ISSN	0901-5027
DOI	10.1016/j.ijom.2024.02.003
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Article ; Online: Delays in oral cavity cancer.

Gigliotti, J / Madathil, S / Makhoul, N

International journal of oral and maxillofacial surgery

2019 Volume 48, Issue 9, Page(s) 1131–1137

Abstract: While the prognosis for early-stage oral cavity cancer is relatively good; the majority of patients are still diagnosed with advanced-stage disease on presentation with an associated poorer prognosis. The aims of this review are to summarize our current ... ...

Abstract	While the prognosis for early-stage oral cavity cancer is relatively good; the majority of patients are still diagnosed with advanced-stage disease on presentation with an associated poorer prognosis. The aims of this review are to summarize our current understanding of delays in oral cavity cancer and their impact on stage at diagnosis and survival. The delays pathway can be subdivided into three components: patient, professional, and treatment delays. Patient delay represents the longest interval in the delays pathway usually lasting between 2 and 5 months and being most influenced by cognitive and psychosocial factors. Professional and treatment delays are shorter in most studies, but highly variable depending on the respective healthcare system. Most studies indicate that advanced stage at diagnosis, primary treatment with radiotherapy, treatment at an academic center, and transitions in care are associated with an increased treatment delay. Based on our current understanding, a delay between definitive diagnosis and treatment of 4-6 weeks seems acceptable from an oncologic perspective. Further studies are needed to better define what a 'safe' waiting time is and to understand the psychological impact of delays for patients.
MeSH term(s)	Humans ; Mouth Neoplasms ; Prognosis ; Time-to-Treatment
Language	English
Publishing date	2019-03-13
Publishing country	Denmark
Document type	Journal Article ; Review
ZDB-ID	353721-3
ISSN	1399-0020 ; 0901-5027
ISSN (online)	1399-0020
ISSN	0901-5027
DOI	10.1016/j.ijom.2019.02.015
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Article ; Online: Demographics, training satisfaction, and career plans of Canadian oral and maxillofacial surgery residents.

Gigliotti, J / Makhoul, N

International journal of oral and maxillofacial surgery

2016 Volume 44, Issue 12, Page(s) 1574–1580

Abstract: The purpose of this study was to evaluate the demographics, training satisfaction, and career plans of Canadian oral and maxillofacial surgery (OMS) residents. A cross-sectional study was conducted using an anonymous online survey that was distributed ... ...

Abstract	The purpose of this study was to evaluate the demographics, training satisfaction, and career plans of Canadian oral and maxillofacial surgery (OMS) residents. A cross-sectional study was conducted using an anonymous online survey that was distributed via e-mail to all current Canadian OMS residents. The completion rate of this survey was 88.9%. Eighty percent of residents were satisfied with their surgical education overall. Residents were most satisfied with their training in the areas of facial trauma and orthognathic surgery. Satisfaction was lowest in the areas of facial cosmetic surgery, maxillofacial reconstructive surgery, cleft and craniofacial surgery, and dental implantology. A majority of residents, 78.1%, indicated that they would prefer to be trained in an MD-integrated OMS certificate program. Seventy-two percent of residents indicated that they would like to complete a fellowship following graduation. The most desirable career path was a combination of private practice and academic practice, with 75.0% of residents selecting this option. Overall, Canadian OMS residents were pleased with their training in the traditional scope of OMS, apart from dental implantology. Among the current generation of trainees, there appears to be a proclivity for a broader scope of practice, dual-degree training, and post-graduate fellowship training.
MeSH term(s)	Adult ; Canada ; Career Choice ; Career Mobility ; Cross-Sectional Studies ; Demography ; Education, Dental ; Education, Medical, Graduate ; Female ; Humans ; Internship and Residency ; Job Satisfaction ; Male ; Orthognathic Surgery/education ; Surgery, Oral/education ; Surgery, Plastic/education ; Surveys and Questionnaires
Language	English
Publishing date	2016-02-12
Publishing country	Denmark
Document type	News
ZDB-ID	353721-3
ISSN	1399-0020 ; 0901-5027
ISSN (online)	1399-0020
ISSN	0901-5027
DOI	10.1016/j.ijom.2015.08.994
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Article ; Online: Titanium Alloy Cutting Guides in Craniomaxillofacial Surgery-A Minimally Invasive Alternative to Synthetic Polymer Guides.

Gigliotti, Jordan / Ying, Yedeh / Morlandt, Anthony B

Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons

2020 Volume 78, Issue 11, Page(s) 2080–2089

Abstract: Purpose: Historically, synthetic polymers, such as polyamide, have been the predominate material used for patient-specific cutting guides in 3-dimensionally guided craniomaxillofacial surgery. The physical properties of polyamide result in guides that ... ...

Abstract	Purpose: Historically, synthetic polymers, such as polyamide, have been the predominate material used for patient-specific cutting guides in 3-dimensionally guided craniomaxillofacial surgery. The physical properties of polyamide result in guides that are bulky and difficult to place within the confines of the facial soft tissue envelope, requiring larger incisions with resultant morbidity. Despite their utility, we found the need for wider exposure simply for guide placement was unacceptable. The purpose of the present study was to evaluate our experience with the newly marketed titanium alloy cutting guides. Materials and methods: We conducted a retrospective cohort study of patients who had undergone either segmental mandibulectomy or maxillectomy using patient-specific titanium alloy cutting guides from May to December 2019. The primary outcome variable was the need for an extended-access cervical incision or a transfacial incision for either maxillectomy or segmental mandibulectomy in patients with benign disorders. The secondary outcome variables included the need for a transfacial incision in patients with malignant pathology requiring either maxillectomy or composite oromandibular resection and the final histopathologic bone margin status. Results: Of the 21 included patients, 11 had undergone maxillectomy (1 of 2) or segmental mandibulectomy (9 of 9) for benign disorders, with 91% (10 of 11) having undergone titanium alloy guide placement and resection entirely transorally without the need for an extended cervical or a transfacial incision. For 10 of the 11 patients undergoing immediate reconstruction with vascularized bone flaps, transcervical access was limited to small 1.5- to 2.5-cm incisions for target vessel access and microvascular anastomosis. None of the 10 patients with a malignant disorder requiring either maxillectomy or composite oromandibular resection required a transfacial incision. The bone margins, as determined by histopathologic analysis, were negative for 100% of the patients. Conclusions: Patient-specific titanium alloy cutting guides represent a viable alternative to traditional synthetic polymer guides. Their superior properties permit easier intraoral placement, decreasing the need for cutaneous incisions and excessive periosteal stripping.
MeSH term(s)	Alloys ; Humans ; Mandibular Osteotomy ; Polymers ; Retrospective Studies ; Titanium
Chemical Substances	Alloys ; Polymers ; Titanium (D1JT611TNE)
Language	English
Publishing date	2020-06-11
Publishing country	United States
Document type	Journal Article
ZDB-ID	392404-x
ISSN	1531-5053 ; 0278-2391
ISSN (online)	1531-5053
ISSN	0278-2391
DOI	10.1016/j.joms.2020.06.010
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Article ; Online: Supplemental Regional Block Anesthesia Reduces Opioid Utilization Following Free Flap Reconstruction of the Oral Cavity: A Prospective, Randomized Clinical Trial.

Le, John M / Gigliotti, Jordan / Sayre, Kelly S / Morlandt, Anthony B / Ying, Yedeh P

Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons

2022 Volume 81, Issue 2, Page(s) 140–149

Abstract: Purpose: Regional anesthesia has been shown to effectively manage acute pain and reduce opioid utilization in the early postoperative period following colorectal, orthopedic, and thoracic surgeries. The same effect, however, has not been demonstrated in ...

Abstract	Purpose: Regional anesthesia has been shown to effectively manage acute pain and reduce opioid utilization in the early postoperative period following colorectal, orthopedic, and thoracic surgeries. The same effect, however, has not been demonstrated in major head and neck surgery. The purpose of this study is to determine whether supplemental regional anesthesia reduces opioid utilization following microvascular free flap reconstruction of the oral cavity. Methods: A prospective, randomized clinical trial was conducted for patients undergoing oral cavity reconstruction using microvascular free tissue transfer between January 2020 and March 2022. The predictor variable was a regional anesthetic nerve block, delivered preoperatively, at the flap donor site. The primary and secondary outcomes were opioid utilization, measured in oral morphine equivalent (OME), from postoperative day 1 to 5, and hospital length of stay (LOS), respectively. Covariates included age, sex, tobacco and alcohol history, prior radiation therapy, pathology, oral site, flap type, tracheostomy, and neck dissection. Student's t test, χ Results: Ninety-eight participants completed the study. The mean age was 56 years with 55% male. Forty-eight patients received a presurgical regional anesthesia block, and 50 patients served as control subjects. Bivariate analysis demonstrated an even distribution of all study variables. Total OME utilization was significantly less in the treatment group compared to the control group, (166.32 vs 118.43 OME; 95% CI, 1.32 to 94.45; P = .04). The LOS was comparable (6.60 vs 6.48 days; 95% CI, -0.53 to 0.77; P = .71). Tobacco use had a positive effect (B = 0.28; 95% CI, 21.63 to 115.31; P = .005) while the block had a negative effect with total OME, (B = -0.19; 95% CI, -90.39 to -0.59; P = .047). The extent of the neck dissection (B = 0.207; 95% CI, 0.026 to 1.403; P = .042) was a positive predictor for LOS. Overall, there were no adverse events associated with the regional block throughout the study period. Conclusions: Supplemental regional anesthesia is safe and associated with reduced opioid utilization in patients undergoing vascularized free flap reconstruction of composite oral cavity defects and does not prolong the length of hospitalization.
MeSH term(s)	Humans ; Male ; Middle Aged ; Female ; Analgesics, Opioid/therapeutic use ; Free Tissue Flaps ; Prospective Studies ; Pain, Postoperative/drug therapy ; Anesthesia, Conduction ; Mouth ; Retrospective Studies
Chemical Substances	Analgesics, Opioid
Language	English
Publishing date	2022-11-01
Publishing country	United States
Document type	Randomized Controlled Trial ; Journal Article
ZDB-ID	392404-x
ISSN	1531-5053 ; 0278-2391
ISSN (online)	1531-5053
ISSN	0278-2391
DOI	10.1016/j.joms.2022.10.015
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Article: Computer-Assisted Microvascular Free Flap Reconstruction and Implant Rehabilitation of the Maxilla-Treatment of a Rare Post-orthognathic Complication.

Le, John M / Gigliotti, Jordan / Ying, Yedeh / Kase, Michael T / Morlandt, Anthony B

Journal of maxillofacial and oral surgery

2021 Volume 21, Issue 1, Page(s) 82–87

Abstract: Orthognathic surgery is generally a safe and predictable procedure. Major postoperative complications are rare and often non-life threatening. An example of a rare complication associated with the LeFort I osteotomy is avascular necrosis of the maxilla ( ... ...

Abstract	Orthognathic surgery is generally a safe and predictable procedure. Major postoperative complications are rare and often non-life threatening. An example of a rare complication associated with the LeFort I osteotomy is avascular necrosis of the maxilla (ANM). While cases of ANM have been described in the literature, the majority involves only a portion or segment of the maxillary complex and is commonly treated with conservative measures such as strict oral hygiene, hyperbaric oxygen therapy and local debridement. Occasionally, larger segments of osteonecrosis may require extensive reconstruction such as bone grafting with local soft tissue flaps. Here, we present a patient that underwent a single-stage microvascular free tissue reconstruction with concomitant placement of dental implants and a patient-specific implant (PSI) for post-orthognathic ANM.
Language	English
Publishing date	2021-01-06
Publishing country	India
Document type	Case Reports
ZDB-ID	2502352-4
ISSN	0974-942X ; 0972-8279
ISSN (online)	0974-942X
ISSN	0972-8279
DOI	10.1007/s12663-020-01492-y
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Article ; Online: Fasciocutaneous Flaps for Refractory Intermediate Stage Osteoradionecrosis of the Mandible-Is It Time for a Shift in Management?

Gigliotti, Jordan / Ying, Yedeh / Redden, David / Kase, Michael / Morlandt, Anthony B

Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons

2020 Volume 79, Issue 5, Page(s) 1156–1167

Abstract: Purpose: Historically, free tissue transfer has been reserved for advanced stage osteoradionecrosis (ORN) of the jaw with pathologic fracture or cutaneous fistula. The purpose of this study was to evaluate if in patients with recalcitrant intermediate ... ...

Abstract	Purpose: Historically, free tissue transfer has been reserved for advanced stage osteoradionecrosis (ORN) of the jaw with pathologic fracture or cutaneous fistula. The purpose of this study was to evaluate if in patients with recalcitrant intermediate stage ORN, would mandibular debridement in combination with vascularized soft tissue coverage result in durable symptom and disease resolution. Patients and methods: A retrospective cohort study of patients with mandibular ORN was performed comparing a mandibular preserving approach with a fasciocutaneous forearm flap for progressive treatment-resistant intermediate stage ORN to mandibulectomy and vascularized bone flap (VBF) reconstruction for advanced stage ORN. The primary outcome was ORN resolution. Results: The sample was composed of 35 patients. One-hundred percent of patients undergoing a mandibular preserving approach experienced ORN resolution compared with 83.3% in the segmental mandibulectomy and VBF reconstruction group (P = .28). Patients in the mandibular preservation group experienced a shorter hospitalization (6 vs 9 days; P = .07), decreased length of surgery (384.9 vs 406.3 minutes; P = .01), and less delayed healing requiring local wound care (9.1 vs 45.8% of patients; P = .06). Conclusions: A mandibular preserving approach is successful at arresting intermediate stage ORN and is associated with a decreased operative time, a shorter hospitalization, and less need for prolonged wound care when compared with VBF reconstruction for advanced stage ORN.
MeSH term(s)	Free Tissue Flaps ; Humans ; Mandible/surgery ; Mandibular Diseases/surgery ; Osteoradionecrosis/surgery ; Reconstructive Surgical Procedures ; Retrospective Studies ; Surgical Flaps
Language	English
Publishing date	2020-12-02
Publishing country	United States
Document type	Journal Article
ZDB-ID	392404-x
ISSN	1531-5053 ; 0278-2391
ISSN (online)	1531-5053
ISSN	0278-2391
DOI	10.1016/j.joms.2020.11.026
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Article ; Online: Does Supplemental Regional Anesthesia Decrease Length of Stay and Opioid Use for Patients Undergoing Head and Neck Microvascular Reconstruction?

Park, Earl Peter / Le, John Minh / Gigliotti, Jordan / Feinstein, Joel / Ying, Yedeh P / Morlandt, Anthony B

Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons

2020 Volume 79, Issue 3, Page(s) 712–721

Abstract: Purpose: The purpose of this study was to compare length of hospital stay and opioid usage among head and neck surgery (HNS) patients treated with and without regional anesthesia for microvascular free-flap donor sites.: Methods: The authors ... ...

Abstract	Purpose: The purpose of this study was to compare length of hospital stay and opioid usage among head and neck surgery (HNS) patients treated with and without regional anesthesia for microvascular free-flap donor sites. Methods: The authors performed a retrospective cohort study for HNS patients undergoing microvascular free-flap reconstruction. The control group received no regional anesthesia. The experimental group had a regional anesthesia nerve block performed immediately before surgery. The primary outcome variable was length of stay, and the secondary outcome variable was total morphine milliequivalents. The data were analyzed using Student t tests, analysis of variance, Mann-Whitney U test, Kruskal-Wallis test, χ Results: The study sample was composed of 148 patients with a mean age of 58.1 years. The mean length of stay for the control group was 6.74 ± 1.57 days, compared with the experimental group at 5.84 ± 1.01 days (P < .0001). The mean morphine milliequivalent was 256.5 ± 164.6 mg for the control group and 208.9 ± 164.8 mg for the experimental group (P = .56). Importantly, the demographics, pathology spectrum, flap selection, duration of procedure, and complication rate were similar in both groups. Conclusions: This study demonstrates that for HNS patients undergoing microvascular reconstruction, regional nerve block at the donor site is associated with significantly shorter hospital stays. Although there was a trend toward decreased opioid usage in the regional anesthesia group, these results did not reach statistical significance. Consideration should be given to incorporate regional anesthesia techniques into early recovery after surgery protocols for centers performing high-volume head and neck microvascular reconstruction.
MeSH term(s)	Analgesics, Opioid/therapeutic use ; Free Tissue Flaps ; Humans ; Length of Stay ; Middle Aged ; Neck/surgery ; Reconstructive Surgical Procedures ; Retrospective Studies
Chemical Substances	Analgesics, Opioid
Language	English
Publishing date	2020-08-29
Publishing country	United States
Document type	Journal Article
ZDB-ID	392404-x
ISSN	1531-5053 ; 0278-2391
ISSN (online)	1531-5053
ISSN	0278-2391
DOI	10.1016/j.joms.2020.08.037
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Book ; Online: Sports in America

Gigliotti, Jim

: 1950-1959

(Sports in America)

2010

Abstract: The booming decade following World War II saw many advances in sports and the continued integration of people of other races into major sports leagues. A lanky Oxford University medical student broke the four-minute-mile record, the first African ... ...

Institution	ebrary, Inc
Author's details	Jim Gigliotti
Series title	Sports in America
Abstract	The booming decade following World War II saw many advances in sports and the continued integration of people of other races into major sports leagues. A lanky Oxford University medical student broke the four-minute-mile record, the first African American won a U.S. Open singles title, and the color barrier broke in the National Basketball Association. 1950-1959, Second Edition explores this decade of sports, presenting full-color and black-and-white photographs and further resources for interested readers. Highlights include: African-American players Nat ""Sweetwater"" Clifton, Chuck Cooper
Keywords	Sports/History
Language	English
Size	Online-Ressource (96 p), ill. (some col.)
Edition	2nd ed
Publisher	Chelsea House
Publishing place	New York
Document type	Book ; Online
Note	Includes bibliographical references and index
ISBN	1604134526 ; 9781438132440 ; 9781604134520 ; 1438132441
Database	Library catalogue of the German National Library of Science and Technology (TIB), Hannover

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Article ; Online: Complications in oncologic mandible reconstruction: A comparative study between the osteocutaneous radial forearm and fibula free flap.

Le, John M / Morlandt, Anthony B / Gigliotti, Jordan / Park, Earl P / Greene, Benjamin J / Ying, Yedeh P

Microsurgery

2021 Volume 42, Issue 2, Page(s) 150–159

Abstract: Background: The osteocutaneous radial forearm free flap (OC-RFFF) has been proposed as a safe and reliable free flap for head and neck reconstruction with low donor site morbidity. The purpose of this study is to compare the late complications (>30 days) ...

Abstract	Background: The osteocutaneous radial forearm free flap (OC-RFFF) has been proposed as a safe and reliable free flap for head and neck reconstruction with low donor site morbidity. The purpose of this study is to compare the late complications (>30 days) associated with using the OC-RFFF versus the free fibula flap (FFF) for mandibular reconstruction following oncologic segmental resection. Methods: We conducted a single-institution, retrospective study composed of patients who underwent oncologic microvascular composite mandibular reconstruction with either the OC-RFFF or FFF. The primary predictor variable was the type of free flap used. The outcome variable was late complication postoperatively (>30 days). Results: A total of 93 patients (28, OC-RFFF and 65, FFF) were analyzed. The majority of patients were male (62%) and with AJCC stage T4a disease (72%). Mean hospital length of stay was comparable between the two flap groups (p = .50). OC-RFFF was associated with more late complications (p = .03) compared to FFF. Nonunion occurred in 10.7% of OC-RFFF and 0% of FFF. Partial or complete flap failure was seen in 7.1% and 0% in the OC-RFFF and FFF, respectively. Two-year disease-free survival was comparable in both groups (p > .05). Conclusions: The results of this study suggest that the rate of nonunion and odds of having a late complication were significantly greater in the OC-RFFF compared to the FFF following oncologic mandibular reconstruction. However, flap success, early complications (<30 days), and length of hospital stay were comparable between the two flaps.
MeSH term(s)	Female ; Fibula ; Forearm/surgery ; Free Tissue Flaps ; Humans ; Male ; Mandible/surgery ; Mandibular Reconstruction ; Reconstructive Surgical Procedures/adverse effects ; Retrospective Studies
Language	English
Publishing date	2021-11-18
Publishing country	United States
Document type	Journal Article
ZDB-ID	605524-2
ISSN	1098-2752 ; 0738-1085
ISSN (online)	1098-2752
ISSN	0738-1085
DOI	10.1002/micr.30841
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