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Papers by Rui Fernandes
Oral and maxillofacial surgery clinics of North America, 2006
Journal of Oral and Maxillofacial Surgery, 2013
The specialty of oral and maxillofacial surgery has witnessed a large trend of inclusion of maxil... more The specialty of oral and maxillofacial surgery has witnessed a large trend of inclusion of maxillofacial oncology and microvascular reconstructive surgery within its scope of practice in recent years. The purpose of this report is to describe the authors' experience with a very active oncologic and microvascular reconstructive surgical service within an academic oral and maxillofacial surgical program at a large university teaching hospital. Materials and Methods: The operative log from July 1, 2010, to June 30, 2011, of 325 operations devoted to head and neck oncology and reconstruction was examined. Thirty-nine patients (group A) received a pedicled flap for head and neck reconstruction. Sixty-three patients (group B) received a microvascular free tissue transfer for head and neck reconstruction. Financial records of 20 consecutive patients who underwent simultaneous ablative and reconstructive procedures in each group were then reviewed for total hospital charges, including direct (surgical fees) and indirect (hospital stay, operating room expenses, and ancillary services) charges, and length of stay. Results: Total hospital charges and direct surgical fees, were higher for the microvascular reconstruction group (group B). Length of hospital stay was not statistically different between the two groups. Conclusions: Microvascular reconstructive surgery performed within an academic oral and maxillofacial surgical program has many financial and intangible benefits within a medical center.
Head & Neck, 2010
Background. This multicenter study was undertaken to characterize the metastatic behavior of oral... more Background. This multicenter study was undertaken to characterize the metastatic behavior of oral maxillary squamous carcinoma and to determine the role of selective neck dissection. Methods. A retrospective, multicenter study of patients surgically treated for oral maxillary squamous carcinoma was completed. Data collected included primary tumor location, cervical lymph node status, and neck failure rate. Results. The study included 146 patients. The adjusted regional metastatic rate was 31.4%. Of those N0 (clinically negative) necks treated with or without neck dissection, 14.4% developed cervical metastasis. Within the cohort, 7.5% of patients died with distant disease. The regional salvage rate was 52.9%. None of the patients with locoregional failures were salvaged. Conclusions. Maxillary palatal, alveolar, and gingival squamous carcinomas exhibit aggressive regional metastatic behavior. Surgical salvage rates for neck failure are low; therefore, selective neck dissection (levels I-III) is recommended at the time of resection of T2, T3, and T4 maxillary squamous carcinomas. V
Atlas of the Oral and Maxillofacial Surgery Clinics, 2006
... Division of Oral and Maxillofacial Surgery, Department of Surgery, University of Florida Heal... more ... Division of Oral and Maxillofacial Surgery, Department of Surgery, University of Florida Health Science Center, 653-1 West 8th Street, Jacksonville, FL 32209, USA. Rui.Fernandes@jax.ufl. edu. PMID: 16959605 [PubMed - indexed for MEDLINE]. MeSH Terms: ...
Oral and maxillofacial surgery clinics of North America, 2006
Journal of Oral and Maxillofacial Surgery, 2013
The specialty of oral and maxillofacial surgery has witnessed a large trend of inclusion of maxil... more The specialty of oral and maxillofacial surgery has witnessed a large trend of inclusion of maxillofacial oncology and microvascular reconstructive surgery within its scope of practice in recent years. The purpose of this report is to describe the authors' experience with a very active oncologic and microvascular reconstructive surgical service within an academic oral and maxillofacial surgical program at a large university teaching hospital. Materials and Methods: The operative log from July 1, 2010, to June 30, 2011, of 325 operations devoted to head and neck oncology and reconstruction was examined. Thirty-nine patients (group A) received a pedicled flap for head and neck reconstruction. Sixty-three patients (group B) received a microvascular free tissue transfer for head and neck reconstruction. Financial records of 20 consecutive patients who underwent simultaneous ablative and reconstructive procedures in each group were then reviewed for total hospital charges, including direct (surgical fees) and indirect (hospital stay, operating room expenses, and ancillary services) charges, and length of stay. Results: Total hospital charges and direct surgical fees, were higher for the microvascular reconstruction group (group B). Length of hospital stay was not statistically different between the two groups. Conclusions: Microvascular reconstructive surgery performed within an academic oral and maxillofacial surgical program has many financial and intangible benefits within a medical center.
Head & Neck, 2010
Background. This multicenter study was undertaken to characterize the metastatic behavior of oral... more Background. This multicenter study was undertaken to characterize the metastatic behavior of oral maxillary squamous carcinoma and to determine the role of selective neck dissection. Methods. A retrospective, multicenter study of patients surgically treated for oral maxillary squamous carcinoma was completed. Data collected included primary tumor location, cervical lymph node status, and neck failure rate. Results. The study included 146 patients. The adjusted regional metastatic rate was 31.4%. Of those N0 (clinically negative) necks treated with or without neck dissection, 14.4% developed cervical metastasis. Within the cohort, 7.5% of patients died with distant disease. The regional salvage rate was 52.9%. None of the patients with locoregional failures were salvaged. Conclusions. Maxillary palatal, alveolar, and gingival squamous carcinomas exhibit aggressive regional metastatic behavior. Surgical salvage rates for neck failure are low; therefore, selective neck dissection (levels I-III) is recommended at the time of resection of T2, T3, and T4 maxillary squamous carcinomas. V
Atlas of the Oral and Maxillofacial Surgery Clinics, 2006
... Division of Oral and Maxillofacial Surgery, Department of Surgery, University of Florida Heal... more ... Division of Oral and Maxillofacial Surgery, Department of Surgery, University of Florida Health Science Center, 653-1 West 8th Street, Jacksonville, FL 32209, USA. Rui.Fernandes@jax.ufl. edu. PMID: 16959605 [PubMed - indexed for MEDLINE]. MeSH Terms: ...