This learning resource will take you through the interpretation of OPG’s, a standard radiographic study used ubiquitously in OMFS.

Gender dysphoria is clinically defined as a ‘marked incongruence between one’s experienced/expressed gender and natal gender of at least 6 months in duration’ (1), with the presence of 2 or more of a list of other specified psychological manifestations.

This can often be confused with gender non-conformity. Gender non-conformity is not a clinical diagnosis, rather a pattern of behaviour exhibited in certain affected individuals where their behaviour and actions are not traditionally conforming to their assigned sex at birth. Gender dysphoria can usually be differentiated by the presence of distress along with the incongruence. (2)

In the field of OMFS it is very important to understand the differences of these diagnoses and how to recognise them. Some of the surgeries (especially those which interface with gender presentation) such as gender-affirming procedures within the field can often be necessary due to these indications, not to mention that some OMFS trainees and staff themselves may be living with these diagnoses themselves.

Everything in life can be compartmentalised – and OMFS on-call is no different. If one really wants to break things down to the very basics, there are only really three different true OMFS emergencies requiring a timely intervention that you may have to handle while on-call: Airway compromise, Infection, and Bleeding (or a combination of the three). This isn’t to say you have to handle these issues alone – senior support would be expected in any of these cases – however, knowledge of the pathophysiology, consequences, and urgencies is crucial for diagnosis, escalation, and initial management.

This is intended to provide an overview of the assessment and initial management of penetrating neck injury for OMFS first on call based on RCS England 2017 Guidelines1. It is important to ensure local policies regarding which specialties manage these injuries are followed and to involve seniors early. Links have been provided to additional sources details of surgical intervention.