- Email: [email protected]
An alternative non surgical treatment for oral hemangioma treatment
e302
E-Poster Presentation
junior doctors and those surveyed suggested that this reflected a nationwide trend. However the security of this modality has been questioned and we would suggest further research into the content of such communications if it is being used to transmit patient specific information.
This was a late complication of silicone elastomeric implants, and there are alternative treatments for defects of the orbital floor. http://dx.doi.org/10.1016/j.ijom.2015.08.367 A 15 year review of paediatric orbital floor fractures
http://dx.doi.org/10.1016/j.ijom.2015.08.365 Haemorrhage following coronectomy of an impacted third molar associated with a bifid mandibular canal ∗
C.V. Linares , A. Mohindra, M. Evans
J. Vesey ∗ , S. Van Eeden, C. Sweet, D. Laraway, M. Boyle, C. Cooper Alder Hey Children’s Hospital, Liverpool, United Kingdom
http://dx.doi.org/10.1016/j.ijom.2015.08.366
Background: Orbital floor fractures are uncommon in the paediatric population and present different challenges in diagnosis and management. There is relatively little in the literature about their aetiology and management compared to their adult counterparts. Objectives: The aim of the review was to assess the aetiology, presenting features and outcomes for paediatric orbital floor fractures in a single centre over 15 years. Method: A retrospective review of the clinical records for patients who presented to the Oral and Maxillofacial Surgery department at Alder Hey Children’s Hospital between 02/01/2000 and 31/12/2014 with an orbital floor fracture was carried out. No cases were excluded. Finding: 45 patients were identified (14% female, 86% male) comprising 47 fractures. The mean age at presentation was 10 years (IQR 6–14). The most common mechanisms of injury were interpersonal violence (21.7%), sporting accidents (17.4%) and road traffic accidents (17.4%). 57% presented with diplopia, 60% vomiting and 25% inferior rectus entrapment. No patients presented with ‘white eye’ symptoms. Patients were managed conservatively (40.0%), with open reduction without fixation (11.1%) or open reduction with placement of alloplastic implant (48.9%). Temporary post-operative diplopia in 5 patients resolved spontaneously. One patient suffered persistent diplopia requiring corrective ophthalmologic surgery. Conclusions: Paediatric orbital floor fractures may not present as the classical ‘white eye’, but often present with diplopia and vomiting. The incidence of the traditional trap-door type fracture is not as common in this series as the literature reports. Long-term complications are rare with the majority of patients responding well to treatment.
Orbitomaxillary mass after repair of the orbital floor
http://dx.doi.org/10.1016/j.ijom.2015.08.368
Department of Oral and Maxillofacial Surgery, Queen Elizabeth Hospital, Birmingham, United Kingdom Background: A bifid mandibular canal is a rare anatomical variant believed to result from failure in fusion of multiple embryonic canals. Although the anatomical variations have been well described, clinical sequalae from this anatomical variant have to our knowledge never been described before. Objectives: To describe potential sequelae from surgery to a third molar tooth in close proximity to a bifid mandibular canal. Methods: We describe a case report and subsequent review of the literature in which a partially erupted third molar closely associated with a bifid mandibular canal was treated by coronectomy. The patient was admitted to hospital as an emergency with haemorrhage necessitating exploration under general anaesthesia to arrest it. Conclusions: Bifid mandibular canals are a rare anatomical variation that requires identification prior to planning of any surgical procedure in the mandible. Complications include haemorrhage, difficulty in providing adequate anaesthesia with an inferior alveolar nerve block and direct damage to the nerve during placement of oral implants. Although coronectomy may reduce the chance of nerve damage due to the proximity of the tooth root, it means that the source of bleeding cannot be easily packed. Without further evidence to the contrary, we would therefore question the rationale for coronectomy in patients with bifid mandibular canals and third molars requiring extraction.
S. Verma
1,∗
1
, A. Garg , A. Nastri
2
1
Oral and Maxillofacial Unit, Royal Hobart Hospital, Hobart, Tasmania, Australia 2 Oral and Maxillofacial Unit, Royal Melbourne Hospital, Melbourne, Victoria, Australia
An alternative non surgical treatment for oral hemangioma treatment C. Vidal 1,∗ , C. Blamey 2 1 2
A 48-year-old man presented with an orbitomaxillary mass 31 years after repair of the orbital floor. He gave a history of progressive diplopia and paresthesia of the right infraorbital nerve. He also noted improvement in his long-standing post-traumatic enophthalmos. Imaging showed a large orbitomaxillary cystic mass, which was thought to be secondary to a silicone implant (Figs 1, 2a and 2b). The implant and the cystic mass were removed, and the orbital floor was reconstructed with titanium mesh. Histological examination confirmed an inclusion cyst. Maxillary antral lesions can present with symptoms such as sinusitis, paraesthesiae, diplopia, and orofacial pain, and they may arise from the lining of the sinus, or from surrounding structures such as the orbit, nose, or maxilla.
Hospital Carlos Van Buren, Valparaíso, Chile Hospital Dr. Carlos Cisternas, Calama, Chile
Background: In 1982 Mulliken and Glowacki’ used clinical behaviour and endothelial cell characteristics to divide vascular birthmarks into two major categories: haemangiomas and malformations. The haemangiomas are principally referred to congenital lesions characterized for appearance after 2–4 weeks after birth, with a fast development from 6 to 8 months and slowly involute by adolescence old. Hemangiomas are characterized by increased endothelial turnover and increased numbers of mast cells during their rapid postnatal growth phase. The usual proposed treatments of these lesions include different possible treatments from an expectative control, surgical removal, and interferon ␣, laser therapy, cryotherapy, steroid
E-Poster Presentation therapy, radiation, and sclerotherapy with different agents. Sclerotherapy decrease the lesion size and change its nature to more fibrous consistency, and could be used as the only treatment or as complement to subsequent surgery. There are different types the sclerosing solution in alcohol, salicilates, hypertonic saline, Na Morrhuate, polidocanol. The use of normal saline solution have no chemical reaction to the body, with low cost and easy to find. Objectives: The aim of the study is to show the clinical value of sclerotherapy for oral hemangiomas. Methods: A series of cases 5 cases treated with our protocol, using hot boiling normal saline solution as sclerosing agent with intra lesion injection. Findings and conclusions: The use this sclerosing agent for oral haemangioma is safe treatment and with acceptable results. This technique offers our patient considerable relief of the symptoms with minimal complication and with a low cost. http://dx.doi.org/10.1016/j.ijom.2015.08.369 Management of politrauma patient with maxillofacial fractures at an emergency department C. Vida ∗ , V. Duarte, R. Osben, S. Riviello, R. Acevedo, M. Arriola, O. Badillo Hospital Carlos Van Buren, Valparaíso, Chile Background: Maxillofacial trauma is still a very challenging area, especially in the early stages of care when other injuries may be present. Craniofacial trauma, with or without life and/or sight-threatening complications, may be associated with significant injuries elsewhere. During the initial assessment of trauma victim patients a systematic approach should ensure that lifethreatening and subsequent injuries are identified and managed in a timely manner. Maxillofacial surgeons should be an integral part of the trauma team for those patients where facial injuries are evident. This involvement is relevant during the management of the airway, hypovolaemia including facial bleeding craniofacial injuries, and in assessment of the eyes. Objective: Show the different managements and the evolution of politrauma patients with maxillofacial fractures received in our hospital. Methods: prospective study that present a series of five cases of politrauma patients with maxillofacial fractures at the Emergency Unit of Carlos Van Buren Hospital in the last year. Distributed by sociodemografic results, clasiffication of maxilofacial injuries, type of facial fractures, other associated fractures and time of resolution of maxillofacial trauma: immediate life or sight-preserving interventions, treatment required within a few hours, treatment can wait 24 h and wait more than 24 h. Conclusions: Definitive repairs will depend on a number of factors related to the patient’s general status, overall prognosis and other planned procedures. This involves a multidisciplinary and coordinated approach. Maxillofacial surgeons should be an integral part of the emergency care team for those patients where facial injuries are involved to addressed in a timely mananagement. http://dx.doi.org/10.1016/j.ijom.2015.08.370
e303
Fronto-orbital reconstruction after severe trauma using a custom-made implant and filler: a case report C. Voisin 1,3,∗ , L. Pisano Gobbi 2 , M. Brognez 1 , R. Rezaei 1,3 , P. Philippart 3 , R. Glineur 1 1
University of Brussels,Erasme Hospital Free University ULB, Belgium 2 Hospital El Cruce, Florencio Varela, Buenos Aires, Argentina 3 University of Brussels, Iris Sud Hospital, Free University ULB, Belgium
Reconstruction of defects and damages in the orbital region can be really challenging. The destroyed bony fronto-orbital region is indeed difficult to replace because of its shape and anatomy. The subsequent tissue damage after a trauma can also be very difficult to repair, due to a fibrosis and tissue retraction, together with facial nerve damage. Background: We present this case of a 49 years old man, who was a victim of a severe trauma In the left fronto-orbital region. His left eye was crushed, as his fronto-orbito-zygomatic area. The frontal branch of the facial nerve was also destroyed. Objectives: Our aim was to restore the anatomy and the function in this destroyed area as much as possible. Methods: A First stage surgery was performed in emergency in order to stop the bleeding, remove the damaged tissues, reduce the fractures using titanium plates. CTSCAN was performed and a custom made prosthesis was built using a mirroring technique. Autoexpansive prosthesis was placed prior to the placement of the custom made material. Findings and conclusions: Good remodelling of the bony structure was achieved but unfortunately because of the partial facial palsy, and the damages to the soft tissues, a defect in the left temporal region became more and more visible and we decided to use a filler to restore the symmetry. http://dx.doi.org/10.1016/j.ijom.2015.08.371 The Olympic Legacy has no effect on journal metrics in facial & dental injury prevention in sport T. Walker 1,∗ , J. Thomas 2 , A. Cobb 3 , S. Thomas 1 , S. Miller 4 1
University of Bristol, Bristol, UK University Hospital Bristol NHS Foundation Trust, Bristol, UK 3 South West Cleft Service, Bristol, UK 4 Chief Medical Officer British Paralympic Association Senior Sports Physician (South West) English Institute of Sport Clinical director Sport and Exercise Medicine University of Bath, Bath, UK 2
Background: Systematic surveillance and analysis of key aspects within sport can contribute to maintaining and improving sporting performance. One integral element is the management and prevention of injuries. The ‘Olympic Legacy’ provides lasting sporting legacies that help promote and develop sport. Bibliometric analysis of injury prevention research may reveal a relationship between quantity and quality of research and the Olympic games – indicating an academic effect of the Olympic Legacy. Methods: A PubMed literature search was undertaken to identify the number of articles published each year between 1996 and 2013 in domains relating to sports injuries and injury prevention. The change in Impact Factor (IF) of the top 5 journals publishing in each of the search domains over this time period was also investigated.
E-Poster Presentation
junior doctors and those surveyed suggested that this reflected a nationwide trend. However the security of this modality has been questioned and we would suggest further research into the content of such communications if it is being used to transmit patient specific information.
This was a late complication of silicone elastomeric implants, and there are alternative treatments for defects of the orbital floor. http://dx.doi.org/10.1016/j.ijom.2015.08.367 A 15 year review of paediatric orbital floor fractures
http://dx.doi.org/10.1016/j.ijom.2015.08.365 Haemorrhage following coronectomy of an impacted third molar associated with a bifid mandibular canal ∗
C.V. Linares , A. Mohindra, M. Evans
J. Vesey ∗ , S. Van Eeden, C. Sweet, D. Laraway, M. Boyle, C. Cooper Alder Hey Children’s Hospital, Liverpool, United Kingdom
http://dx.doi.org/10.1016/j.ijom.2015.08.366
Background: Orbital floor fractures are uncommon in the paediatric population and present different challenges in diagnosis and management. There is relatively little in the literature about their aetiology and management compared to their adult counterparts. Objectives: The aim of the review was to assess the aetiology, presenting features and outcomes for paediatric orbital floor fractures in a single centre over 15 years. Method: A retrospective review of the clinical records for patients who presented to the Oral and Maxillofacial Surgery department at Alder Hey Children’s Hospital between 02/01/2000 and 31/12/2014 with an orbital floor fracture was carried out. No cases were excluded. Finding: 45 patients were identified (14% female, 86% male) comprising 47 fractures. The mean age at presentation was 10 years (IQR 6–14). The most common mechanisms of injury were interpersonal violence (21.7%), sporting accidents (17.4%) and road traffic accidents (17.4%). 57% presented with diplopia, 60% vomiting and 25% inferior rectus entrapment. No patients presented with ‘white eye’ symptoms. Patients were managed conservatively (40.0%), with open reduction without fixation (11.1%) or open reduction with placement of alloplastic implant (48.9%). Temporary post-operative diplopia in 5 patients resolved spontaneously. One patient suffered persistent diplopia requiring corrective ophthalmologic surgery. Conclusions: Paediatric orbital floor fractures may not present as the classical ‘white eye’, but often present with diplopia and vomiting. The incidence of the traditional trap-door type fracture is not as common in this series as the literature reports. Long-term complications are rare with the majority of patients responding well to treatment.
Orbitomaxillary mass after repair of the orbital floor
http://dx.doi.org/10.1016/j.ijom.2015.08.368
Department of Oral and Maxillofacial Surgery, Queen Elizabeth Hospital, Birmingham, United Kingdom Background: A bifid mandibular canal is a rare anatomical variant believed to result from failure in fusion of multiple embryonic canals. Although the anatomical variations have been well described, clinical sequalae from this anatomical variant have to our knowledge never been described before. Objectives: To describe potential sequelae from surgery to a third molar tooth in close proximity to a bifid mandibular canal. Methods: We describe a case report and subsequent review of the literature in which a partially erupted third molar closely associated with a bifid mandibular canal was treated by coronectomy. The patient was admitted to hospital as an emergency with haemorrhage necessitating exploration under general anaesthesia to arrest it. Conclusions: Bifid mandibular canals are a rare anatomical variation that requires identification prior to planning of any surgical procedure in the mandible. Complications include haemorrhage, difficulty in providing adequate anaesthesia with an inferior alveolar nerve block and direct damage to the nerve during placement of oral implants. Although coronectomy may reduce the chance of nerve damage due to the proximity of the tooth root, it means that the source of bleeding cannot be easily packed. Without further evidence to the contrary, we would therefore question the rationale for coronectomy in patients with bifid mandibular canals and third molars requiring extraction.
S. Verma
1,∗
1
, A. Garg , A. Nastri
2
1
Oral and Maxillofacial Unit, Royal Hobart Hospital, Hobart, Tasmania, Australia 2 Oral and Maxillofacial Unit, Royal Melbourne Hospital, Melbourne, Victoria, Australia
An alternative non surgical treatment for oral hemangioma treatment C. Vidal 1,∗ , C. Blamey 2 1 2
A 48-year-old man presented with an orbitomaxillary mass 31 years after repair of the orbital floor. He gave a history of progressive diplopia and paresthesia of the right infraorbital nerve. He also noted improvement in his long-standing post-traumatic enophthalmos. Imaging showed a large orbitomaxillary cystic mass, which was thought to be secondary to a silicone implant (Figs 1, 2a and 2b). The implant and the cystic mass were removed, and the orbital floor was reconstructed with titanium mesh. Histological examination confirmed an inclusion cyst. Maxillary antral lesions can present with symptoms such as sinusitis, paraesthesiae, diplopia, and orofacial pain, and they may arise from the lining of the sinus, or from surrounding structures such as the orbit, nose, or maxilla.
Hospital Carlos Van Buren, Valparaíso, Chile Hospital Dr. Carlos Cisternas, Calama, Chile
Background: In 1982 Mulliken and Glowacki’ used clinical behaviour and endothelial cell characteristics to divide vascular birthmarks into two major categories: haemangiomas and malformations. The haemangiomas are principally referred to congenital lesions characterized for appearance after 2–4 weeks after birth, with a fast development from 6 to 8 months and slowly involute by adolescence old. Hemangiomas are characterized by increased endothelial turnover and increased numbers of mast cells during their rapid postnatal growth phase. The usual proposed treatments of these lesions include different possible treatments from an expectative control, surgical removal, and interferon ␣, laser therapy, cryotherapy, steroid
E-Poster Presentation therapy, radiation, and sclerotherapy with different agents. Sclerotherapy decrease the lesion size and change its nature to more fibrous consistency, and could be used as the only treatment or as complement to subsequent surgery. There are different types the sclerosing solution in alcohol, salicilates, hypertonic saline, Na Morrhuate, polidocanol. The use of normal saline solution have no chemical reaction to the body, with low cost and easy to find. Objectives: The aim of the study is to show the clinical value of sclerotherapy for oral hemangiomas. Methods: A series of cases 5 cases treated with our protocol, using hot boiling normal saline solution as sclerosing agent with intra lesion injection. Findings and conclusions: The use this sclerosing agent for oral haemangioma is safe treatment and with acceptable results. This technique offers our patient considerable relief of the symptoms with minimal complication and with a low cost. http://dx.doi.org/10.1016/j.ijom.2015.08.369 Management of politrauma patient with maxillofacial fractures at an emergency department C. Vida ∗ , V. Duarte, R. Osben, S. Riviello, R. Acevedo, M. Arriola, O. Badillo Hospital Carlos Van Buren, Valparaíso, Chile Background: Maxillofacial trauma is still a very challenging area, especially in the early stages of care when other injuries may be present. Craniofacial trauma, with or without life and/or sight-threatening complications, may be associated with significant injuries elsewhere. During the initial assessment of trauma victim patients a systematic approach should ensure that lifethreatening and subsequent injuries are identified and managed in a timely manner. Maxillofacial surgeons should be an integral part of the trauma team for those patients where facial injuries are evident. This involvement is relevant during the management of the airway, hypovolaemia including facial bleeding craniofacial injuries, and in assessment of the eyes. Objective: Show the different managements and the evolution of politrauma patients with maxillofacial fractures received in our hospital. Methods: prospective study that present a series of five cases of politrauma patients with maxillofacial fractures at the Emergency Unit of Carlos Van Buren Hospital in the last year. Distributed by sociodemografic results, clasiffication of maxilofacial injuries, type of facial fractures, other associated fractures and time of resolution of maxillofacial trauma: immediate life or sight-preserving interventions, treatment required within a few hours, treatment can wait 24 h and wait more than 24 h. Conclusions: Definitive repairs will depend on a number of factors related to the patient’s general status, overall prognosis and other planned procedures. This involves a multidisciplinary and coordinated approach. Maxillofacial surgeons should be an integral part of the emergency care team for those patients where facial injuries are involved to addressed in a timely mananagement. http://dx.doi.org/10.1016/j.ijom.2015.08.370
e303
Fronto-orbital reconstruction after severe trauma using a custom-made implant and filler: a case report C. Voisin 1,3,∗ , L. Pisano Gobbi 2 , M. Brognez 1 , R. Rezaei 1,3 , P. Philippart 3 , R. Glineur 1 1
University of Brussels,Erasme Hospital Free University ULB, Belgium 2 Hospital El Cruce, Florencio Varela, Buenos Aires, Argentina 3 University of Brussels, Iris Sud Hospital, Free University ULB, Belgium
Reconstruction of defects and damages in the orbital region can be really challenging. The destroyed bony fronto-orbital region is indeed difficult to replace because of its shape and anatomy. The subsequent tissue damage after a trauma can also be very difficult to repair, due to a fibrosis and tissue retraction, together with facial nerve damage. Background: We present this case of a 49 years old man, who was a victim of a severe trauma In the left fronto-orbital region. His left eye was crushed, as his fronto-orbito-zygomatic area. The frontal branch of the facial nerve was also destroyed. Objectives: Our aim was to restore the anatomy and the function in this destroyed area as much as possible. Methods: A First stage surgery was performed in emergency in order to stop the bleeding, remove the damaged tissues, reduce the fractures using titanium plates. CTSCAN was performed and a custom made prosthesis was built using a mirroring technique. Autoexpansive prosthesis was placed prior to the placement of the custom made material. Findings and conclusions: Good remodelling of the bony structure was achieved but unfortunately because of the partial facial palsy, and the damages to the soft tissues, a defect in the left temporal region became more and more visible and we decided to use a filler to restore the symmetry. http://dx.doi.org/10.1016/j.ijom.2015.08.371 The Olympic Legacy has no effect on journal metrics in facial & dental injury prevention in sport T. Walker 1,∗ , J. Thomas 2 , A. Cobb 3 , S. Thomas 1 , S. Miller 4 1
University of Bristol, Bristol, UK University Hospital Bristol NHS Foundation Trust, Bristol, UK 3 South West Cleft Service, Bristol, UK 4 Chief Medical Officer British Paralympic Association Senior Sports Physician (South West) English Institute of Sport Clinical director Sport and Exercise Medicine University of Bath, Bath, UK 2
Background: Systematic surveillance and analysis of key aspects within sport can contribute to maintaining and improving sporting performance. One integral element is the management and prevention of injuries. The ‘Olympic Legacy’ provides lasting sporting legacies that help promote and develop sport. Bibliometric analysis of injury prevention research may reveal a relationship between quantity and quality of research and the Olympic games – indicating an academic effect of the Olympic Legacy. Methods: A PubMed literature search was undertaken to identify the number of articles published each year between 1996 and 2013 in domains relating to sports injuries and injury prevention. The change in Impact Factor (IF) of the top 5 journals publishing in each of the search domains over this time period was also investigated.