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Dentoalveolar trauma treatment in an A&E setting
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Free poster abstracts numbered P1 - P255 / British Journal of Oral and Maxillofacial Surgery 54 (2016) e66–e153
Methods: The Emergency Department electronic records were searched from June 2013 to June 2015 for patients with animal bites. Notes were reviewed to establish clinical management, referral patterns, and patient demographic, and socioeconomic data. Results: 100 patients were identified, mean age 21. Index of Multiple Deprivations was 22.9, compared to national mean of 21.7 (p > 0.05). 97% of bites were from dogs, 1% cats, 1% horses, and 1% ferrets. Clinical management varied: initial irrigation with saline or water in 25% of cases, while appropriate antibiotic choice ranged from 67 - 100% depending upon bite location and animal. 20% of cases required specialist input - 85% of these referrals were to OMFS. Conclusions: Animal bites are common, particularly dog bites. The majority of cases are dealt with in the Emergency Department, though OMFS deal with the vast majority that require specialist input. With specialist intervention deviating from national guidance, a review of both local and national guidance is advised. The review of this service does not support the link between social deprivation and risk of animal bites. http://dx.doi.org/10.1016/j.bjoms.2016.11.028 P23 Dentoalveolar trauma treatment in an A&E setting Sara Trajkovic ∗ , Ursala Jogezai, Robert Banks Sunderland Royal Hospital The International Association of Dental Traumatology guidelines for the gold standard immediate management of dento-alveolar trauma are widely available and accepted by both dental and maxillofacial professionals. It was felt by the authors however that the provision of this gold standard treatment is not always possible by an On-Call Maxillofacial Senior House Officer working in an Accident and Emergency Department, either due to lack of resources or the current time pressures felt in Accident and Emergency. Following a pilot study in the North-East of England we contacted the Maxillofacial Units around the UK as to the resources available and what they were able to provide as first line care via Accident and Emergency departments. We also looked at when this equipment was available, comparing facilities during the week, at weekends and through the night. In conjunction with the Paediatric Department at Newcastle Dental Hospital this information has been used to attempt to standardise the first line treatment offered by our regional units to patients with dento-alveolar trauma in such a way that it not only achieves an acceptable standard of treatment under the often less than ideal circumstances in Accident and Emergency http://dx.doi.org/10.1016/j.bjoms.2016.11.029
P24 Fine Needle Aspiration of Thyroid nodules in Chichester, West Sussex: An audit of cytology and histology results. Time for a “one-stop” thyroid clinic? Clifton Wan ∗ , Peyman Alam Western Sussex Hospitals NHS Foundation Trust Introduction: To determine the accuracy and value of thyroid fine needle aspiration (FNA) and to assess the need for a combined “one-stop” thyroid clinic as recommended by the British Thyroid Association(BTA). Methods: A retrospective study of all FNA examinations of solitary thyroid nodules between January 2014 and August 2015. FNAs classified into 5 groups as per BTA: THY1 – non diagnostic, THY2 non-neoplastic, THY3 – neoplasm possible, THY4 – suspicious of malignancy, THY5 – diagnostic of malignancy. The histology and medical records were reviewed to determine whether cytology was accurate. Results: 309 FNAs assessed. There were 167 (54.0%) THY1 FNAs. To date, no malignancies followed 99 (32%) THY2 FNA category. 36 (11.7%) THY3 FNAs resulted in six malignancies (3 papillary carcinoma, 3 follicular carcinoma). 3 (1.0%) FNAs were THY4, histology of which confirmed to be papillary carcinoma. Of the 4 (1.3%) THY5’s, 2 were papillary carcinoma, one recurrence of follicular carcinoma, 1 squamous cell carcinoma metastases from distant site. This gives overall sensitivity of 100%, and specificity of 76%, positive predictive values for both THY4 and THY5 were 100% and negative predictive value of THY2 was 100%. Conclusions: Chichester THY2-THY5 data is comparable with national figures reinforcing that THY2 can be a reassuring result for patients. Our high THY1 figures highlight a need for a “one-stop” clinic, where the pathologist (technician) assesses adequacy of sample at time of testing. This can not only minimise frequent hospital visits and associated anxiety for patients but also has financial benefit for the organisation. http://dx.doi.org/10.1016/j.bjoms.2016.11.030 P25 Medication Induced Osteonecrosis of the Jaws (MRONJ): an update for the General Medical Practitioner Mei Ying Yeoh ∗ , Mohammed Imran Suida, Jonathon Reid Pinderfields General Hospital Introduction: Medication Related Osteonecrosis of the Jaw (MRONJ) is a rare but serious complication in patients who are treated with antiresorptive/antiangiogenic medications. The reported incidence rates are up to 10% where longer term treatment has been evident. MRONJ can occur
Free poster abstracts numbered P1 - P255 / British Journal of Oral and Maxillofacial Surgery 54 (2016) e66–e153
Methods: The Emergency Department electronic records were searched from June 2013 to June 2015 for patients with animal bites. Notes were reviewed to establish clinical management, referral patterns, and patient demographic, and socioeconomic data. Results: 100 patients were identified, mean age 21. Index of Multiple Deprivations was 22.9, compared to national mean of 21.7 (p > 0.05). 97% of bites were from dogs, 1% cats, 1% horses, and 1% ferrets. Clinical management varied: initial irrigation with saline or water in 25% of cases, while appropriate antibiotic choice ranged from 67 - 100% depending upon bite location and animal. 20% of cases required specialist input - 85% of these referrals were to OMFS. Conclusions: Animal bites are common, particularly dog bites. The majority of cases are dealt with in the Emergency Department, though OMFS deal with the vast majority that require specialist input. With specialist intervention deviating from national guidance, a review of both local and national guidance is advised. The review of this service does not support the link between social deprivation and risk of animal bites. http://dx.doi.org/10.1016/j.bjoms.2016.11.028 P23 Dentoalveolar trauma treatment in an A&E setting Sara Trajkovic ∗ , Ursala Jogezai, Robert Banks Sunderland Royal Hospital The International Association of Dental Traumatology guidelines for the gold standard immediate management of dento-alveolar trauma are widely available and accepted by both dental and maxillofacial professionals. It was felt by the authors however that the provision of this gold standard treatment is not always possible by an On-Call Maxillofacial Senior House Officer working in an Accident and Emergency Department, either due to lack of resources or the current time pressures felt in Accident and Emergency. Following a pilot study in the North-East of England we contacted the Maxillofacial Units around the UK as to the resources available and what they were able to provide as first line care via Accident and Emergency departments. We also looked at when this equipment was available, comparing facilities during the week, at weekends and through the night. In conjunction with the Paediatric Department at Newcastle Dental Hospital this information has been used to attempt to standardise the first line treatment offered by our regional units to patients with dento-alveolar trauma in such a way that it not only achieves an acceptable standard of treatment under the often less than ideal circumstances in Accident and Emergency http://dx.doi.org/10.1016/j.bjoms.2016.11.029
P24 Fine Needle Aspiration of Thyroid nodules in Chichester, West Sussex: An audit of cytology and histology results. Time for a “one-stop” thyroid clinic? Clifton Wan ∗ , Peyman Alam Western Sussex Hospitals NHS Foundation Trust Introduction: To determine the accuracy and value of thyroid fine needle aspiration (FNA) and to assess the need for a combined “one-stop” thyroid clinic as recommended by the British Thyroid Association(BTA). Methods: A retrospective study of all FNA examinations of solitary thyroid nodules between January 2014 and August 2015. FNAs classified into 5 groups as per BTA: THY1 – non diagnostic, THY2 non-neoplastic, THY3 – neoplasm possible, THY4 – suspicious of malignancy, THY5 – diagnostic of malignancy. The histology and medical records were reviewed to determine whether cytology was accurate. Results: 309 FNAs assessed. There were 167 (54.0%) THY1 FNAs. To date, no malignancies followed 99 (32%) THY2 FNA category. 36 (11.7%) THY3 FNAs resulted in six malignancies (3 papillary carcinoma, 3 follicular carcinoma). 3 (1.0%) FNAs were THY4, histology of which confirmed to be papillary carcinoma. Of the 4 (1.3%) THY5’s, 2 were papillary carcinoma, one recurrence of follicular carcinoma, 1 squamous cell carcinoma metastases from distant site. This gives overall sensitivity of 100%, and specificity of 76%, positive predictive values for both THY4 and THY5 were 100% and negative predictive value of THY2 was 100%. Conclusions: Chichester THY2-THY5 data is comparable with national figures reinforcing that THY2 can be a reassuring result for patients. Our high THY1 figures highlight a need for a “one-stop” clinic, where the pathologist (technician) assesses adequacy of sample at time of testing. This can not only minimise frequent hospital visits and associated anxiety for patients but also has financial benefit for the organisation. http://dx.doi.org/10.1016/j.bjoms.2016.11.030 P25 Medication Induced Osteonecrosis of the Jaws (MRONJ): an update for the General Medical Practitioner Mei Ying Yeoh ∗ , Mohammed Imran Suida, Jonathon Reid Pinderfields General Hospital Introduction: Medication Related Osteonecrosis of the Jaw (MRONJ) is a rare but serious complication in patients who are treated with antiresorptive/antiangiogenic medications. The reported incidence rates are up to 10% where longer term treatment has been evident. MRONJ can occur