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Management of lip malignancies
1010 ICOMS 2011—Abstracts: Invited Papers multidisciplinary pre-surgical examination for a well-established treatment planning. The primary curative intent of the oncological treatment and the prognosis for later prosthodontic rehabilitation have to be taken into account too. doi:10.1016/j.ijom.2011.07.852
13 State of the art in implant anchored facial prosthesis V.S. Konstantinovic Clinic of Maxillofacial Surgery, University of Belgrade, Belgrade, Serbia
The main problem in maxillofacial prosthodontic is retention of prosthesis. The introduction of implants improves prosthesis stability and therefore the quality of the life of the patients. However there are certain problems in everyday practice. There are some specifics of maxillofacial implantology: explicit anatomical relation to the intracranial structures; less bone quality and quantity; more compact bone; irradiated tissues. Lack of the bone limits use of conventional screw like implants. Also, implant survival in irradiated tissues is much lower. Implantation during the primary surgical procedure is not recommended in patients who will undergo postoperative irradiation. According to the literature, there is no type of implant which could be considered as superior for the implantation in the irradiated bone. Many studies shows, that the increasing of time interval between irradiation and implantation could be of great importance for implant survival. However, there are only few studies performed in humans, so there is no unique protocol concerning to the time of implant placement. Basally oseointegrated implants (disk implants) present excellent alternative in irradiated patients. Patients with auricular, nasal and orbital implant anchored prosthesis will be presented. doi:10.1016/j.ijom.2011.07.853
14 Does screening for oral cancer saves lives? P. Chaturvedi Head and Neck Surgery, Tata Memorial Hospital, Mumbai, India
Oral cancer is one of the commonest cancer in Indian men (12.6 per 100 000) and common in women also. It is the leading cause of cancer related deaths in Indian men.
Internationally it is the eighth most common malignancy reported associated with high mortality rate. It is common among illiterates and those with low income, poor hygiene, poor nutrition and tobacco/areca nut users. Though Oral cancer is one of the best model of screening amongst all human cancers, most of the patients present at a late stage of disease and die in the same year as the year of diagnosis. A cluster randomized trial in south of India showed that screening of oral cancer reduced mortality due to oral cancer in high risk population. The screening test used in that trial was “visual examination by health workers”. Such an intervention is most suited for impoverished nations because it is cheap and reasonably accurate. The sensitivity and specificity are generally of a high order with the pooled average of six studies have yielded a reasonable sensitivity and specificity. The accuracy of the visual inspection can be improved by appropriate standardization and training of the screening individual. Needless to say that, research to develop non invasive diagnostic tools (spectroscopy, salivary test, etc.) that can not only improve but also expedite the diagnosis are need of the hour. It seems that screening and subsequent prompt diagnosis may lead to significant reduction of oral cancer incidence and mortality rate. doi:10.1016/j.ijom.2011.07.854
15 Contemporary management of paranasal sinus tumors R.A. Ord Oral and Maxillofacial Surgery, University of Maryland, Baltimore, MD, USA
This presentation will review the complex anatomy of the paranasal sinuses with emphasis on the maxillary sinus. The diverse nature of the tumours of this region, surgical approaches and classification is discussed. Specific areas of controversy to be examined are the management of the neck, management of the globe/orbit, and the role of craniofacial resection. The presentation will also discuss the current emergence of primary reconstruction of the maxillectomy defect utilizing microvascular free flaps. doi:10.1016/j.ijom.2011.07.855
16 Management of lip malignancies J.C. Roldán 1,2 1 Cranio-Maxillo-Facial Plastic Surgery, University of Regensburg, Regensburg, Germany 2 Facial Plastic Reconstructive and Aesthetic Surgery, Clinic for Facial Plastic Surgery, Hamburg, Germany
Lips are commonly involved by nonmelanoma skin cancer. Basal cell carcinoma (BCC) involves predominantly the upper lip (skin), whereas squamous cell carcinoma (SSC) the lower lip (vermilion). Lip cancer in the earlier stages has a good prognosis. Advanced stages of BCC with bone infiltration are surgically and oncologically very challenging. SCC of the lower lip with lymph node metastasis has a poor prognosis. Surgical techniques for tumour resection play a critical role on the functional and aesthetic outcome. The vermilionectomy, as a supplementary treatment of lower lip carcinoma in presence of actinic cheilitis, improves the oncological outcome. An algorithm for lip reconstruction will be presented. The concept is based on the length of the resulted lip defect. The authors choose a rectangular excision and a bilateral step stair technique according to Johanson for lower lip defects up to 2/3 of the lip length. For lower lip defects >2/3 an Abbe flap is supplemented with Johanson plasty. In subtotal lower lip defects a double Abbe flap and a Johanson plasty is the first choice. For an upper lip defect up to 1/3 of the lip a rectangular resection with inclusion of a crescentic peri-alar skin excision is recommended. Upper lip defects >than 1/3 of the lip are repaired with an Abbe flap and a Johanson plasty in the lower lip (donor area). Upper lip defects including more than 2/3 of the lip are reconstructed with the techniques mentioned before and supplemented by nasolabial flaps. doi:10.1016/j.ijom.2011.07.856
17 Long-term outcomes in complete uclp and bclp U. Joos Cranio-Maxillofacial Surgery, Muenster University Hospital, Muenster, Germany
Anyone who has treated CLP knows the problems associated with skeletal growth occurring during treatment. There were numerous attempts to find out the source of these problems to improve treatment. It was assumed that a growth deficit results
13 State of the art in implant anchored facial prosthesis V.S. Konstantinovic Clinic of Maxillofacial Surgery, University of Belgrade, Belgrade, Serbia
The main problem in maxillofacial prosthodontic is retention of prosthesis. The introduction of implants improves prosthesis stability and therefore the quality of the life of the patients. However there are certain problems in everyday practice. There are some specifics of maxillofacial implantology: explicit anatomical relation to the intracranial structures; less bone quality and quantity; more compact bone; irradiated tissues. Lack of the bone limits use of conventional screw like implants. Also, implant survival in irradiated tissues is much lower. Implantation during the primary surgical procedure is not recommended in patients who will undergo postoperative irradiation. According to the literature, there is no type of implant which could be considered as superior for the implantation in the irradiated bone. Many studies shows, that the increasing of time interval between irradiation and implantation could be of great importance for implant survival. However, there are only few studies performed in humans, so there is no unique protocol concerning to the time of implant placement. Basally oseointegrated implants (disk implants) present excellent alternative in irradiated patients. Patients with auricular, nasal and orbital implant anchored prosthesis will be presented. doi:10.1016/j.ijom.2011.07.853
14 Does screening for oral cancer saves lives? P. Chaturvedi Head and Neck Surgery, Tata Memorial Hospital, Mumbai, India
Oral cancer is one of the commonest cancer in Indian men (12.6 per 100 000) and common in women also. It is the leading cause of cancer related deaths in Indian men.
Internationally it is the eighth most common malignancy reported associated with high mortality rate. It is common among illiterates and those with low income, poor hygiene, poor nutrition and tobacco/areca nut users. Though Oral cancer is one of the best model of screening amongst all human cancers, most of the patients present at a late stage of disease and die in the same year as the year of diagnosis. A cluster randomized trial in south of India showed that screening of oral cancer reduced mortality due to oral cancer in high risk population. The screening test used in that trial was “visual examination by health workers”. Such an intervention is most suited for impoverished nations because it is cheap and reasonably accurate. The sensitivity and specificity are generally of a high order with the pooled average of six studies have yielded a reasonable sensitivity and specificity. The accuracy of the visual inspection can be improved by appropriate standardization and training of the screening individual. Needless to say that, research to develop non invasive diagnostic tools (spectroscopy, salivary test, etc.) that can not only improve but also expedite the diagnosis are need of the hour. It seems that screening and subsequent prompt diagnosis may lead to significant reduction of oral cancer incidence and mortality rate. doi:10.1016/j.ijom.2011.07.854
15 Contemporary management of paranasal sinus tumors R.A. Ord Oral and Maxillofacial Surgery, University of Maryland, Baltimore, MD, USA
This presentation will review the complex anatomy of the paranasal sinuses with emphasis on the maxillary sinus. The diverse nature of the tumours of this region, surgical approaches and classification is discussed. Specific areas of controversy to be examined are the management of the neck, management of the globe/orbit, and the role of craniofacial resection. The presentation will also discuss the current emergence of primary reconstruction of the maxillectomy defect utilizing microvascular free flaps. doi:10.1016/j.ijom.2011.07.855
16 Management of lip malignancies J.C. Roldán 1,2 1 Cranio-Maxillo-Facial Plastic Surgery, University of Regensburg, Regensburg, Germany 2 Facial Plastic Reconstructive and Aesthetic Surgery, Clinic for Facial Plastic Surgery, Hamburg, Germany
Lips are commonly involved by nonmelanoma skin cancer. Basal cell carcinoma (BCC) involves predominantly the upper lip (skin), whereas squamous cell carcinoma (SSC) the lower lip (vermilion). Lip cancer in the earlier stages has a good prognosis. Advanced stages of BCC with bone infiltration are surgically and oncologically very challenging. SCC of the lower lip with lymph node metastasis has a poor prognosis. Surgical techniques for tumour resection play a critical role on the functional and aesthetic outcome. The vermilionectomy, as a supplementary treatment of lower lip carcinoma in presence of actinic cheilitis, improves the oncological outcome. An algorithm for lip reconstruction will be presented. The concept is based on the length of the resulted lip defect. The authors choose a rectangular excision and a bilateral step stair technique according to Johanson for lower lip defects up to 2/3 of the lip length. For lower lip defects >2/3 an Abbe flap is supplemented with Johanson plasty. In subtotal lower lip defects a double Abbe flap and a Johanson plasty is the first choice. For an upper lip defect up to 1/3 of the lip a rectangular resection with inclusion of a crescentic peri-alar skin excision is recommended. Upper lip defects >than 1/3 of the lip are repaired with an Abbe flap and a Johanson plasty in the lower lip (donor area). Upper lip defects including more than 2/3 of the lip are reconstructed with the techniques mentioned before and supplemented by nasolabial flaps. doi:10.1016/j.ijom.2011.07.856
17 Long-term outcomes in complete uclp and bclp U. Joos Cranio-Maxillofacial Surgery, Muenster University Hospital, Muenster, Germany
Anyone who has treated CLP knows the problems associated with skeletal growth occurring during treatment. There were numerous attempts to find out the source of these problems to improve treatment. It was assumed that a growth deficit results