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Treatment of malocclusion following reconstruction of the mandible with the free fibula flap
Poster presentation / British Journal of Oral and Maxillofacial Surgery 49S (2011) S26–S116
Salmon-calcitonin nasal spray provides a simple, effective, easy-to-use method of treatment which may also improve likeliness of compliance. We illustrate this case with clinical photographs and serial imaging. doi:10.1016/j.bjoms.2011.03.011 P3 An investigation into patients expect from an Oral & Maxillofacial Surgery unit website: a multi-centre qualitative study M. Abu-Serriah ∗ , R. Banks, P. Ameerally, D.K. Dhariwall Oxford Radcliffe Hospitals NHS Trust, Oxford, United Kingdom Aim: • To measure the online of presence of Oral and Maxillofacial Surgery (OMFS) units in the UK. • To identify patient expectations of an OMFS unit website. • To examine whether OMFS units in the UK satisfy these expectations. Material and methods: A random group of patients who attended the OMFS units in three cities (Oxford, Sunderland and Northampton) were invited directly or by post to express their views on the nature of information they would like to find on an OMFS unit website. The questionnaire was distributed, time was given to browse the site and responses were recorded. An updated list of all OMFS units in the UK was obtained. Google search engine was used to identify whether each unit has a website and if so, whether the content of this site satisfied patients’ expectations. Results: A total of 100 responses were received, of which 9 individuals expressed no interest. A total of 18 common themes were identified. Information about available facilities at hospital (e.g. car parking) was the commonest theme. Only half (51%) of OMFS units in the UK have websites. At best OMFS units satisfied 50% of what patients expected from a website. Conclusion: • The worldwide web is poorly used by our specialty in the UK. • The content of these websites commonly fails to meet patient expectations. • The clinical, educational, economical, social and political implications of a strong online presence will be discussed. doi:10.1016/j.bjoms.2011.03.012
S27
P4 Treatment of malocclusion following reconstruction of the mandible with the free fibula flap A. Ahmed ∗ , M. Gilhooly, B. Visavadia, M. Kumar, M. Amin Northwick Park Hospital, United Kingdom Introduction: Vascularized fibula transfer has become a preferred method of mandibular restoration after oncologic surgical ablation. Malocclusion may result after free fibula flap reconstruction of the mandible, because of inadequate positioning of the temporomandibular joint, inaccurate contouring of the reconstruction plate, or subsequent fracture of a miniplate. Factors that alter the vascularity of the transplanted fibula may also result in a delayed presentation of malocclusion. Method: We describe 2 cases that had reconstruction of the Mandible following oncological resection with Free fibula flaps who subsequently presented with malocclusion. Case 1-fibular osteotomy: had an increased AP discrepancy treated with a fibular osteotomy. The advantage of the sagittal split is that it gives the opportunity to correct the asymmetry by moving the cut fragments in both the horizontal and vertical planes, and it has ample juxtaposed thick cortical bone to ensure good fixation, stabilisation, and subsequent healing. Case 2-fibular distraction osteogenesis: Applied to a fibula microvascularized flap the craniomaxillofacial (CMF) distraction system is a modular system of internal distraction devices was used to slowly distract the fibula until the asymmetry and malocclusion was corrected. Conclusions: Reconstruction of large mandibular defects can be complicated by asymmetry and malocclusion particularly if the whole of the mandible is removed. We describe 2 methods of treatment to treat various malocclusions in vascularized fibula flaps. doi:10.1016/j.bjoms.2011.03.013 P5 An audit of parotidectomy cases from 2008 to 2010 at NWLH trust A. Ahmed ∗ , Z. Syed, T. Levine, M. Gilhooley North West London Hospitals Trust, United Kingdom Introduction: There are various guidelines available that outline a clinical pathway patients should follow when presenting with parotid and salivary gland pathology, backed up by a number of previous studies, only 2 however have been conducted within the UK. Thanks to these it has become standard practice for these patients to have clinical review, ultrasound (US) or appropriate imaging and fine needle aspiration (FNA) of parotid lesions before the decision for surgical intervention is finally made. It is therefore within
Salmon-calcitonin nasal spray provides a simple, effective, easy-to-use method of treatment which may also improve likeliness of compliance. We illustrate this case with clinical photographs and serial imaging. doi:10.1016/j.bjoms.2011.03.011 P3 An investigation into patients expect from an Oral & Maxillofacial Surgery unit website: a multi-centre qualitative study M. Abu-Serriah ∗ , R. Banks, P. Ameerally, D.K. Dhariwall Oxford Radcliffe Hospitals NHS Trust, Oxford, United Kingdom Aim: • To measure the online of presence of Oral and Maxillofacial Surgery (OMFS) units in the UK. • To identify patient expectations of an OMFS unit website. • To examine whether OMFS units in the UK satisfy these expectations. Material and methods: A random group of patients who attended the OMFS units in three cities (Oxford, Sunderland and Northampton) were invited directly or by post to express their views on the nature of information they would like to find on an OMFS unit website. The questionnaire was distributed, time was given to browse the site and responses were recorded. An updated list of all OMFS units in the UK was obtained. Google search engine was used to identify whether each unit has a website and if so, whether the content of this site satisfied patients’ expectations. Results: A total of 100 responses were received, of which 9 individuals expressed no interest. A total of 18 common themes were identified. Information about available facilities at hospital (e.g. car parking) was the commonest theme. Only half (51%) of OMFS units in the UK have websites. At best OMFS units satisfied 50% of what patients expected from a website. Conclusion: • The worldwide web is poorly used by our specialty in the UK. • The content of these websites commonly fails to meet patient expectations. • The clinical, educational, economical, social and political implications of a strong online presence will be discussed. doi:10.1016/j.bjoms.2011.03.012
S27
P4 Treatment of malocclusion following reconstruction of the mandible with the free fibula flap A. Ahmed ∗ , M. Gilhooly, B. Visavadia, M. Kumar, M. Amin Northwick Park Hospital, United Kingdom Introduction: Vascularized fibula transfer has become a preferred method of mandibular restoration after oncologic surgical ablation. Malocclusion may result after free fibula flap reconstruction of the mandible, because of inadequate positioning of the temporomandibular joint, inaccurate contouring of the reconstruction plate, or subsequent fracture of a miniplate. Factors that alter the vascularity of the transplanted fibula may also result in a delayed presentation of malocclusion. Method: We describe 2 cases that had reconstruction of the Mandible following oncological resection with Free fibula flaps who subsequently presented with malocclusion. Case 1-fibular osteotomy: had an increased AP discrepancy treated with a fibular osteotomy. The advantage of the sagittal split is that it gives the opportunity to correct the asymmetry by moving the cut fragments in both the horizontal and vertical planes, and it has ample juxtaposed thick cortical bone to ensure good fixation, stabilisation, and subsequent healing. Case 2-fibular distraction osteogenesis: Applied to a fibula microvascularized flap the craniomaxillofacial (CMF) distraction system is a modular system of internal distraction devices was used to slowly distract the fibula until the asymmetry and malocclusion was corrected. Conclusions: Reconstruction of large mandibular defects can be complicated by asymmetry and malocclusion particularly if the whole of the mandible is removed. We describe 2 methods of treatment to treat various malocclusions in vascularized fibula flaps. doi:10.1016/j.bjoms.2011.03.013 P5 An audit of parotidectomy cases from 2008 to 2010 at NWLH trust A. Ahmed ∗ , Z. Syed, T. Levine, M. Gilhooley North West London Hospitals Trust, United Kingdom Introduction: There are various guidelines available that outline a clinical pathway patients should follow when presenting with parotid and salivary gland pathology, backed up by a number of previous studies, only 2 however have been conducted within the UK. Thanks to these it has become standard practice for these patients to have clinical review, ultrasound (US) or appropriate imaging and fine needle aspiration (FNA) of parotid lesions before the decision for surgical intervention is finally made. It is therefore within