- Email: [email protected]
10 years experience in intra-oral vertical subsigmoid osteotomy at University Hospitals of Leicester
S94
Poster presentation / British Journal of Oral and Maxillofacial Surgery 49S (2011) S26–S116
P191 Self publication for medical or dental texts A. Sadler The high cost of producing, printing and distributing a specialist text books means publication is often uneconomic where a high demand is unlikely. Desk Top Publishing software, on line selling and more recently high quality digital printing with ‘Print on Demand’ mean that it is now feasible for an author to do it themselves. Whereas there are disadvantages to not having a conventional publisher there are also significant advantages. The author maintains the copyright, the text can be easily changed or updated each time it is printed and there is the potential to produce a higher income with a lower cover price. ‘Dentist on the Ward – An introduction to the general hospital for students and foundation trainees in Dental, Oral and Maxillofacial Surgery’ was so produced. The technology, printing and distribution will be explained together with the economics as they apply to this book. doi:10.1016/j.bjoms.2011.03.197 P192 Patient satisfaction survey following intra-oral vertical subsigmoid osteotomy S. Sah ∗ , S. Shenoy, I. Ormiston The Leicester Royal Infirmary, United Kingdom Aim: The purpose of this retrospective postal survey was to determine patient satisfaction, in particular with reference to inter-maxillary fixation (IMF). Method: Ninety-one patients in this study underwent intra-oral vertical subsigmoid osteotomy between January 2004 and December 2009. The survey was comprised of 19 questions answered by the patients expressing their grading for the surgery. Out of 19 questions, there were 12 questions using visual analogue scale (VAS; 0 = poor, 10 = excellent). The remaining 7 questions were closed-form questions with yes/no answers, as well as one open question for ‘further remarks’. Results: Out of 91 patients, 50 returned the completed questionnaire. Seven questionnaires were returned back as the patient had changed his/her address. The motive to undergo IVSO only for aesthetic improvement was observed in 14% of patients; only improvement of chewing and biting function in 30%; both in 49%; and none/do not know in around 7%. Seventy-seven percent of the patients stated that they noticed improvement in aesthetics and masticatory function following the surgery. More than 95% of the patients felt significant increase in self-confidence. Conclusion: Due to IMF, majority of the patients had difficulty in eating, speaking and lost weight. But only one patient reported to have numbness of lower lip. So, the outcome was
that 96% respondents preferred to have IVSO and intermaxillary fixation over sagittal split osteotomy with higher risk of permanent numbness of lip and tongue. If advised, 81% of respondents were willing to go through the same procedure again in the future. doi:10.1016/j.bjoms.2011.03.198 P193 10 years experience in intra-oral vertical subsigmoid osteotomy at University Hospitals of Leicester S. Sah ∗ , S. Shenoy, I. Ormiston The Leicester Royal Infirmary, United Kingdom Introduction: Intra-oral vertical subsigmoid osteotomy (IVSO) is a mandibular ramus osteotomy technique used for correction of mandibular prognathism and post traumatic deformity. This technique is simple and less time consuming. But, it has a steep learning curve. The procedure results in less neurosensory disturbances compared to sagittal split osteotomy of the mandible. Downside of the technique is limited access and visibility during the procedure. Further, patients will require inter-maxillary fixation (IMF) for six weeks to ensure satisfactory bone healing. Objective: To illustrate the usefulness of intra-oral vertical subsigmoid osteotomy (ISVO) in correction of mandibular deformities. Material and methods: Total of 138 patients who have had IVSO procedures are involved in the retrospective data collection from July 2000 to June 2010 (10 years). Result: There was no significant complication in our case series. The average hospital stay with this procedure was 48 h in general surgical ward. None of the patients needed HDU care. Out of 138 sample size, only one patient needed removal of IMF in recovery due to upper airway problem. Three percent of the patients suffered with neurosensory disturbances of inferior alveolar nerve. Conclusion: VSSO is neither a new nor an advanced procedure. The study highlights the importance of an alternative osteotomy technique in the management of mandibular deformity. The oral maxillofacial surgeon should be familiar with a diverse range of surgical techniques in correction of dentofacial deformity. doi:10.1016/j.bjoms.2011.03.199
Poster presentation / British Journal of Oral and Maxillofacial Surgery 49S (2011) S26–S116
P191 Self publication for medical or dental texts A. Sadler The high cost of producing, printing and distributing a specialist text books means publication is often uneconomic where a high demand is unlikely. Desk Top Publishing software, on line selling and more recently high quality digital printing with ‘Print on Demand’ mean that it is now feasible for an author to do it themselves. Whereas there are disadvantages to not having a conventional publisher there are also significant advantages. The author maintains the copyright, the text can be easily changed or updated each time it is printed and there is the potential to produce a higher income with a lower cover price. ‘Dentist on the Ward – An introduction to the general hospital for students and foundation trainees in Dental, Oral and Maxillofacial Surgery’ was so produced. The technology, printing and distribution will be explained together with the economics as they apply to this book. doi:10.1016/j.bjoms.2011.03.197 P192 Patient satisfaction survey following intra-oral vertical subsigmoid osteotomy S. Sah ∗ , S. Shenoy, I. Ormiston The Leicester Royal Infirmary, United Kingdom Aim: The purpose of this retrospective postal survey was to determine patient satisfaction, in particular with reference to inter-maxillary fixation (IMF). Method: Ninety-one patients in this study underwent intra-oral vertical subsigmoid osteotomy between January 2004 and December 2009. The survey was comprised of 19 questions answered by the patients expressing their grading for the surgery. Out of 19 questions, there were 12 questions using visual analogue scale (VAS; 0 = poor, 10 = excellent). The remaining 7 questions were closed-form questions with yes/no answers, as well as one open question for ‘further remarks’. Results: Out of 91 patients, 50 returned the completed questionnaire. Seven questionnaires were returned back as the patient had changed his/her address. The motive to undergo IVSO only for aesthetic improvement was observed in 14% of patients; only improvement of chewing and biting function in 30%; both in 49%; and none/do not know in around 7%. Seventy-seven percent of the patients stated that they noticed improvement in aesthetics and masticatory function following the surgery. More than 95% of the patients felt significant increase in self-confidence. Conclusion: Due to IMF, majority of the patients had difficulty in eating, speaking and lost weight. But only one patient reported to have numbness of lower lip. So, the outcome was
that 96% respondents preferred to have IVSO and intermaxillary fixation over sagittal split osteotomy with higher risk of permanent numbness of lip and tongue. If advised, 81% of respondents were willing to go through the same procedure again in the future. doi:10.1016/j.bjoms.2011.03.198 P193 10 years experience in intra-oral vertical subsigmoid osteotomy at University Hospitals of Leicester S. Sah ∗ , S. Shenoy, I. Ormiston The Leicester Royal Infirmary, United Kingdom Introduction: Intra-oral vertical subsigmoid osteotomy (IVSO) is a mandibular ramus osteotomy technique used for correction of mandibular prognathism and post traumatic deformity. This technique is simple and less time consuming. But, it has a steep learning curve. The procedure results in less neurosensory disturbances compared to sagittal split osteotomy of the mandible. Downside of the technique is limited access and visibility during the procedure. Further, patients will require inter-maxillary fixation (IMF) for six weeks to ensure satisfactory bone healing. Objective: To illustrate the usefulness of intra-oral vertical subsigmoid osteotomy (ISVO) in correction of mandibular deformities. Material and methods: Total of 138 patients who have had IVSO procedures are involved in the retrospective data collection from July 2000 to June 2010 (10 years). Result: There was no significant complication in our case series. The average hospital stay with this procedure was 48 h in general surgical ward. None of the patients needed HDU care. Out of 138 sample size, only one patient needed removal of IMF in recovery due to upper airway problem. Three percent of the patients suffered with neurosensory disturbances of inferior alveolar nerve. Conclusion: VSSO is neither a new nor an advanced procedure. The study highlights the importance of an alternative osteotomy technique in the management of mandibular deformity. The oral maxillofacial surgeon should be familiar with a diverse range of surgical techniques in correction of dentofacial deformity. doi:10.1016/j.bjoms.2011.03.199