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A Retrospective Review of Open Tracheostomies at Grady Memorial Hospital by Emory Oral and Maxillofacial Surgery
Poster Session associated with positivity of the PVS (p<0.05). Stress/ PTSD and depression are significantly greater in AfroAmerican females when compared with their non-AfroAmerican cohorts (p<0.01). Conclusions: This is the first study to identify the prevalence of IPV in patients who frequent the oral surgery clinic at MMCSOD. HNF injuries and PVS were statistically significant as predictors of a present/past IPV injury etiology (p<0.001).2 Anxiety, depression, PTSD/stress, palpitations/chest pain/memory loss are statistically significant/ associated with IPV exposure. Afro-American females when compared to non-Afro-American cohorts have a statistically significant increase in stress/PTSD and depression. Although the sample is small, with greater numbers we expect that the use of these predictor variables will help to decipher the mechanistic pathway(s) of how IPV exposure precipitates/exacerbates chronic health disparities affecting a victim’s lifespan. The OMFS can provide a segway for community healthcare awareness to decrease the burden of health disparities due to IPVand save billions of dollars in healthcare cost.
POSTER 15 African Americans in Oral and Maxillofacial Surgery: Factors Affecting Career Choice, Satisfaction and Practice Patterns T. R. Criddle: Oregon Health and Science University, N. C. Gordon, G. Blakey, R. B. Bell Introduction: There is little data available on the factors involved in the selection of OMS as a specialty or the practice patterns and satisfaction among minority oral surgeons1. Therefore, the purpose of this study is to: 1) explore the motivating factors that contribute to African-Americans choosing oral and maxillofacial surgery as a career; 2) examine attitudes and personal satisfaction among minority oral and maxillofacial surgeons with the OMS residency application and training process; 3) report on practice patterns among minority oral and maxillofacial surgeons, and 4) identify perceived bias for or against African-American and other minority oral and maxillofacial surgeons in an attempt to aid the efforts of OMS residency programs and organizations to foster diversity2. Methods: A 19-item survey was sent to 80 OMS practitioners using contact information from the National Society of Oral and Maxillofacial Surgeons, an AAOMS affiliated organization, mailing list. All surveys were administered in paper format by mail and were followed by a reminder mailing after eight weeks. Only responses delivered within 16 weeks were accepted for analysis. Results: Of the 80 mailed surveys, 41 returned within the 16-week parameters representing a return rate of 51%. The majority of minority surgeon respondents were married males with a mean age of 60 who practice AAOMS 2015
surgery in a private practice setting. Most respondents currently practice on the eastern coast of the United States with some practicing on the western coast. Exposure in dental school was the most important factor in selecting OMFS as a specialty and both location and prestige were the most important factors in selecting a residency program. Most respondents reported that race did not affect the success of their application to residency and does not currently affect the success of their practice. However, 25-46% of participants have experienced racerelated harassment and 48-55% of participants feel there is a bias against African Americans in oral and maxillofacial surgery. Conclusions: Our data suggests that a significant number of minority oral and maxillofacial surgeons subjectively perceive race-based bias in their career, although it did not appear to affect professional success. References: 1. Aziz SR. Racial diversity in American oral and maxillofacial surgery. J Oral Maxillofac Surg. 2010 Aug;68(8):1723-31. Epub 2010 May 26. 2. Peterson NB, Friedman RH, Ash AS. Faculty self-reported experiences with racial and ethnic discrimination in academic medicine. J Gen Intern Med. 2004: 19-259-265.
POSTER 16 A Retrospective Review of Open Tracheostomies at Grady Memorial Hospital by Emory Oral and Maxillofacial Surgery S. Young: Emory University, S. Abramowicz, G. F. Bouloux Statement of Problem: The purpose of this study was to report our institution’s outcomes following open tracheostomies. Additionally, our study examined the number of subjects who were discharged from the ICU or weaned off mechanical ventilation within five postoperative days. Materials and Methods: A retrospective analysis of subjects who had tracheostomies at Grady Memorial Hospital from 2008 to 2015 was conducted. Subject charts were reviewed. Predictor variables were demographic information, indications, intraoperative complications, postoperative complications, and disposition on post-op day 5. Descriptive statistics were computed. Results: A total of 115 subjects (mean age 72, range 20-85) were included. 104/115 (90.4%) of the subjects included in this study received open tracheostomies due to prolonged mechanical ventilation. The two intraoperative complications (1.7%) consisted of a cardiac arrest with return of spontaneous circulation after ACLS and inability to initially access trachea. There were four subjects (3.5%) with postoperative bleeding which was e-57
Poster Session managed appropriately with surgicel packing. Two subjects (1.7%) died within five days postoperatively for reasons unrelated to the surgical tracheostomy. 64/115 (55.6%) of subjects were either discharged from the ICU or weaned off mechanical ventilation within 5 days postoperatively. Conclusion: The results of this study indicate that open tracheostomies performed by Oral and Maxillofacial Surgery at Grady Memorial Hospital with proper resident training and supervision are safe and have few complications. Our study also reveals that tracheostomies are successful in weaning patients off of mechanical ventilation and decreasing length of stay. References: 1. Haspel et al. Retrospective Study of Tracheostomy Indications and perioperative Complications on Oral and Maxillofacial Surgery Service. JOMS. 2012. 2. Rowshan. Surgical Tracheostomy. Atlas of the Oral and Maxillofacial Surgery Clinics. 2010.
POSTER 17 Oral Assessment of the Patients With Hematological Malignancies, 161 Cases During 2 Years Y. Shimada: National Center for Global Health and Medicine Hospital, Y. Kawasaki, I. Sato, Y. Nakagawa, S. Miyasako, M. Tayama, H. Kurokawa, H. Yamada, Y. Maruoka Statements of the Problem: The oral cavity has been identified as a potential site of complications in patients who need chemotherapy for hematological malignancy. However, there are few literatures that investigated the optimal oral management before chemotherapy and the details of oral complications after chemotherapy by a large-scale cohort study. This retrospective study was designed to carefully define and evaluate oral health conditions before and after chemotherapy and complications related to tooth extraction in a population of the patients with hematological malignancy. Materials and Methods: The study population included 161 patients with hematological malignancies such as multiple myeloma, malignant lymphoma, acute myeloid / lymphoid leukemia, and myelodysplastic syndrome seen in the Department of Oral and Maxillofacial Surgery, National Center for Global Health and Medicine Hospital, Tokyo, Japan, during the 2-year study period from January 2011 through December 2012. Patients who had already received chemotherapy were excluded. Of these patients, 80 visited our institution before chemotherapy was initiated. Oral health care and dental treatments including tooth e-58
extraction were performed for these patients. Charts and panoramic radiographs were reviewed retrospectively to evaluate oral health conditions before and after chemotherapy. Attention was directed to a time frame about one month after the chemotherapy was performed. Results: The patients included 45 males (56%) and 35 females (44%) whose age at first visit ranged from 26 to 90 years, with a median of 64 years. Of the 80 patients, 8 (10%) suffered oral complications after chemotherapy, the most common of these being the progression of marginal periodontitis (n = 3; 38%), which is unrelated to the tooth extraction site. Two of the 28 tooth extraction cases (7.1%) had poor prognosis such as dry socket and bacterial infection. Two cases that we decided not to do tooth extraction owing to tight schedule of chemotherapy and physical conditions had acute inflammation of the affected sites after chemotherapy. On the other hand, 72 (90%) patients did not suffer any oral complications after chemotherapy and were able to go on chemotherapy without stress in their oral cavity. Conclusion: This study suggests that the removal of infection focus in oral cavity as much as possible before chemotherapy is crucial for the patients with hematologic malignancy without reducing their quality of life.
References: 1. Raut A, Huryn JM, et al: Sequelae and complications related to dental extractions in patients with hematologic malignancies and the impact on medical outcome. Oral Surg Oral Med Oral Pathol Oral Radio Endod 92: 49-55, 2001. 2. Guven GS, Uzun O, et al: Infectious complicationshematologicalbyDiseasesretrospective cohort study (1997-2001). Support Care Cancer 14: 52-55, 2006.
OBSTRUCTIVE SLEEP APNEA (OSA) POSTER 18 How Does the Anatomy of the Lingual Artery Limit Base of Tongue Reduction for Obstructive Sleep Apnea? A Retrospective Review of a Large Cohort Using CT Angiograms of the Neck B. Williams: Assistant Professor - University of Utah, D. Drake, K. Sansom, M. Error Statement of the Problem: Obstructive sleep apnea with the level of obstruction at the base of tongue can be a challenge to treat successfully. Removal or ablation of AAOMS 2015
POSTER 15 African Americans in Oral and Maxillofacial Surgery: Factors Affecting Career Choice, Satisfaction and Practice Patterns T. R. Criddle: Oregon Health and Science University, N. C. Gordon, G. Blakey, R. B. Bell Introduction: There is little data available on the factors involved in the selection of OMS as a specialty or the practice patterns and satisfaction among minority oral surgeons1. Therefore, the purpose of this study is to: 1) explore the motivating factors that contribute to African-Americans choosing oral and maxillofacial surgery as a career; 2) examine attitudes and personal satisfaction among minority oral and maxillofacial surgeons with the OMS residency application and training process; 3) report on practice patterns among minority oral and maxillofacial surgeons, and 4) identify perceived bias for or against African-American and other minority oral and maxillofacial surgeons in an attempt to aid the efforts of OMS residency programs and organizations to foster diversity2. Methods: A 19-item survey was sent to 80 OMS practitioners using contact information from the National Society of Oral and Maxillofacial Surgeons, an AAOMS affiliated organization, mailing list. All surveys were administered in paper format by mail and were followed by a reminder mailing after eight weeks. Only responses delivered within 16 weeks were accepted for analysis. Results: Of the 80 mailed surveys, 41 returned within the 16-week parameters representing a return rate of 51%. The majority of minority surgeon respondents were married males with a mean age of 60 who practice AAOMS 2015
surgery in a private practice setting. Most respondents currently practice on the eastern coast of the United States with some practicing on the western coast. Exposure in dental school was the most important factor in selecting OMFS as a specialty and both location and prestige were the most important factors in selecting a residency program. Most respondents reported that race did not affect the success of their application to residency and does not currently affect the success of their practice. However, 25-46% of participants have experienced racerelated harassment and 48-55% of participants feel there is a bias against African Americans in oral and maxillofacial surgery. Conclusions: Our data suggests that a significant number of minority oral and maxillofacial surgeons subjectively perceive race-based bias in their career, although it did not appear to affect professional success. References: 1. Aziz SR. Racial diversity in American oral and maxillofacial surgery. J Oral Maxillofac Surg. 2010 Aug;68(8):1723-31. Epub 2010 May 26. 2. Peterson NB, Friedman RH, Ash AS. Faculty self-reported experiences with racial and ethnic discrimination in academic medicine. J Gen Intern Med. 2004: 19-259-265.
POSTER 16 A Retrospective Review of Open Tracheostomies at Grady Memorial Hospital by Emory Oral and Maxillofacial Surgery S. Young: Emory University, S. Abramowicz, G. F. Bouloux Statement of Problem: The purpose of this study was to report our institution’s outcomes following open tracheostomies. Additionally, our study examined the number of subjects who were discharged from the ICU or weaned off mechanical ventilation within five postoperative days. Materials and Methods: A retrospective analysis of subjects who had tracheostomies at Grady Memorial Hospital from 2008 to 2015 was conducted. Subject charts were reviewed. Predictor variables were demographic information, indications, intraoperative complications, postoperative complications, and disposition on post-op day 5. Descriptive statistics were computed. Results: A total of 115 subjects (mean age 72, range 20-85) were included. 104/115 (90.4%) of the subjects included in this study received open tracheostomies due to prolonged mechanical ventilation. The two intraoperative complications (1.7%) consisted of a cardiac arrest with return of spontaneous circulation after ACLS and inability to initially access trachea. There were four subjects (3.5%) with postoperative bleeding which was e-57
Poster Session managed appropriately with surgicel packing. Two subjects (1.7%) died within five days postoperatively for reasons unrelated to the surgical tracheostomy. 64/115 (55.6%) of subjects were either discharged from the ICU or weaned off mechanical ventilation within 5 days postoperatively. Conclusion: The results of this study indicate that open tracheostomies performed by Oral and Maxillofacial Surgery at Grady Memorial Hospital with proper resident training and supervision are safe and have few complications. Our study also reveals that tracheostomies are successful in weaning patients off of mechanical ventilation and decreasing length of stay. References: 1. Haspel et al. Retrospective Study of Tracheostomy Indications and perioperative Complications on Oral and Maxillofacial Surgery Service. JOMS. 2012. 2. Rowshan. Surgical Tracheostomy. Atlas of the Oral and Maxillofacial Surgery Clinics. 2010.
POSTER 17 Oral Assessment of the Patients With Hematological Malignancies, 161 Cases During 2 Years Y. Shimada: National Center for Global Health and Medicine Hospital, Y. Kawasaki, I. Sato, Y. Nakagawa, S. Miyasako, M. Tayama, H. Kurokawa, H. Yamada, Y. Maruoka Statements of the Problem: The oral cavity has been identified as a potential site of complications in patients who need chemotherapy for hematological malignancy. However, there are few literatures that investigated the optimal oral management before chemotherapy and the details of oral complications after chemotherapy by a large-scale cohort study. This retrospective study was designed to carefully define and evaluate oral health conditions before and after chemotherapy and complications related to tooth extraction in a population of the patients with hematological malignancy. Materials and Methods: The study population included 161 patients with hematological malignancies such as multiple myeloma, malignant lymphoma, acute myeloid / lymphoid leukemia, and myelodysplastic syndrome seen in the Department of Oral and Maxillofacial Surgery, National Center for Global Health and Medicine Hospital, Tokyo, Japan, during the 2-year study period from January 2011 through December 2012. Patients who had already received chemotherapy were excluded. Of these patients, 80 visited our institution before chemotherapy was initiated. Oral health care and dental treatments including tooth e-58
extraction were performed for these patients. Charts and panoramic radiographs were reviewed retrospectively to evaluate oral health conditions before and after chemotherapy. Attention was directed to a time frame about one month after the chemotherapy was performed. Results: The patients included 45 males (56%) and 35 females (44%) whose age at first visit ranged from 26 to 90 years, with a median of 64 years. Of the 80 patients, 8 (10%) suffered oral complications after chemotherapy, the most common of these being the progression of marginal periodontitis (n = 3; 38%), which is unrelated to the tooth extraction site. Two of the 28 tooth extraction cases (7.1%) had poor prognosis such as dry socket and bacterial infection. Two cases that we decided not to do tooth extraction owing to tight schedule of chemotherapy and physical conditions had acute inflammation of the affected sites after chemotherapy. On the other hand, 72 (90%) patients did not suffer any oral complications after chemotherapy and were able to go on chemotherapy without stress in their oral cavity. Conclusion: This study suggests that the removal of infection focus in oral cavity as much as possible before chemotherapy is crucial for the patients with hematologic malignancy without reducing their quality of life.
References: 1. Raut A, Huryn JM, et al: Sequelae and complications related to dental extractions in patients with hematologic malignancies and the impact on medical outcome. Oral Surg Oral Med Oral Pathol Oral Radio Endod 92: 49-55, 2001. 2. Guven GS, Uzun O, et al: Infectious complicationshematologicalbyDiseasesretrospective cohort study (1997-2001). Support Care Cancer 14: 52-55, 2006.
OBSTRUCTIVE SLEEP APNEA (OSA) POSTER 18 How Does the Anatomy of the Lingual Artery Limit Base of Tongue Reduction for Obstructive Sleep Apnea? A Retrospective Review of a Large Cohort Using CT Angiograms of the Neck B. Williams: Assistant Professor - University of Utah, D. Drake, K. Sansom, M. Error Statement of the Problem: Obstructive sleep apnea with the level of obstruction at the base of tongue can be a challenge to treat successfully. Removal or ablation of AAOMS 2015