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An audit of facial radiographs taken in an accident & emergency department
Abstracts Tumours Osman
of maxillofacial Sejfija. Medical
Maxillofacial
region
in children
Faculty, Surgery, Prishtina.
and
Department
young
patients.
of Oral and
Tumours of the maxillofacial region are frequently (mainly) with dermal (epithelial) origins, and rarely of mesodermal. Tumours are benign and malignant and can mainly be found in elderly persons. Benign tumours, especially dentogen ones, can be found in young adults too. Malignant tumours, especially ectodermal ones, are found mainly in elderly patients, but in some cases we have found them in children as well. We have had these benign extraoral tumours of maxillofacial region: fibromas, chondromas, papillomas, etc. In parotid gland we found pleomorphic adenoma and haemangioma. The surgical treatment was satisfactory. As to benign intraoral tumours, we have frequently found fibromas, gigantocelulare tumour, odontoma and ameloblastoma. Similarly, except ameloblastomas, surgical treatment of those turnouts was easy. In some cases of ameloblastomas osteotransplantation was indicated. Recurrence and malignant alteration, after the surgical treatment occurred. Extraoral malignant tumours: squamous carcinoma of face skin in young persons are rare. Those cases which are malignant usually have xerodermia pigmentosa characteristics. Surgical treatment has given good results. Patients with squamous carcinoma of parotid gland were successfully treated with radical surgical treatment. Intraoral malignant tumous: osteochondrosarcomas and malignant ameloblastomas. Surgical treatment in the first case was successful, but not in the second one. Evidence for in situ clonal T-cell expansion in oral squamous cell carcinoma. M Stephens*, S. H. Limt, P. Stephens, M Fardy & D. W. Thomas. Departments of *Oral & Maxillofacial Surgery, and *Haematology Car&x UK.
Oral squamous cell carcinomas (OSCC) are frequently associated with tumour infiltrating lymphocytes (TIL) which may reflect an in viva immune reaction against the tumour cells.’ To test this hypothesis T-cell receptor (TCR) VP gene usage was studied in TIL and peripheral blood mononuclear cells (PMNC) of 10 patients with OSCC. The molecular techniques of reversetranscription polymerase chain reaction (using a panel of 25 family specific primers; Clontech Laboratories Inc., Ca) and Southern blotting (with a CD internal probe) were used to confirm TCR Vfl restriction, TCR V/I usage was uniformly unrestricted in the peripheral blood of OSCC patients (>22/25 TCR VP sub-families present). Restricted TCR V/I usage was however evident in TIL and varied between patients and between primary tumours and regional lymph nodes. In a patient with histological evidence of marked tumour destruction associated with the TIL, cloning and nucleotide sequence analysis were performed. Only 2/25 VP TCR families were evident in this tumour (V/36, VPS) whereas all 25 VP families were represented in the PMNC. V/?S cDNA from TIL and PMNC was cloned using a TA cloning kit (Invitrogen Corporation, USA). DNA length analysis, single-strand conformation polymorphism (SSCP) and nucleotide sequencing were performed. All colonies of TIL V/j’8 that were selected demonstrated identical nucleotide sequences using Jb2.7 and Ca2 genes. In the PMNC there was no repetition of TCR length or SSCP of the V/38 clones. These data have demonstrated for the first time the specific recruitment and clonal expansion of TIL in OSCC and provide
257
support for the investigation of tumour-specific immunotheraphy in OSCC.
Reference 1. Thomas DW et al. J Oral Path01 Med 1995; 24: 23-3 1. An audit of facial department. Keith
Maxillofacial Trent.
radiographs taken in an Accident & Emergency Webster & Tim Malins. Department of Oral
Surgery, North
Staffordshire Hospital,
& Stoke-on-
A retrospective review of 1538 facial radiographs of 414 patients attending the Accident & Emergency department of the North Staffordshire Hospital over a 6 month period was undertaken. The number, type and appropriateness of the views taken was compared with guidelines issued to the Accident & Emergency department 3 years previously. The number of radiographs taken exceeded that in the guidelines. The mean number of films taken, the aetiology of injury, the number of actual and missed fractures detected is presented, along with suggestions on how the guidelines can be better implemented. Amylase
in lymphoepithelial
cysts.
D. Wedg+izood
& A. Fraser.
Royal
Shrewsbury Hospital, Shropshire, UK. High amylase levels have been noted in lymphoepithelial (branchial) cysts. Amylase titres are compared with those in non-lymphoepithelial cysts. Evidence is presented of amylase production in cyst lining. Possible significance in relation to theories of aetiology of LE cysts is discussed. Stickler
-
Maxillofacial
the
elusive
syndrome.
K.
Wilson
& D.
W
Patton.
Unit, Morriston Hospital, Swansea, UK.
Stickler syndrome is a rare genetic disorder of connective tissues. Also known as hereditary progressive arthro-ophthalmopathy, the characteristic features include orofacial, eye and joint abnormalities, Named after the paediatrician who first described the condition in the 1960s it is a diagnosis easily overlooked because of its diverse presentation. Early diagnosis is important in order that any ocular involvement may be detected early, to avoid visual impairment. Unfortunately the diagnosis is frequently missed in children presenting with a cleft palate. It is therefore important that maxillofacial surgeons are aware of the condition and its significance in cleft palate children. Inherited as an autosomal dominant trait, collagen production is abnormal leading to a variety of defects which vary in their degree of severity even within affected families. Facial manifestations may include a cleft palate, Pierre Robin sequence, midface hypoplasia and nasal deformities. Eye involvement includes retinal detachments, tears and degeneration; severe myopia, early cataracts and secondary glaucoma. The poster emphasises the importance of early diagnosis in this condition.
Abstracts of papersfrom the 1996 BAOMS Meeting Head and neck malignant S. D. Adcock & N. Baker.
melanoma
- a 10 year
follow-up
study.
St Richard’s Hospital, Chichester, (South Coast Training Programme), UK. Cutaneous malignant melanoma causes up to 2% of deaths due to carcinoma and the incidence is thought to be rising. A retrospective study of patients treated in the Maxillofacial Unit based at St Richard’s Hospital was carried out. The study period was over the last 10 years and 75 patients were identified.
The presence or absence of a previous pigmented lesion at the site of the malignant melanoma was documented as well as site, size, ulceration, Breslow thickness and Clark’s level of invasion. These factors were related to the incidence of metastases and recurrence. Excision margins at the time of primary surgery were also related to outcome. A lower rate of local recurrence and distant metastases than in malignant melanoma at other cutaneous sites was noted and is discussed.
of maxillofacial Sejfija. Medical
Maxillofacial
region
in children
Faculty, Surgery, Prishtina.
and
Department
young
patients.
of Oral and
Tumours of the maxillofacial region are frequently (mainly) with dermal (epithelial) origins, and rarely of mesodermal. Tumours are benign and malignant and can mainly be found in elderly persons. Benign tumours, especially dentogen ones, can be found in young adults too. Malignant tumours, especially ectodermal ones, are found mainly in elderly patients, but in some cases we have found them in children as well. We have had these benign extraoral tumours of maxillofacial region: fibromas, chondromas, papillomas, etc. In parotid gland we found pleomorphic adenoma and haemangioma. The surgical treatment was satisfactory. As to benign intraoral tumours, we have frequently found fibromas, gigantocelulare tumour, odontoma and ameloblastoma. Similarly, except ameloblastomas, surgical treatment of those turnouts was easy. In some cases of ameloblastomas osteotransplantation was indicated. Recurrence and malignant alteration, after the surgical treatment occurred. Extraoral malignant tumours: squamous carcinoma of face skin in young persons are rare. Those cases which are malignant usually have xerodermia pigmentosa characteristics. Surgical treatment has given good results. Patients with squamous carcinoma of parotid gland were successfully treated with radical surgical treatment. Intraoral malignant tumous: osteochondrosarcomas and malignant ameloblastomas. Surgical treatment in the first case was successful, but not in the second one. Evidence for in situ clonal T-cell expansion in oral squamous cell carcinoma. M Stephens*, S. H. Limt, P. Stephens, M Fardy & D. W. Thomas. Departments of *Oral & Maxillofacial Surgery, and *Haematology Car&x UK.
Oral squamous cell carcinomas (OSCC) are frequently associated with tumour infiltrating lymphocytes (TIL) which may reflect an in viva immune reaction against the tumour cells.’ To test this hypothesis T-cell receptor (TCR) VP gene usage was studied in TIL and peripheral blood mononuclear cells (PMNC) of 10 patients with OSCC. The molecular techniques of reversetranscription polymerase chain reaction (using a panel of 25 family specific primers; Clontech Laboratories Inc., Ca) and Southern blotting (with a CD internal probe) were used to confirm TCR Vfl restriction, TCR V/I usage was uniformly unrestricted in the peripheral blood of OSCC patients (>22/25 TCR VP sub-families present). Restricted TCR V/I usage was however evident in TIL and varied between patients and between primary tumours and regional lymph nodes. In a patient with histological evidence of marked tumour destruction associated with the TIL, cloning and nucleotide sequence analysis were performed. Only 2/25 VP TCR families were evident in this tumour (V/36, VPS) whereas all 25 VP families were represented in the PMNC. V/?S cDNA from TIL and PMNC was cloned using a TA cloning kit (Invitrogen Corporation, USA). DNA length analysis, single-strand conformation polymorphism (SSCP) and nucleotide sequencing were performed. All colonies of TIL V/j’8 that were selected demonstrated identical nucleotide sequences using Jb2.7 and Ca2 genes. In the PMNC there was no repetition of TCR length or SSCP of the V/38 clones. These data have demonstrated for the first time the specific recruitment and clonal expansion of TIL in OSCC and provide
257
support for the investigation of tumour-specific immunotheraphy in OSCC.
Reference 1. Thomas DW et al. J Oral Path01 Med 1995; 24: 23-3 1. An audit of facial department. Keith
Maxillofacial Trent.
radiographs taken in an Accident & Emergency Webster & Tim Malins. Department of Oral
Surgery, North
Staffordshire Hospital,
& Stoke-on-
A retrospective review of 1538 facial radiographs of 414 patients attending the Accident & Emergency department of the North Staffordshire Hospital over a 6 month period was undertaken. The number, type and appropriateness of the views taken was compared with guidelines issued to the Accident & Emergency department 3 years previously. The number of radiographs taken exceeded that in the guidelines. The mean number of films taken, the aetiology of injury, the number of actual and missed fractures detected is presented, along with suggestions on how the guidelines can be better implemented. Amylase
in lymphoepithelial
cysts.
D. Wedg+izood
& A. Fraser.
Royal
Shrewsbury Hospital, Shropshire, UK. High amylase levels have been noted in lymphoepithelial (branchial) cysts. Amylase titres are compared with those in non-lymphoepithelial cysts. Evidence is presented of amylase production in cyst lining. Possible significance in relation to theories of aetiology of LE cysts is discussed. Stickler
-
Maxillofacial
the
elusive
syndrome.
K.
Wilson
& D.
W
Patton.
Unit, Morriston Hospital, Swansea, UK.
Stickler syndrome is a rare genetic disorder of connective tissues. Also known as hereditary progressive arthro-ophthalmopathy, the characteristic features include orofacial, eye and joint abnormalities, Named after the paediatrician who first described the condition in the 1960s it is a diagnosis easily overlooked because of its diverse presentation. Early diagnosis is important in order that any ocular involvement may be detected early, to avoid visual impairment. Unfortunately the diagnosis is frequently missed in children presenting with a cleft palate. It is therefore important that maxillofacial surgeons are aware of the condition and its significance in cleft palate children. Inherited as an autosomal dominant trait, collagen production is abnormal leading to a variety of defects which vary in their degree of severity even within affected families. Facial manifestations may include a cleft palate, Pierre Robin sequence, midface hypoplasia and nasal deformities. Eye involvement includes retinal detachments, tears and degeneration; severe myopia, early cataracts and secondary glaucoma. The poster emphasises the importance of early diagnosis in this condition.
Abstracts of papersfrom the 1996 BAOMS Meeting Head and neck malignant S. D. Adcock & N. Baker.
melanoma
- a 10 year
follow-up
study.
St Richard’s Hospital, Chichester, (South Coast Training Programme), UK. Cutaneous malignant melanoma causes up to 2% of deaths due to carcinoma and the incidence is thought to be rising. A retrospective study of patients treated in the Maxillofacial Unit based at St Richard’s Hospital was carried out. The study period was over the last 10 years and 75 patients were identified.
The presence or absence of a previous pigmented lesion at the site of the malignant melanoma was documented as well as site, size, ulceration, Breslow thickness and Clark’s level of invasion. These factors were related to the incidence of metastases and recurrence. Excision margins at the time of primary surgery were also related to outcome. A lower rate of local recurrence and distant metastases than in malignant melanoma at other cutaneous sites was noted and is discussed.