Classification of complications in major head and neck surgery

ICOMS 2011—Abstracts: Oral Papers

165 Classification of complications in major head and neck surgery C. MacIver, M.H. Smith ∗ , C.J. Wales, J.D. McMahon, J.C. Devine Regional Maxillofacial Unit – Southern General Hospital, NHS Greater Glasgow & Clyde, Glasgow, UK

Introduction: While many report success with microvascular free tissue transfer, few aim to stratify postoperative morbidity. Postoperative complications vary from the insignificant to the life threatening, and may in rare circumstances result in mortality. Aims: To evaluate the application of an established postoperative complication classification system used in general surgery to head and neck oncology patients Patients and methods: A prospective cohort study has been undertaken on a consecutive series of head and neck oncology patients that were undergoing ablative and microvascular reconstruction surgery in a single maxillofacial unit. Patients treated between August 2009 and February 2011 were evaluated, and complications were scored based on an established classification system (Clavien). Results: 130 patients were evaluated and postoperative complications were graded. Severity of complications was compared to preoperative medical comorbidity, nutritional status, operative time and perioperative steroid and blood products use. Conclusions: A classification of postoperative surgical complications can be applied to head and neck cancer patients and allows meaningful conclusions to be drawn from postoperative analytical studies. While larger patient populations still need to be investigated, this study offers insight to severity of complications and how best to provide quality assurance to our patients. Conflict of interest: None declared. doi:10.1016/j.ijom.2011.07.166

166 A year prospective study on the epidemiology and clinical presentation of odontogenic tumors in Nigeria F.O. Oginni 1,∗ , P.J.W. Stoelinga 2 , S.A. Ajike 3 , O.N. Obuekwe 4 , W.L. Adeyemo 5 , O. Fasola 6 , R.A. Adebola 7 , B. Aluko Olokun 8 , O.A. Adesina 9 , B.O. Akinbami 10 , I.O. Iwegbu 11 , K.E. Adebiyi 12 1 Oral and Maxillofacial Surgery, Faculty of Dentistry, College of Health Sciences, Ile-Ife, Nigeria 2 Maxillofacial Surgery, University Medical Centre, Nijmegen, Netherlands 3 Maxillofacial Surgery, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria 4 Maxillofacial Surgery, University of Benin Teaching Hospital, Benin, Nigeria 5 Maxillofacial Surgery, Lagos University Teaching Hospital, Lagos, Nigeria 6 Maxillofacial Surgery, University College Hospital, Ibadan, Nigeria 7 Maxillofacial Surgery, Aminu Kano University Teaching Hospital, Kano, Nigeria 8 Maxillofacial Surgery, National Hospital, Abuja, Nigeria 9 Maxillofacial Surgery, University of Maiduguri Teaching Hospital, Maiduguri, Nigeria 10 Maxillofacial Surgery, University of Port Harcourt Teaching Hospital, Choba, Nigeria 11 Maxillofacial Surgery, Federal Medical Centre, Umuahia, Nigeria 12 Oral Pathology, Obafemi Awolowo University, Ile-Ife, Nigeria

Introduction and background: Odontogenic tumours have been studied retrospectively in most countries of the world. Most of these studies leave the question of relative frequency and incidence of the disease unanswered. Aim: To determine the epidemiological pattern, relative frequency and incidence of odontogenic tumours in the Nigerian population. Methods: Requests for prospective data collection over a year period (January 1st–December 31st 2009) were sent to centres involved in the management of Odontogenic tumours in Nigeria. We collected through a structured questionnaire designed to obtain demographic and clinico-pathologic information on all cases of odontogenic tumours presenting and diagnosed at the centres over the study period. Data was entered into SPSS statistical soft ware and analysed using simple descriptive statistics. Results: A total of 277 patients’ information was obtained from responding

1075

centres. They were 146 males and 131 females aged 8–75 years. Their mean age (SD) was 32.37 (14.16). An estimated national incidence of 1.97 per million population was obtained. 242 (87.3%), of the lesions were in the mandible, 31 (11.1%) in the maxilla and the rest affected both jaws. There was a greater predilection for the body/angle/ramus parts of the mandible. Ameloblastoma had the highest relative frequency constituting (217/277) 78.3% and an incidence rate of 1.54 per million followed by odontogenic myxoma (11/277) 3.97% with an incidence rate of 0.078 per million. Conclusion: This study like many others suggests that ameloblastoma is the most prevalent odontogenic tumour in Nigeria however; we found higher incidence figures than in some African and European reports. Conflict of interest: None declared. doi:10.1016/j.ijom.2011.07.167

167 SMAS flap and Frey’s clinic and subclinic syndrome: incidence, quality of life and cosmetic results. 11 years of experience F. Castillo Farias ∗ , R. Barberá Durban, I. Cobeta Marco Hospital Universitario Ramón y Cajal, Madrid, Spain

Introduction: SMAS flap (superficial musculoaponeurotic system) appears to decrease the incidence of Frey’s syndrome and improve the cosmetic results of surgery of the parotid gland. There is no known incidence of the subclinical syndrome and its impact on patient’s quality of life. Patients and methods: We reviewed patients undergoing parotid surgery since 10 months until the start of the study. We rate the clinical Frey Syndrome (CFS), the implication in their quality of life and cosmetic results. We perform the Minor and HDSS test (Hyperhidrosis Disease Severity Scale) to assess the severity of Frey Syndrome. Results: There were 47 patients available for the study. SMAS was performed in 42.2% of patients. The incidence of CFS was 29.1% (median follow-up = 5.2 years). CFS and Subclinical Frey (SCFS) increases total Frey to 39.6%. The syndrome does not affect the quality of life in 82.7% of patients. SMAS is associated with lower incidence of CFS (p = 0.034) but not by adding SCFS patients (p = 3.54). 79.3% of patients were satisfied with the cosmetic result of their surgery, which was