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Endoscopic controlled sinus floor elevation using ballooning technique
e152
Oral Presentation
Findings: PET scans led us up the colon, axilla and several other garden paths. There was not a single instance of a PET study that changed management apart from a delay in definitive therapy. Conclusions: The role of PET scans in the early management of mucosal cancers of the H&N appears to be of questionable value. http://dx.doi.org/10.1016/j.ijom.2015.08.829 Endoscopic controlled sinus floor elevation using ballooning technique N.M. Timmenga 1,∗ , R. van Weissenbruch 2 1 Department of Oral and Maxillofacial surgery, Wilhelmina Hospital Assen, The Netherlands 2 ENT-surgery, Wilhelmina Hospital Assen, The Netherlands
Background: The morbidity of sinus floor elevation surgery might be substantially in elderly patients. Therefore, a balloon controlled sinus floor elevation technique was introduced. (Miambe procedure). In our ENT & Oral and Maxillofacial Surgery setting, this minimal invasive flapless antral mucosa lift is presented and supported by video endoscopic examination. Methods: In local anaesthesia, via the accessory maxillary ostium, a flexible endoscope (lumen 4 mm), was introduced via the antrum infundibulae, to examine the sinus floor. The Osstem CAS drill system and antral lifting were accurately monitored. Findings: Video endoscopy examination confirmed the minimal invasive aspect of the Miambe procedure, and was well accepted bij the Schneiderian membrane. No perforations occurred perioperatively. Morbidity was reduced to a minimum. Conclusions: The balloon controlled lifting is a useful and feasible procedure, especially in elderly patients. Discussion: Extensive surgical procedures have impact on morbidity and recovery period, especially in eldelry patients. The balloon controlled minimal invasive antral lifting procedure proposes a reliable alternative to the standard procedures. Prior to sinus floor elevation surgery, preoperatively screening of the maxillary sinus and infundibulum is required, to analyse the sinus performance in case of osteomeatal obstruction. http://dx.doi.org/10.1016/j.ijom.2015.08.830 Cleft orthognathic surgery. A critical review L. Too ∗ , S. Good, P. Haers Evelina London Children’s Hospital, London, United Kingdom Background: The characteristic features in patients with maxillary growth deficiency and unilateral cleft lip and palate (UCLP) are midface retrusion, reduced facial convexity and reversed incisal relationship. Often, compensating orthodontic techniques cannot achieve a functional occlusion and restoration of facial convexity is not offered to patients. Orthognathic surgery in these cases consists mainly of maxillary advancement, correction of the anterior facial vertical hypoplasia, and often releasing mandibular osteotomy. Surgery aims to achieve facial balance, a functional occlusion with correction of midline and cleft associated asymmetries, and tilt of the occlusal plane. Objectives: To analyse the improvement of facial convexity in UCLP patients with Class III malocclusion and to assess if major maxillary advancement affects short term post operative skeletal stability.
Methods: A review was done on non-syndromic UCLP patients, younger than 30, who have maxillary deficiency and Class III malocclusion. These patients have had no previous orthognathic surgery, no velopharyngeal flaps and have undergone bimaxillary surgery between 2003 and 2014 (single surgeon). Skeletal movements were measured using lateral cephalograms taken preoperatively and postoperatively and a minimum of 1 year later. Changes in facial convexity and skeletal stability were recorded prospectively in all patients. Findings: 25 patients were identified. Their radiographs were analysed to assess changes in facial convexity in both the skeletal and soft tissues aspects. These findings are then reported and statistically analysed. Conclusions: Reduced facial convexity as measured on lateral cephalograms in UCLP patients can be corrected without endangering skeletal stability. Further 3D analysis should also assess the correction of facial volumes. http://dx.doi.org/10.1016/j.ijom.2015.08.831 Impact of extent of parotid resection on postoperative wound complications: a prospective study J. Tuckett 1,2,∗ , R. Glynn 2 , P. Sheahan 2 1 2
Princess Alexandra Hospital, Brisbane, Australia South Infirmary Victoria University Hospital, Cork, Ireland
Background: Sialocele and salivary fistula are common complications after parotidectomy. The purpose of the present study was to investigate whether extent of parotidectomy influences the incidence of these complications. Methods: We conducted a prospective study of 66 consecutive parotidectomies. Cases undergoing skin or bone resection or flap reconstruction were excluded. Patients were divided into 2 groups based on extent of surgery: group 1 (extracapsular dissection or partial superficial parotidectomy); and group 2 (superficial parotidectomy or more extensive resection). The incidence of postoperative sialocele, salivary fistula, and facial weakness was studied. Findings: Eleven patients (16.7%) developed a sialocele, and 4 (6.1%) developed a salivary fistula. Group 1 had a significantly higher incidence of wound complications (p = .008), but a significantly lower incidence of facial weakness (p = .004). Conclusions: Less extensive parotid resection seems to be associated with a higher incidence of postoperative sialocele and salivary fistula, but is also associated with less postoperative facial nerve dysfunction. http://dx.doi.org/10.1016/j.ijom.2015.08.832 Radiologically inserted gastrostomy tubes in head and neck cancer patients – demographics, treatment modality and complication rates – our experience over three years in 101 consecutive cases J. Tuckett 1,2,∗ , R. O’Shea 1 , A. Hevers 1 , L. Perrot 1 , H. Byrne 1 , M. Murphy 1 , P. Sheahan 1 1 2
South Infirmary Victoria University Hospital, Cork, Ireland Princess Alexandra Hospital, Brisbane, Australia
Background: Head and neck cancer patients undergoing chemotherapy and radiotherapy are at high risk of malnutrition and weight loss. Despite the absence of a recommended guideline there has been a significant increase in radiologically inserted
Oral Presentation
Findings: PET scans led us up the colon, axilla and several other garden paths. There was not a single instance of a PET study that changed management apart from a delay in definitive therapy. Conclusions: The role of PET scans in the early management of mucosal cancers of the H&N appears to be of questionable value. http://dx.doi.org/10.1016/j.ijom.2015.08.829 Endoscopic controlled sinus floor elevation using ballooning technique N.M. Timmenga 1,∗ , R. van Weissenbruch 2 1 Department of Oral and Maxillofacial surgery, Wilhelmina Hospital Assen, The Netherlands 2 ENT-surgery, Wilhelmina Hospital Assen, The Netherlands
Background: The morbidity of sinus floor elevation surgery might be substantially in elderly patients. Therefore, a balloon controlled sinus floor elevation technique was introduced. (Miambe procedure). In our ENT & Oral and Maxillofacial Surgery setting, this minimal invasive flapless antral mucosa lift is presented and supported by video endoscopic examination. Methods: In local anaesthesia, via the accessory maxillary ostium, a flexible endoscope (lumen 4 mm), was introduced via the antrum infundibulae, to examine the sinus floor. The Osstem CAS drill system and antral lifting were accurately monitored. Findings: Video endoscopy examination confirmed the minimal invasive aspect of the Miambe procedure, and was well accepted bij the Schneiderian membrane. No perforations occurred perioperatively. Morbidity was reduced to a minimum. Conclusions: The balloon controlled lifting is a useful and feasible procedure, especially in elderly patients. Discussion: Extensive surgical procedures have impact on morbidity and recovery period, especially in eldelry patients. The balloon controlled minimal invasive antral lifting procedure proposes a reliable alternative to the standard procedures. Prior to sinus floor elevation surgery, preoperatively screening of the maxillary sinus and infundibulum is required, to analyse the sinus performance in case of osteomeatal obstruction. http://dx.doi.org/10.1016/j.ijom.2015.08.830 Cleft orthognathic surgery. A critical review L. Too ∗ , S. Good, P. Haers Evelina London Children’s Hospital, London, United Kingdom Background: The characteristic features in patients with maxillary growth deficiency and unilateral cleft lip and palate (UCLP) are midface retrusion, reduced facial convexity and reversed incisal relationship. Often, compensating orthodontic techniques cannot achieve a functional occlusion and restoration of facial convexity is not offered to patients. Orthognathic surgery in these cases consists mainly of maxillary advancement, correction of the anterior facial vertical hypoplasia, and often releasing mandibular osteotomy. Surgery aims to achieve facial balance, a functional occlusion with correction of midline and cleft associated asymmetries, and tilt of the occlusal plane. Objectives: To analyse the improvement of facial convexity in UCLP patients with Class III malocclusion and to assess if major maxillary advancement affects short term post operative skeletal stability.
Methods: A review was done on non-syndromic UCLP patients, younger than 30, who have maxillary deficiency and Class III malocclusion. These patients have had no previous orthognathic surgery, no velopharyngeal flaps and have undergone bimaxillary surgery between 2003 and 2014 (single surgeon). Skeletal movements were measured using lateral cephalograms taken preoperatively and postoperatively and a minimum of 1 year later. Changes in facial convexity and skeletal stability were recorded prospectively in all patients. Findings: 25 patients were identified. Their radiographs were analysed to assess changes in facial convexity in both the skeletal and soft tissues aspects. These findings are then reported and statistically analysed. Conclusions: Reduced facial convexity as measured on lateral cephalograms in UCLP patients can be corrected without endangering skeletal stability. Further 3D analysis should also assess the correction of facial volumes. http://dx.doi.org/10.1016/j.ijom.2015.08.831 Impact of extent of parotid resection on postoperative wound complications: a prospective study J. Tuckett 1,2,∗ , R. Glynn 2 , P. Sheahan 2 1 2
Princess Alexandra Hospital, Brisbane, Australia South Infirmary Victoria University Hospital, Cork, Ireland
Background: Sialocele and salivary fistula are common complications after parotidectomy. The purpose of the present study was to investigate whether extent of parotidectomy influences the incidence of these complications. Methods: We conducted a prospective study of 66 consecutive parotidectomies. Cases undergoing skin or bone resection or flap reconstruction were excluded. Patients were divided into 2 groups based on extent of surgery: group 1 (extracapsular dissection or partial superficial parotidectomy); and group 2 (superficial parotidectomy or more extensive resection). The incidence of postoperative sialocele, salivary fistula, and facial weakness was studied. Findings: Eleven patients (16.7%) developed a sialocele, and 4 (6.1%) developed a salivary fistula. Group 1 had a significantly higher incidence of wound complications (p = .008), but a significantly lower incidence of facial weakness (p = .004). Conclusions: Less extensive parotid resection seems to be associated with a higher incidence of postoperative sialocele and salivary fistula, but is also associated with less postoperative facial nerve dysfunction. http://dx.doi.org/10.1016/j.ijom.2015.08.832 Radiologically inserted gastrostomy tubes in head and neck cancer patients – demographics, treatment modality and complication rates – our experience over three years in 101 consecutive cases J. Tuckett 1,2,∗ , R. O’Shea 1 , A. Hevers 1 , L. Perrot 1 , H. Byrne 1 , M. Murphy 1 , P. Sheahan 1 1 2
South Infirmary Victoria University Hospital, Cork, Ireland Princess Alexandra Hospital, Brisbane, Australia
Background: Head and neck cancer patients undergoing chemotherapy and radiotherapy are at high risk of malnutrition and weight loss. Despite the absence of a recommended guideline there has been a significant increase in radiologically inserted