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European Sentinel Node group interim results
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British Journal of Oral and Maxillofacial Surgery 47 (2009) e35–e69
Oral Abstracts Presented at the BAOMS Annual Scientific Meeting in Bournemouth, 3–5 June 2009
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Patient centred functional outcome measurement in orthognathic surgery—a review of 300 consecutive operated cases
European Sentinel Node group interim results
Raheela Rafiq ∗ , E.J. Woolley, D. Richardson
Department Maxillofacial Surgery, Guys Hospital, London, United Kingdom
Regional Maxillofacial Unit, University Hospital Aintree, Liverpool, United Kingdom Demonstration of the benefits and quality of surgical intervention is becoming increasingly important. As with other surgical interventions the value to patients of orthognathic surgery may come under scrutiny by PCT’s, commissioners and NICE. Patient assessed rather than clinician assessed outcome arguably is the ideal measure. Aims: The aim of this study was to measure the improvement in function following orthognathic treatment of those patients presenting with an initial complaint of poor function related to their jaw deformity. Methods: 300 Patients undergoing orthognathic surgery completed self-assessment questionnaires at presentation and 1–3 years following treatment. Domains included mastication, speech, TMJ symptoms, nasal airway patency and snoring. Results: A sub-group of patients presenting with functional concerns as part of their original complaint had their results analysed which showed that the majority reported a high level of satisfaction with the improvement in functional outcome following treatment. The outcomes will be presented in more detail. Conclusion: This study shows the value of orthognathic surgery in improving functional outcome related to jaw deformity as rated by patients. It lends evidence to the benefit of providing orthognathic treatment to such patients. doi:10.1016/j.bjoms.2009.06.028
Clare Schilling ∗ , B. Gurney, M. McGurk
Objectives: Sentinel Node Biopsy (SNB) is well-established in management of both breast cancer and melanoma. Tumour within cervical lymph nodes spreads in an orderly fashion from one nodal basin to the next. Lymphoscintigraphy accurately identifies the Sentinel Node. If negative for metastasis, a neck dissection can be avoided. The interim results of the European Sentinel Node Study (SENT) are presented Methods: Mutlicentre European (n = 15) observational SNB study commenced in 2006. Eligibility; 0.5–4 cm oral squamous cell carcinoma with CT proven N0 necks. Patients with identifiable Sentinel Nodes on lymphoscintigraphy were entered in the study and nodes retrieved intraoperatively by hand held gamma probe and blue dye. A positive SN led to neck dissection within 3 weeks of biopsy. Results: In the period 2006–2008 218 cases were recruited, (60% M, 40% F, 62% T1, 33.5% T2, 4.5% T3). Positive SNB occurred in 48 patients (22%), 13 of which had further positive nodes on neck dissection. False negative occurred in 5 cases, subsequently treated with neck dissection and adjuvant RT (1 with concomitant chemotherapy). Tumour recurrence after positive SNB and neck dissection occurred in 3 patients. Complications were low (<5%). 22 Patients excluded from the trial due to disease elsewhere or death from other causes. Conclusions: As a result of SNB 75% of patients in the trial avoided neck dissection. 92.7% of patients are disease free at mean of 14 months follow-up, one patient has died from disease. SNB has a sensitivity of 90.6% and a negative predictive value of 97%. doi:10.1016/j.bjoms.2009.06.029
0266-4356/$ – see front matter
British Journal of Oral and Maxillofacial Surgery 47 (2009) e35–e69
Oral Abstracts Presented at the BAOMS Annual Scientific Meeting in Bournemouth, 3–5 June 2009
1
2
Patient centred functional outcome measurement in orthognathic surgery—a review of 300 consecutive operated cases
European Sentinel Node group interim results
Raheela Rafiq ∗ , E.J. Woolley, D. Richardson
Department Maxillofacial Surgery, Guys Hospital, London, United Kingdom
Regional Maxillofacial Unit, University Hospital Aintree, Liverpool, United Kingdom Demonstration of the benefits and quality of surgical intervention is becoming increasingly important. As with other surgical interventions the value to patients of orthognathic surgery may come under scrutiny by PCT’s, commissioners and NICE. Patient assessed rather than clinician assessed outcome arguably is the ideal measure. Aims: The aim of this study was to measure the improvement in function following orthognathic treatment of those patients presenting with an initial complaint of poor function related to their jaw deformity. Methods: 300 Patients undergoing orthognathic surgery completed self-assessment questionnaires at presentation and 1–3 years following treatment. Domains included mastication, speech, TMJ symptoms, nasal airway patency and snoring. Results: A sub-group of patients presenting with functional concerns as part of their original complaint had their results analysed which showed that the majority reported a high level of satisfaction with the improvement in functional outcome following treatment. The outcomes will be presented in more detail. Conclusion: This study shows the value of orthognathic surgery in improving functional outcome related to jaw deformity as rated by patients. It lends evidence to the benefit of providing orthognathic treatment to such patients. doi:10.1016/j.bjoms.2009.06.028
Clare Schilling ∗ , B. Gurney, M. McGurk
Objectives: Sentinel Node Biopsy (SNB) is well-established in management of both breast cancer and melanoma. Tumour within cervical lymph nodes spreads in an orderly fashion from one nodal basin to the next. Lymphoscintigraphy accurately identifies the Sentinel Node. If negative for metastasis, a neck dissection can be avoided. The interim results of the European Sentinel Node Study (SENT) are presented Methods: Mutlicentre European (n = 15) observational SNB study commenced in 2006. Eligibility; 0.5–4 cm oral squamous cell carcinoma with CT proven N0 necks. Patients with identifiable Sentinel Nodes on lymphoscintigraphy were entered in the study and nodes retrieved intraoperatively by hand held gamma probe and blue dye. A positive SN led to neck dissection within 3 weeks of biopsy. Results: In the period 2006–2008 218 cases were recruited, (60% M, 40% F, 62% T1, 33.5% T2, 4.5% T3). Positive SNB occurred in 48 patients (22%), 13 of which had further positive nodes on neck dissection. False negative occurred in 5 cases, subsequently treated with neck dissection and adjuvant RT (1 with concomitant chemotherapy). Tumour recurrence after positive SNB and neck dissection occurred in 3 patients. Complications were low (<5%). 22 Patients excluded from the trial due to disease elsewhere or death from other causes. Conclusions: As a result of SNB 75% of patients in the trial avoided neck dissection. 92.7% of patients are disease free at mean of 14 months follow-up, one patient has died from disease. SNB has a sensitivity of 90.6% and a negative predictive value of 97%. doi:10.1016/j.bjoms.2009.06.029
0266-4356/$ – see front matter