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Evaluation and management of skull base tumours
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Abstracts
focused on the volume change of airway space, pressure and velocity in the expiration using CFD (Midas Co, Korea). Findings and Conclusion: Facial height, chin point and hyoid bone position were similar to preoperation. Airway length (UI) was significantly increased after reconstruction. Mandibular width was increased after anterior mandibular arch reconstruction with fibular flap. This seems the reflection of over-correction for camouflage of the bone and soft tissue defect after tumour ablation. The retroglossal (RG), RG lateral dimension, RG-cross sectional area were significantly decreased in the postoperative CT (P < 0.05), which might be result of tongue and muscles attached points change. However, the postoperative airway volume was not significantly changed compared with preoperation. There were no statistically significant differences in the minimal pressures and the maximal velocities during the expirations between the preoperative and the postoperative states, however, the hypopharynx showed increased pressure and velocity. http://dx.doi.org/10.1016/j.ijom.2017.02.117 Application of the use of recombinant human bone morphogenetic protein-2 in augmentation of alveolar defects for dental implants P.K.M. Lee Dental Implant and Maxillofacial Centre, Hong Kong Replacement of missing teeth with dental implant nowadays is becoming more and more a standard treatment option for dental patient. However, due to different reasons, the implant site might not be optimal for implant placement. The dental practitioners often need to perform bone augmentation to optimise the implant site. To achieve a predictable outcome in severely compromised site could be a challenge and require careful planning and different surgical skills. Guided bone regeneration was a predicable mean to increase bone volume of implant sites. Although autogneous bone is still consider a gold standard for bone grafting procedure, various biological materials are available as an option for patients who do not want a second wound for bone harvest. Bone morphogenetic protein-2 (BMP-2) is now used in oral and maxillofacial surgery and orthopaedic surgery to for bone growth. This presentation will discuss indications and contraindications of the application of BMP-2 in different clinical situations for dental implant patients. http://dx.doi.org/10.1016/j.ijom.2017.02.118 Evaluation and management of skull base tumours G. Liao ∗ , Y.J. Liang, G. Zheng, S. Zhang, X. Lao, S. Li Guanghua Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China Objective: Skull base surgery is one of the most challenged surgery. Because of the complex anatomy in the cranial base, structure violation and functional lesion are difficult to evaluate. Safety surgical approach to resect the tumours and multidisciplinary comprehensive treatment to control malignancies are required. This study is to characterise our experience with the evaluation and surgical management of skull base lesions. Methods: 86 patients who underwent resection of anterior and middle skull base tumours with craniofacial approach were review. There were 11 involving in anterior, 65 involving in middle,
and 11involving in anterior and middle skull base. Examination of cranial nerves was performed to evaluate nerve involvement and structure violation. Computed tomography (CT) and magnetic resonance imaging scan was applied to observe the bony destruction and lesion position. Traditional open incision was assisted by intro-operative navigation. It is difficult to design a safe surgical approach to reach the lesion. Coronal incision with unilateral or bilateral frontal craniotomy approach was applied to expose anterior skull base malignancy. Weber-Ferguson incision with maxillary swinging approach provides directly exposure for middle skull base lesions. There were plenty approaches to explore anterior and middle skull base. After surgery, a CT scan was needed to see the tumour was completely removed or not. In the follow-up period, recurrence and survival were record. Postoperative complications, such as, cerebrospinal fluid (CSF) leak, diplopia, vision changes, intracranial infections were review. Results: 86 cases of surgically resected anterior and middle skull base lesions were included over the 10-year period from 2006 through 2015. Two patients had a CSF leak postoperatively, one each from middle skull base surgery and combination surgery. Orbital complications include 8.1% of patients experiencing vision changes and 7.0% with diplopia. The average period of follow-up was 52.4 months. Locally recurrent or persistent disease was seen in 43.6% of patients Conclusion: According to our study, choosing appropriate surgical approach could provide better lesion exposure structure protection quality of life improvement and complications reduction. Frontotemporal-orbitozygomatic combined approach is suitable for the malignancies involving anterior and middle skull base. Preoperative evaluation, especially the cranial nerves examination, was very important for surgical planning. http://dx.doi.org/10.1016/j.ijom.2017.02.119 Orthognatic surgery in temporomandibular joint patients: evaluation, diagnosis, when and why to operate the temporomandibular joint L. Lobo Santa Paula Hospital, Brazil A big challenge for studying temporomandibular joint (TMJ) is the fact that it is a joint that belongs to a system (stomatognatha) with mechanical characteristics organised by a physiology rich in details. From this point of view, it is necessary to know all mechanics and their distribution of forces in order to understand how functional equilibrium can be obtained. The vision that must be given to the orthognathic surgery planning is balance of forces so that the best functional performance can be obtained. Understanding that the principle of motion resembles a class III lever. Where all the force generated in the movement will be directed to the TMJ (interpower force). What we need to evaluate when we are planning is to understand the moment to living the patient’s TMJ. Whether it is too symptomatic or not. Because any change in the skeleton of the face will generate a load on the TMJ and it should be reshaped. Of this form if there is already a functional change some procedure should be indicated. This can range from arthrocentesis to a prosthesis. http://dx.doi.org/10.1016/j.ijom.2017.02.120
Abstracts
focused on the volume change of airway space, pressure and velocity in the expiration using CFD (Midas Co, Korea). Findings and Conclusion: Facial height, chin point and hyoid bone position were similar to preoperation. Airway length (UI) was significantly increased after reconstruction. Mandibular width was increased after anterior mandibular arch reconstruction with fibular flap. This seems the reflection of over-correction for camouflage of the bone and soft tissue defect after tumour ablation. The retroglossal (RG), RG lateral dimension, RG-cross sectional area were significantly decreased in the postoperative CT (P < 0.05), which might be result of tongue and muscles attached points change. However, the postoperative airway volume was not significantly changed compared with preoperation. There were no statistically significant differences in the minimal pressures and the maximal velocities during the expirations between the preoperative and the postoperative states, however, the hypopharynx showed increased pressure and velocity. http://dx.doi.org/10.1016/j.ijom.2017.02.117 Application of the use of recombinant human bone morphogenetic protein-2 in augmentation of alveolar defects for dental implants P.K.M. Lee Dental Implant and Maxillofacial Centre, Hong Kong Replacement of missing teeth with dental implant nowadays is becoming more and more a standard treatment option for dental patient. However, due to different reasons, the implant site might not be optimal for implant placement. The dental practitioners often need to perform bone augmentation to optimise the implant site. To achieve a predictable outcome in severely compromised site could be a challenge and require careful planning and different surgical skills. Guided bone regeneration was a predicable mean to increase bone volume of implant sites. Although autogneous bone is still consider a gold standard for bone grafting procedure, various biological materials are available as an option for patients who do not want a second wound for bone harvest. Bone morphogenetic protein-2 (BMP-2) is now used in oral and maxillofacial surgery and orthopaedic surgery to for bone growth. This presentation will discuss indications and contraindications of the application of BMP-2 in different clinical situations for dental implant patients. http://dx.doi.org/10.1016/j.ijom.2017.02.118 Evaluation and management of skull base tumours G. Liao ∗ , Y.J. Liang, G. Zheng, S. Zhang, X. Lao, S. Li Guanghua Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China Objective: Skull base surgery is one of the most challenged surgery. Because of the complex anatomy in the cranial base, structure violation and functional lesion are difficult to evaluate. Safety surgical approach to resect the tumours and multidisciplinary comprehensive treatment to control malignancies are required. This study is to characterise our experience with the evaluation and surgical management of skull base lesions. Methods: 86 patients who underwent resection of anterior and middle skull base tumours with craniofacial approach were review. There were 11 involving in anterior, 65 involving in middle,
and 11involving in anterior and middle skull base. Examination of cranial nerves was performed to evaluate nerve involvement and structure violation. Computed tomography (CT) and magnetic resonance imaging scan was applied to observe the bony destruction and lesion position. Traditional open incision was assisted by intro-operative navigation. It is difficult to design a safe surgical approach to reach the lesion. Coronal incision with unilateral or bilateral frontal craniotomy approach was applied to expose anterior skull base malignancy. Weber-Ferguson incision with maxillary swinging approach provides directly exposure for middle skull base lesions. There were plenty approaches to explore anterior and middle skull base. After surgery, a CT scan was needed to see the tumour was completely removed or not. In the follow-up period, recurrence and survival were record. Postoperative complications, such as, cerebrospinal fluid (CSF) leak, diplopia, vision changes, intracranial infections were review. Results: 86 cases of surgically resected anterior and middle skull base lesions were included over the 10-year period from 2006 through 2015. Two patients had a CSF leak postoperatively, one each from middle skull base surgery and combination surgery. Orbital complications include 8.1% of patients experiencing vision changes and 7.0% with diplopia. The average period of follow-up was 52.4 months. Locally recurrent or persistent disease was seen in 43.6% of patients Conclusion: According to our study, choosing appropriate surgical approach could provide better lesion exposure structure protection quality of life improvement and complications reduction. Frontotemporal-orbitozygomatic combined approach is suitable for the malignancies involving anterior and middle skull base. Preoperative evaluation, especially the cranial nerves examination, was very important for surgical planning. http://dx.doi.org/10.1016/j.ijom.2017.02.119 Orthognatic surgery in temporomandibular joint patients: evaluation, diagnosis, when and why to operate the temporomandibular joint L. Lobo Santa Paula Hospital, Brazil A big challenge for studying temporomandibular joint (TMJ) is the fact that it is a joint that belongs to a system (stomatognatha) with mechanical characteristics organised by a physiology rich in details. From this point of view, it is necessary to know all mechanics and their distribution of forces in order to understand how functional equilibrium can be obtained. The vision that must be given to the orthognathic surgery planning is balance of forces so that the best functional performance can be obtained. Understanding that the principle of motion resembles a class III lever. Where all the force generated in the movement will be directed to the TMJ (interpower force). What we need to evaluate when we are planning is to understand the moment to living the patient’s TMJ. Whether it is too symptomatic or not. Because any change in the skeleton of the face will generate a load on the TMJ and it should be reshaped. Of this form if there is already a functional change some procedure should be indicated. This can range from arthrocentesis to a prosthesis. http://dx.doi.org/10.1016/j.ijom.2017.02.120