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How reliable is the fibula skin paddle?
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Oral presentation / British Journal of Oral and Maxillofacial Surgery 49S (2011) S1–S25
Conclusions: Computer referrals ensures all data is collated and presented in a logical, standardized form, prompts ensure no essential information is missing prior to referral, particularly useful to junior rotating ED teams. Defined response timelines gives busy referring doctors an opportunity to continue working, and benefit accepting doctors who have time to review data and images. Patient data is secure, available prior to transfer, linked to patients’ notes, and when coupled to a login based audit trail results in less miscommunication. Web referral can improve delivery of maxillofacial services, which may lead to an improved patient experience. doi:10.1016/j.bjoms.2011.04.061 61 How reliable is the fibula skin paddle? E. Dodson∗ , Z. Al-Asaadi, T. Martin, S. Parmar University Hospitals Birmingham NHS Foundation Trust, United Kingdom The fibula is the bone of choice for many reconstructive surgeons for head and neck defects. However, many of the defects being reconstructed are not limited to bone and often involve the intraoral mucosa or external facial skin. Many authors have questioned the reliability of the fibula skin paddle and routinely use a radial forearm flap in conjunction with the fibula. Aims: To assess the reliability of the fibula skin paddle in our series of 57 composite fibula flaps. Materials and methods: A retrospective analysis was carried out in our unit of all composite fibula flaps. Results: 57 fibula flaps were raised for reconstruction of complex head and neck defects between 2005 and 2010. All the fibulas were raised without a tourniquet. All the skin paddles were raised with a large cuff of flexor hallucis. The soleus was never taken. The fibula donor site healed well and never required further surgery. 2 of the flaps failed in our fibula series (3.5%). Only 1 of the surviving 55 fibula flaps was the skin paddle lost (1.8%). Conclusions: The fibula skin paddle is extremely reliable if raised carefully, from the correct location on the leg, with preoperative Doppler markings and with a good cuff of flexor hallucis. A separate soft tissue flap is rarely required. doi:10.1016/j.bjoms.2011.04.062
62 Listening to head and neck cancer patients—the Bradford experience A. Pick∗ , A. Liu, J. McCaul Bradford Institute of Health Research, United Kingdom Introduction: Public/patient involvement is repeatedly trumpeted and heralded in research. Significantly, it has been assisted by the recent Department of Health policy document ‘Best Research for Best Health’ making generous and glowing references to the benefits of public involvement in health and social research. The experience of both INVOLVE and UKCRC is that increasing engagement with patients and public has positive benefits to clinical research. Methods: We outline our experience in Bradford’s Head and Neck patients Involvement Forum. We will describe our evolving methods of patient interaction from initial approach of survivors of head and neck cancers to targeted techniques such as focus group meetings. Interactions and meaningful dialogue between patients, CNS, Consultant Surgeons and Research Nurses from the outset are pivotal to successful application. Results: Not only are barriers to research in the NHS effectively removed, but future research can be tailored to the needs of patients, placing them at the centre of the clinician’s work. Developing effective patient and public engagement requires commitment, dedication and skills on part of the health professionals. We conclude with evidence that patient involvement is essential not just for successful grant application but that what they shared with health professionals is enlightening and useful in clinical research. doi:10.1016/j.bjoms.2011.04.063 63 Accuracy of MRI in prediction of tumour thickness and nodal stage in oral carcinoma C.T.-T.J.W. Lwin∗ , R. Hanlon, D. Lowe, R.J. Shaw, S.N. Rogers, J.S. Brown, F. Bekiroglu Univeristy Hospital Aintree, Liverpool, United Kingdom Aims: Tumour thickness is important in helping to predict local recurrence, nodal metastasis and patient survival. An accurate preoperative assessment of tumour thickness is desirable for optimal treatment planning. The aim of our study is to evaluate the correlation and accuracy of MRI measured depth of invasion and histological tumour thickness for various sub-sites of OSCC and determine its predictive accuracy for nodal metastases. Methods: Retrospective histological review of 102 consecutive patients with OSCC who underwent primary surgical treatment was completed. MRI STIR sequence in axial plane and T2-weighted images in coronal plane were used to
Oral presentation / British Journal of Oral and Maxillofacial Surgery 49S (2011) S1–S25
Conclusions: Computer referrals ensures all data is collated and presented in a logical, standardized form, prompts ensure no essential information is missing prior to referral, particularly useful to junior rotating ED teams. Defined response timelines gives busy referring doctors an opportunity to continue working, and benefit accepting doctors who have time to review data and images. Patient data is secure, available prior to transfer, linked to patients’ notes, and when coupled to a login based audit trail results in less miscommunication. Web referral can improve delivery of maxillofacial services, which may lead to an improved patient experience. doi:10.1016/j.bjoms.2011.04.061 61 How reliable is the fibula skin paddle? E. Dodson∗ , Z. Al-Asaadi, T. Martin, S. Parmar University Hospitals Birmingham NHS Foundation Trust, United Kingdom The fibula is the bone of choice for many reconstructive surgeons for head and neck defects. However, many of the defects being reconstructed are not limited to bone and often involve the intraoral mucosa or external facial skin. Many authors have questioned the reliability of the fibula skin paddle and routinely use a radial forearm flap in conjunction with the fibula. Aims: To assess the reliability of the fibula skin paddle in our series of 57 composite fibula flaps. Materials and methods: A retrospective analysis was carried out in our unit of all composite fibula flaps. Results: 57 fibula flaps were raised for reconstruction of complex head and neck defects between 2005 and 2010. All the fibulas were raised without a tourniquet. All the skin paddles were raised with a large cuff of flexor hallucis. The soleus was never taken. The fibula donor site healed well and never required further surgery. 2 of the flaps failed in our fibula series (3.5%). Only 1 of the surviving 55 fibula flaps was the skin paddle lost (1.8%). Conclusions: The fibula skin paddle is extremely reliable if raised carefully, from the correct location on the leg, with preoperative Doppler markings and with a good cuff of flexor hallucis. A separate soft tissue flap is rarely required. doi:10.1016/j.bjoms.2011.04.062
62 Listening to head and neck cancer patients—the Bradford experience A. Pick∗ , A. Liu, J. McCaul Bradford Institute of Health Research, United Kingdom Introduction: Public/patient involvement is repeatedly trumpeted and heralded in research. Significantly, it has been assisted by the recent Department of Health policy document ‘Best Research for Best Health’ making generous and glowing references to the benefits of public involvement in health and social research. The experience of both INVOLVE and UKCRC is that increasing engagement with patients and public has positive benefits to clinical research. Methods: We outline our experience in Bradford’s Head and Neck patients Involvement Forum. We will describe our evolving methods of patient interaction from initial approach of survivors of head and neck cancers to targeted techniques such as focus group meetings. Interactions and meaningful dialogue between patients, CNS, Consultant Surgeons and Research Nurses from the outset are pivotal to successful application. Results: Not only are barriers to research in the NHS effectively removed, but future research can be tailored to the needs of patients, placing them at the centre of the clinician’s work. Developing effective patient and public engagement requires commitment, dedication and skills on part of the health professionals. We conclude with evidence that patient involvement is essential not just for successful grant application but that what they shared with health professionals is enlightening and useful in clinical research. doi:10.1016/j.bjoms.2011.04.063 63 Accuracy of MRI in prediction of tumour thickness and nodal stage in oral carcinoma C.T.-T.J.W. Lwin∗ , R. Hanlon, D. Lowe, R.J. Shaw, S.N. Rogers, J.S. Brown, F. Bekiroglu Univeristy Hospital Aintree, Liverpool, United Kingdom Aims: Tumour thickness is important in helping to predict local recurrence, nodal metastasis and patient survival. An accurate preoperative assessment of tumour thickness is desirable for optimal treatment planning. The aim of our study is to evaluate the correlation and accuracy of MRI measured depth of invasion and histological tumour thickness for various sub-sites of OSCC and determine its predictive accuracy for nodal metastases. Methods: Retrospective histological review of 102 consecutive patients with OSCC who underwent primary surgical treatment was completed. MRI STIR sequence in axial plane and T2-weighted images in coronal plane were used to