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O.295 Coblation – A preliminary report into its use in the oral cavity
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Journal of Cranio-Maxillofacial Surgery 34(2006) Suppl. S1
Results: Tissue sloughing occurred within 1 to 3 days, and healing was complete in 3 to 5 weeks. There were no cases of intraoperative or postoperative bleeding. Four of the cases needed “touch up” photocoagulations to remove residual islets of hypervascular tissue. One of the large hemangiomas of the toungue recurred one year after laser photocoagulation, and the procedure was repeated. In one case of a large venous malformation of the upper lip, two photocoagulation procedures were followed by surgical excision. There was only one case of slight postoperative infection, which was overcome with oral antibiotics. Overall, patients were very pleased with treatment outcomes. Conclusion: The Nd:YAG laser is a safe and effective tool for removal of large vascular lesions. O.294 Micromorphometrical analysis of different osteotomy techniques at the rabbit skull P. Maurer1 , M.S. Kriwalsky1 , A.W. Eckert1 , C. Heiss2 . 1 Department of Oral and Plastic Maxillofacial Surgery; MartinLuther-University Halle-Wittenberg, Germany; 2 Department of Trauma Surgery Giessen; University of Giessen-Marburg, Germany Introduction and Objectives: The ultrasonic osteotome which was recently introduced is an alternative to conventional methods of osteotomy. The aim of the present study was to establish the differences between three osteotomy techniques and to perform a quantitative roughness analysis of the osteotomized bone surfaces. Material and Methods: Fresh bony samples of standardized size were taken from the rabbit skull. The techniques used were as follows: reciprocate micro-saw, Lindemann bur, ultrasonic osteotome with the two insert tips OT6 (rough) and OT7 (fine). The prepared surfaces were examined by light microscopy, environmental surface electron microscopy (ESEM) and by confocal laser scanning microscopy (CLSM). Results: It was difficult to distingush between cortical and cancellous bone after using the conventional osteotomy technique. The ultrasonic technique preserved the original structure of the bone. The values observed for superficial roughness were as follows: 5.97 mm (micro-saw), 5.70 mm (Lindemann bur), 2.48 mm (OT6) and 3.00 mm (OT7). There was a statistical difference between the micro-saw and insert tip OT6 (p = 0.032). Conclusions: In the present study micromorphological differences after using various osteotomy techniques could be clearly identified. O.295 Coblation – A preliminary report into its use in the oral cavity A.I. Edwards1 , S.G. Langton1 , J.G. Smith1 , M.S. Timms2 . 1 Department of Oral & Maxillofacial Surgery, Blackburn Royal Infirmary, Blackburn, BB2 3LR, UK; 2 Deartmenpt of Otolaryngology, Blackburn Royal Infirmary, Blackburn, BB2 3LR, UK Coblation or cold ablation is a method of soft tissue surgery that utilizes radiofrequency current to permit cutting at relatively low temperatures. This presentation describes preliminary experience using coblation in surgery of the oral cavity and discusses the potential uses, advantages and disadvantages of this technique. A small case series is presented. As a method of tissue resection within the oral environment this technique warrants further study.
Abstracts, EACFMS XVIII Congress O.296 Treatment of facial and intraoral venous malformations: Results in 52 patients J. Mommsen, T. Erdsach, I. Potthoff, R. Reich. Clinic for Oral and Maxillofacial Surgery, University of Bonn, Germany Introduction: Venous vascular malformations (VVM) of the head and neck region are a common reason for consultation of a maxillofacial surgeon. VVM develop due to a congenital laxity of the vessel’s wall, possibly due to a lack of innervation. They are present but frequently not obvious at birth and become clinically relevant during the course of life, eventually promoted by trauma or hormonal changes. Treatment cannot be curative, thus indication of treatment is strictly depending on the gravity of the symptoms. Materials and Methods: Over a course of 6 years 52 Patients underwent 95 laser treatments: 34 female and 18 male, age ranging from 6 months to 82 years (mean 29.9 years). Present in 21.6% intraorally and in 29.7% in the lips, the oral and perioral region were most commonly involved, followed by the cheeks in 17.6%. Reason for treatment were functional difficulties, aesthetic impairment and risk of trauma and bleeding. Laser treatment was carried out with Nd:YAG/ice cube technique in 78.9%, intralesionally with Nd:YAG/barefiber in 12.6% and with the KTP-Laser in 5.25%. Results: The results greatly depend on the size of the malformation: smaller VVMs (<2 cm2 ) could be reduced effectively in 29 of 29 cases, larger VVMs (up to 5 cm2 ) in 7 of 12 cases and large VVMs (>5 cm2 ) in 3 of 9 cases. Eleven patients experienced an improvement of their symptoms, with little reduction of the VVM’s volume. Conclusion: Laser treatment of VVM can be considered effective and was well tolerated.
O.297 Resection of tumours of the oral cavity with the harmonic scalpel A. Dean, F.J. Alamillos, J.J. Ruiz, J.A. Garc´ıa. Dpto Cirug´ıa Oral y Maxilofacial, Hospital Regional Universitario Reina Sof´ıa, C´ordoba, Spain Introduction and Objectives: The scalpel Ultracision® uses ultrasonic energy to obtain dissection, accurate incision and coagulation. A generator supplying electric power and a transducer transforming it onto mechanical energy compose it. The terminal vibrates with high frequency producing 55,500 Hz ultrasonic waves; this produces denaturalization of tissue proteins and coagulation of blood vessels. The purpose of this paper is to evaluate advantages, disadvantages and complications of tumour ablation in the oral cavity with Ultracision® . Material and Methods: Twenty seven patients with squamous cell carcinoma of the oral cavity underwent resection with Ultracision® . We have evaluated the haemostatic capacity, the surgical time employed in the resection, the easiness of handling of the instrument and the post-operative evolution. Results: In all the cases a considerable decrease of the intraoperative bleeding is obtained during ablation. The time of ablation decreases in 15%. The easiness of use of the terminals improves as the learning curve progresses. There have not been complications related with the use of Ultracision® . Conclusions: Ultracision® is a handy instrument that allows the cut and the local haemostasis in vessels of up to 2–3 mm diameter. The surgical field stays bloodless and this facilitates and shortens the operative time. Since the harmonic scalpel does not transmit electricity there is no risk of electric complications for the patient or sanitary personnel. The scalpel Ultracision® is advisable since
Journal of Cranio-Maxillofacial Surgery 34(2006) Suppl. S1
Results: Tissue sloughing occurred within 1 to 3 days, and healing was complete in 3 to 5 weeks. There were no cases of intraoperative or postoperative bleeding. Four of the cases needed “touch up” photocoagulations to remove residual islets of hypervascular tissue. One of the large hemangiomas of the toungue recurred one year after laser photocoagulation, and the procedure was repeated. In one case of a large venous malformation of the upper lip, two photocoagulation procedures were followed by surgical excision. There was only one case of slight postoperative infection, which was overcome with oral antibiotics. Overall, patients were very pleased with treatment outcomes. Conclusion: The Nd:YAG laser is a safe and effective tool for removal of large vascular lesions. O.294 Micromorphometrical analysis of different osteotomy techniques at the rabbit skull P. Maurer1 , M.S. Kriwalsky1 , A.W. Eckert1 , C. Heiss2 . 1 Department of Oral and Plastic Maxillofacial Surgery; MartinLuther-University Halle-Wittenberg, Germany; 2 Department of Trauma Surgery Giessen; University of Giessen-Marburg, Germany Introduction and Objectives: The ultrasonic osteotome which was recently introduced is an alternative to conventional methods of osteotomy. The aim of the present study was to establish the differences between three osteotomy techniques and to perform a quantitative roughness analysis of the osteotomized bone surfaces. Material and Methods: Fresh bony samples of standardized size were taken from the rabbit skull. The techniques used were as follows: reciprocate micro-saw, Lindemann bur, ultrasonic osteotome with the two insert tips OT6 (rough) and OT7 (fine). The prepared surfaces were examined by light microscopy, environmental surface electron microscopy (ESEM) and by confocal laser scanning microscopy (CLSM). Results: It was difficult to distingush between cortical and cancellous bone after using the conventional osteotomy technique. The ultrasonic technique preserved the original structure of the bone. The values observed for superficial roughness were as follows: 5.97 mm (micro-saw), 5.70 mm (Lindemann bur), 2.48 mm (OT6) and 3.00 mm (OT7). There was a statistical difference between the micro-saw and insert tip OT6 (p = 0.032). Conclusions: In the present study micromorphological differences after using various osteotomy techniques could be clearly identified. O.295 Coblation – A preliminary report into its use in the oral cavity A.I. Edwards1 , S.G. Langton1 , J.G. Smith1 , M.S. Timms2 . 1 Department of Oral & Maxillofacial Surgery, Blackburn Royal Infirmary, Blackburn, BB2 3LR, UK; 2 Deartmenpt of Otolaryngology, Blackburn Royal Infirmary, Blackburn, BB2 3LR, UK Coblation or cold ablation is a method of soft tissue surgery that utilizes radiofrequency current to permit cutting at relatively low temperatures. This presentation describes preliminary experience using coblation in surgery of the oral cavity and discusses the potential uses, advantages and disadvantages of this technique. A small case series is presented. As a method of tissue resection within the oral environment this technique warrants further study.
Abstracts, EACFMS XVIII Congress O.296 Treatment of facial and intraoral venous malformations: Results in 52 patients J. Mommsen, T. Erdsach, I. Potthoff, R. Reich. Clinic for Oral and Maxillofacial Surgery, University of Bonn, Germany Introduction: Venous vascular malformations (VVM) of the head and neck region are a common reason for consultation of a maxillofacial surgeon. VVM develop due to a congenital laxity of the vessel’s wall, possibly due to a lack of innervation. They are present but frequently not obvious at birth and become clinically relevant during the course of life, eventually promoted by trauma or hormonal changes. Treatment cannot be curative, thus indication of treatment is strictly depending on the gravity of the symptoms. Materials and Methods: Over a course of 6 years 52 Patients underwent 95 laser treatments: 34 female and 18 male, age ranging from 6 months to 82 years (mean 29.9 years). Present in 21.6% intraorally and in 29.7% in the lips, the oral and perioral region were most commonly involved, followed by the cheeks in 17.6%. Reason for treatment were functional difficulties, aesthetic impairment and risk of trauma and bleeding. Laser treatment was carried out with Nd:YAG/ice cube technique in 78.9%, intralesionally with Nd:YAG/barefiber in 12.6% and with the KTP-Laser in 5.25%. Results: The results greatly depend on the size of the malformation: smaller VVMs (<2 cm2 ) could be reduced effectively in 29 of 29 cases, larger VVMs (up to 5 cm2 ) in 7 of 12 cases and large VVMs (>5 cm2 ) in 3 of 9 cases. Eleven patients experienced an improvement of their symptoms, with little reduction of the VVM’s volume. Conclusion: Laser treatment of VVM can be considered effective and was well tolerated.
O.297 Resection of tumours of the oral cavity with the harmonic scalpel A. Dean, F.J. Alamillos, J.J. Ruiz, J.A. Garc´ıa. Dpto Cirug´ıa Oral y Maxilofacial, Hospital Regional Universitario Reina Sof´ıa, C´ordoba, Spain Introduction and Objectives: The scalpel Ultracision® uses ultrasonic energy to obtain dissection, accurate incision and coagulation. A generator supplying electric power and a transducer transforming it onto mechanical energy compose it. The terminal vibrates with high frequency producing 55,500 Hz ultrasonic waves; this produces denaturalization of tissue proteins and coagulation of blood vessels. The purpose of this paper is to evaluate advantages, disadvantages and complications of tumour ablation in the oral cavity with Ultracision® . Material and Methods: Twenty seven patients with squamous cell carcinoma of the oral cavity underwent resection with Ultracision® . We have evaluated the haemostatic capacity, the surgical time employed in the resection, the easiness of handling of the instrument and the post-operative evolution. Results: In all the cases a considerable decrease of the intraoperative bleeding is obtained during ablation. The time of ablation decreases in 15%. The easiness of use of the terminals improves as the learning curve progresses. There have not been complications related with the use of Ultracision® . Conclusions: Ultracision® is a handy instrument that allows the cut and the local haemostasis in vessels of up to 2–3 mm diameter. The surgical field stays bloodless and this facilitates and shortens the operative time. Since the harmonic scalpel does not transmit electricity there is no risk of electric complications for the patient or sanitary personnel. The scalpel Ultracision® is advisable since