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Oral cavity examination (OCE) during upper aerodigestive tract investigations (UATI)
21st ICOMS 2013 - Abstracts: Oral Papers
1313
T24.OR005
T24.OR007
Mandibular osteomyelitis: a rare complication of sickle cell anaemia. Report of two cases
Oral cavity examination (OCE) during upper aerodigestive tract investigations (UATI)
A.
Bakathir ∗ ,
A.H. Al-Rawas
Sultan Qaboos University Hospital, Oman
N. Clifford 1,∗ , T. Walker 2 , G. Logan 1 , M. Shorafa 1 , L. Cascarini 1 1 North 2
Published literature indicates that the prevalence of osteomyelitis in sickle cell anaemic patients is up to 29%. While sickle cell osteomyelitis is more commonly seen in long bones, its occurrence in the jawbones remain relatively rare, with scientific literature reports few cases occurring mainly in young adults. The pathogenesis of jaw osteomyelitis start by intravascular sickling, which leads to ischaemic infarction and necrosis of bone, which in turn create a favorable environment for bacterial growth from the oral region. Jaw osteomyelitis in sickle cell anaemic patients tends to occur more commonly in mandible with the mandibular molar region being most commonly involved area. This poster presentation describes two clinical cases of 16 and 23-years old male sickle cell anaemic patients, who presented with 1–2 months duration of chronic pus discharge from buccal aspect of mandibular body. Based on clinical, radiographic and laboratory investigations the diagnosis of osteomyelitis of the mandible was confirmed with involvement of actinomycosis species in one case and Streptococcus anginosus in the second case. Both patients were managed by local sequestrectomy, removal of involved teeth and the use of long-term antibiotic therapy directed towards the causative microorganism with a final successful outcome. http://dx.doi.org/10.1016/j.ijom.2013.07.483 T24.OR006 Inverted ductal papilloma—a case report N. Berridge ∗ , M. Kumar Hillingdon Hospital, United Kingdom Ductal papillomas are rare benign papillary tumours of the minor salivary glands. The World Health Organization (WHO) has sub-classified ductal papillomas to include inverted ductal papilloma, sialadenoma papilliferum and intraductal papilloma. They represent adenomas with unique histopathological features and arise from the excretory ducts of the salivary glands. The oral inverted ductal papilloma (IDP), first described by White et al. (1982), is the least common lesion, with only 12 cases reported to date in our search of the English-language literature. We describe an interesting case of oral IDP, the histopathological findings and pertinent clinical features. An elderly woman presented with a longstanding asymptomatic submucosal lesion with a central crater-like defect in the buccal sulcus. Surgical excision of the lesion was performed, and at a 2 year follow-up there was no evidence of clinical recurrence. Histologically, the tumour showed a characteristic endophytic growth pattern, composed of bulbous papillary projections of basaloid cells dilating and filling the superficial portion of the excretory duct. Oral IDP is histologically similar to the more common inverted papilloma (IP) of the nose and paranasal sinuses. However, unlike IP the oral variant of the lesion is a completely benign entity and is not reported to be associated with malignant transformation. It is important for clinicians of the Head and Neck region to be aware of oral IDP, so that correct diagnosis and appropriate management may be instituted. http://dx.doi.org/10.1016/j.ijom.2013.07.484
West London Hospitals, United Kingdom Kings College, University of London, United Kingdom
Introduction: Oral cancer is an ideal candidate for screening. Many oral cancers are preceded by pre malignant lesions which are amenable to detection through simple oral cavity examination (OCE). At present oral cancers frequently present at a late stage with poor prognosis. The risk factors for oral and upper digestive tract malignancy are similar and synchronous carcinoma is sometimes seen. At present oral examinations are not current practice for patients undergoing an UATI with endoscopy, whereas rectal exams for colonoscopy are. Aim/method: The aim of this study was to examine the oral cavity of patients undergoing UATI with endoscopy. The OC was examined to identify any pre-malignancy/frank carcinoma and findings documented on a specific proforma. Information collected included risk factors, patient demographics and findings of the OCE/UATI. A pilot study of 35 patients identified ease of implementation and value in identifying suspicions lesions. Results: We will present the results from 200 OCE’s for urgent and routine UATI and suggest modifications to the current national UATI protocols in light of our findings. Many patients presenting for urgent UATI have high risk factors for OC malignancy. Conclusion: The risk factors for malignancy of the UAT and OC are similar and assessment of the OC should form a rigid part of the UATI protocol. The knowledge and skill for performing an OCE is often poor amongst medically qualified personal and appropriate education/training is required. This will help to ensure that easily identifiable oral cancers/pre malignant lesions are not missed. http://dx.doi.org/10.1016/j.ijom.2013.07.485 T24.OR008 Evaluation of the possible role of drinking water copper ion concentration in the pathogenesis of oral submucous fibrosis—pilot study S. Colbert 1,∗ , G. Arakeri 2 , P. Brennan 1 1 2
Queen Alexandra Hospital, Portsmouth, United Kingdom Bangalore Institute of Oncology, Bangalore, India
Aims and objectives: Oral submucous fibrosis (OSMF) is well known to be related to chronic areca nut chewing. There is considerable evidence for the role that copper contained in the nut has in the pathogenesis.The aim of our pilot study was to investigate the copper ion concentrations in drinking water and assess whether raised systemic Cu concentrations might have a possible role of in the pathogenesis of OSMF. Methodology: The ethically approved study was conducted in India on fifty patients with OSMF diagnosed clinically and histologically. Fifty healthy individuals matched for age and gender were used as controls. In both groups copper ion concentrations in serum, saliva and home drinking water were measured using atomic absorption spectroscopy and intelligent nephelometry technology. Serum ceruloplasmin level was also estimated in both the groups. Results: The mean home drinking water copper ion concentrations in OSMF patients was significantly higher (1.2 ± 0.7 g/ml) when compared to controls (0.48 ± 0.5 g/ml) (P < 0.001). OSMF patients also had a subtle increase in both serum and saliva copper concentrations and serum ceruloplasmin compared to controls which was statistically significant (P < 0.001) Conclusion: The present data has found for the first time a positive association between home drinking water copper ion concentrations and OSMF. It raises the possibility of whether increased copper in drinking water is a contributing factor in the development of OSMF, and adds to the total copper ingested during areca nut chewing. Key words: copper; drinking water; oral submucous fibrosis http://dx.doi.org/10.1016/j.ijom.2013.07.486
1313
T24.OR005
T24.OR007
Mandibular osteomyelitis: a rare complication of sickle cell anaemia. Report of two cases
Oral cavity examination (OCE) during upper aerodigestive tract investigations (UATI)
A.
Bakathir ∗ ,
A.H. Al-Rawas
Sultan Qaboos University Hospital, Oman
N. Clifford 1,∗ , T. Walker 2 , G. Logan 1 , M. Shorafa 1 , L. Cascarini 1 1 North 2
Published literature indicates that the prevalence of osteomyelitis in sickle cell anaemic patients is up to 29%. While sickle cell osteomyelitis is more commonly seen in long bones, its occurrence in the jawbones remain relatively rare, with scientific literature reports few cases occurring mainly in young adults. The pathogenesis of jaw osteomyelitis start by intravascular sickling, which leads to ischaemic infarction and necrosis of bone, which in turn create a favorable environment for bacterial growth from the oral region. Jaw osteomyelitis in sickle cell anaemic patients tends to occur more commonly in mandible with the mandibular molar region being most commonly involved area. This poster presentation describes two clinical cases of 16 and 23-years old male sickle cell anaemic patients, who presented with 1–2 months duration of chronic pus discharge from buccal aspect of mandibular body. Based on clinical, radiographic and laboratory investigations the diagnosis of osteomyelitis of the mandible was confirmed with involvement of actinomycosis species in one case and Streptococcus anginosus in the second case. Both patients were managed by local sequestrectomy, removal of involved teeth and the use of long-term antibiotic therapy directed towards the causative microorganism with a final successful outcome. http://dx.doi.org/10.1016/j.ijom.2013.07.483 T24.OR006 Inverted ductal papilloma—a case report N. Berridge ∗ , M. Kumar Hillingdon Hospital, United Kingdom Ductal papillomas are rare benign papillary tumours of the minor salivary glands. The World Health Organization (WHO) has sub-classified ductal papillomas to include inverted ductal papilloma, sialadenoma papilliferum and intraductal papilloma. They represent adenomas with unique histopathological features and arise from the excretory ducts of the salivary glands. The oral inverted ductal papilloma (IDP), first described by White et al. (1982), is the least common lesion, with only 12 cases reported to date in our search of the English-language literature. We describe an interesting case of oral IDP, the histopathological findings and pertinent clinical features. An elderly woman presented with a longstanding asymptomatic submucosal lesion with a central crater-like defect in the buccal sulcus. Surgical excision of the lesion was performed, and at a 2 year follow-up there was no evidence of clinical recurrence. Histologically, the tumour showed a characteristic endophytic growth pattern, composed of bulbous papillary projections of basaloid cells dilating and filling the superficial portion of the excretory duct. Oral IDP is histologically similar to the more common inverted papilloma (IP) of the nose and paranasal sinuses. However, unlike IP the oral variant of the lesion is a completely benign entity and is not reported to be associated with malignant transformation. It is important for clinicians of the Head and Neck region to be aware of oral IDP, so that correct diagnosis and appropriate management may be instituted. http://dx.doi.org/10.1016/j.ijom.2013.07.484
West London Hospitals, United Kingdom Kings College, University of London, United Kingdom
Introduction: Oral cancer is an ideal candidate for screening. Many oral cancers are preceded by pre malignant lesions which are amenable to detection through simple oral cavity examination (OCE). At present oral cancers frequently present at a late stage with poor prognosis. The risk factors for oral and upper digestive tract malignancy are similar and synchronous carcinoma is sometimes seen. At present oral examinations are not current practice for patients undergoing an UATI with endoscopy, whereas rectal exams for colonoscopy are. Aim/method: The aim of this study was to examine the oral cavity of patients undergoing UATI with endoscopy. The OC was examined to identify any pre-malignancy/frank carcinoma and findings documented on a specific proforma. Information collected included risk factors, patient demographics and findings of the OCE/UATI. A pilot study of 35 patients identified ease of implementation and value in identifying suspicions lesions. Results: We will present the results from 200 OCE’s for urgent and routine UATI and suggest modifications to the current national UATI protocols in light of our findings. Many patients presenting for urgent UATI have high risk factors for OC malignancy. Conclusion: The risk factors for malignancy of the UAT and OC are similar and assessment of the OC should form a rigid part of the UATI protocol. The knowledge and skill for performing an OCE is often poor amongst medically qualified personal and appropriate education/training is required. This will help to ensure that easily identifiable oral cancers/pre malignant lesions are not missed. http://dx.doi.org/10.1016/j.ijom.2013.07.485 T24.OR008 Evaluation of the possible role of drinking water copper ion concentration in the pathogenesis of oral submucous fibrosis—pilot study S. Colbert 1,∗ , G. Arakeri 2 , P. Brennan 1 1 2
Queen Alexandra Hospital, Portsmouth, United Kingdom Bangalore Institute of Oncology, Bangalore, India
Aims and objectives: Oral submucous fibrosis (OSMF) is well known to be related to chronic areca nut chewing. There is considerable evidence for the role that copper contained in the nut has in the pathogenesis.The aim of our pilot study was to investigate the copper ion concentrations in drinking water and assess whether raised systemic Cu concentrations might have a possible role of in the pathogenesis of OSMF. Methodology: The ethically approved study was conducted in India on fifty patients with OSMF diagnosed clinically and histologically. Fifty healthy individuals matched for age and gender were used as controls. In both groups copper ion concentrations in serum, saliva and home drinking water were measured using atomic absorption spectroscopy and intelligent nephelometry technology. Serum ceruloplasmin level was also estimated in both the groups. Results: The mean home drinking water copper ion concentrations in OSMF patients was significantly higher (1.2 ± 0.7 g/ml) when compared to controls (0.48 ± 0.5 g/ml) (P < 0.001). OSMF patients also had a subtle increase in both serum and saliva copper concentrations and serum ceruloplasmin compared to controls which was statistically significant (P < 0.001) Conclusion: The present data has found for the first time a positive association between home drinking water copper ion concentrations and OSMF. It raises the possibility of whether increased copper in drinking water is a contributing factor in the development of OSMF, and adds to the total copper ingested during areca nut chewing. Key words: copper; drinking water; oral submucous fibrosis http://dx.doi.org/10.1016/j.ijom.2013.07.486