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P60 Evaluation of the concurrent intraaterial chemo-radiotherapy for locally advanced oral cavity cancer
The other three patients refused any form of prosthesis as they could tolerate their diet well. Mouth opening was good in four patients ranging from 35 to 50 mm while one patient could only open about 10 mm. Speech and swallowing was acceptable in all patients. Morphology and profile was acceptable in four patients. Conclusion: Reconstruction plate provides good mandibular continuity with good occlusal and functional rehabilitation. Keywords: reconstruction plate, mandibular defects, functional rehabilitation P57 Management of osteoradionecrosis of the jaw bones following radiotherapy for nasopharyngeal carcinoma R. Ramli1 , F.A. Karim1 , R.A.L. Rahman1 , R.K. Rajandram1 , M.S.F. Mohamad1 , M.N.A. Jabar1 , S.H.A. Primuharsa Putra2 *. 1 Hospital Universiti Kebangsaan Malaysia, Malaysia, 2 Seremban Specialist Hospital, Malaysia Objective: The objective of this study was to investigate the diagnosis and management of osteoradionecrosis (ORN) of the jaw bones following radiotherapy (RT) for nasopharyngeal carcinoma (NPC). Patients and Methods: All patients with the diagnosis of ORN of the jaw bones who previously had RT due to NPC were included in this study. Data related to demographics, location of the ORN, aetiology, treatment carried out and outcome were evaluated. Results: Between February 2002 to June 2006, 10 patients who had RT for NPC were referred to the Oral and Maxillofacial Surgery Clinic, Hospital Universiti Kebangsaan Malaysia, Kuala Lumpur for the management of ORN of the jaw bones. There were 2 females and 8 males giving female: ratio of 1:4. Nine patients were Chinese and the other one was a Malay boy. The age ranged from 18 to 67 years old (mean age of 49.3 years). 6 patients had ORN of the mandible and 4 involved the maxillary bone. The aetiology include tooth extraction (2 patients had extraction after RT and 3 before RT), one patient had a fall and sustained fracture of the mandible and in four patients, the aetiology was unknown. 8 patients had surgical intervention. Prior to surgery, seven patients had pre-operative therapeutic ultrasound to improve vascularization. Two patients did not have any treatment; one succumbed to the disease and the other one defaulted treatment. Success of treatment was achieved in 75% of patients. Conclusion: ORN is a debilitating condition and difficult to treat. The principle of treatment is to provide support to wound healing prior to any surgical intervention. Keywords: osteoradionecrosis, nasopharyngeal carcinoma, radiotherapy P58 The use of buccal pad of fat to augment defects caused by osteoradionecrosis R. Ramli1 , R.A. Rahman1 , S.H.A. Primuharsa Putra2 *. 1 Hospital Universiti Kebangsaan Malaysia, Malaysia, 2 Seremban Specialist Hospital, Malaysia Introduction: Osteoradionecrosis (ORN) is a condition where the bone is complicated by impaired nutrition and avascular necrosis. Buccal pad of fat flap has been used to correct defects in the oral cavity e.g in oro-antral communications. Its use in ORN defects has never been reported. The aim of this study is to evaluate the success of buccal pad of fat in the reconstruction of oral defects associated with ORN. Patients and Methods: From March to December, 2006, 5 patients; 4 males and 1 female patient were seen at the Oral & Maxillofacial Surgery Clinic, Hospital Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia for the management of ORN of the jaw bones. These patients received radiotherapy to the head and neck previously because of nasopharyngeal
149 carcinoma. The infected ORN sites involved two posterior maxilla and three posterior mandible. During surgery, the necrotic bone was removed. The size of the defects was noted to be between small to moderate. Buccal pad of fat was used to augment the defects. Results: Post-operatively, all patients remain well with no discharge and foul odour from the mouth. Clinically the mucosa overlying the defects appeared healthy. However, the flap was not intact in one patient. 80% of patients reported better appetite following surgery. Conclusion: Buccal pad of fat provides a good reconstruction for a small to moderate size of osteoradionecrotic bone in the oral cavity. Keywords: osteoradionecrosis, bony defect, buccal pad of fat flap P59 Mandibular re-education after treatment for a head and neck cancer M.Y. Louis *, Y. Souquieres, J. Launay, S. Theillier, J. Somoza, P. Jean Pierre. Centre Fran¸cois Baclesse, France After treatment (surgery, radiotherapy) for a head and neck cancer, patients have problems to open correctly the mouth. So they have difficulties to eat, to speak, . . . Their quality of life is perturbed. We can’t look after their initial cancer. We’ve been realising mandibular reeducation to increase that for two years. Nurses realise massages of head and neck, explain and look after exercises to open the mouth. Patients must repeat these exercises at home. They come back once a week and we measure the opening of the mouth, we note the increasing, the way they eat, the way they speak. We also note if they have pain. Sometimes we use mobilisator to help patients at home. The beginning and the end of this reeducation is organised by the doctor. We note a real increasing of the quality of life about few sessions. Keywords: mandibular, reeducation, quality of life, oral cancer P60 Evaluation of the concurrent intraaterial chemo-radiotherapy for locally advanced oral cavity cancer S.L. Lian *, C.J. Huang, C.M. Huang, C.F. Wu, C.H. Chen, H.E. Lee. Kaohsiung Medical University, Taiwan The aim of the present study was to evaluate DNA damage (micronucleus) in cytokinesis-blocked lymphocytes and exfoliated buccal mucosa cells from children with malignant tumors and under chemotherapy. Micronucleated cells were assessed from children before, during and after chemotherapy. A total of 21 healthy children (controls), matched for gender and age were used as control. The results pointed out higher frequencies of micronucleated lymphocytes in children with malignant tumor before any therapy when compared to healthy probands. Furthermore, it was detected an increase of micronucleated lymphocytes during and after chemotherapy when compared to the data obtained before chemotherapy. No statistically significant increases of micronucleated cells were noticed in buccal mucosa cells in all of the moments evaluated. Taken together, these data indicate that the presence of malignant tumors may increase the frequency of DNA damage in circulating lymphocytes, being these cells more sensitive for detecting chromosome aberrations caused by anti-cancer drugs. The chromosome damage found herein represents a certain degree of genomic instability, reinforcing the approach to evaluate the side health effects induced by chemotherapy as well as to contribute to the micronucleus database for understanding and/or improving this methodology. Keywords: children, chemotherapy, micronucleus test, oral mucosa cells
Poster abstracts
Poster abstracts, Friday 18 May
149 carcinoma. The infected ORN sites involved two posterior maxilla and three posterior mandible. During surgery, the necrotic bone was removed. The size of the defects was noted to be between small to moderate. Buccal pad of fat was used to augment the defects. Results: Post-operatively, all patients remain well with no discharge and foul odour from the mouth. Clinically the mucosa overlying the defects appeared healthy. However, the flap was not intact in one patient. 80% of patients reported better appetite following surgery. Conclusion: Buccal pad of fat provides a good reconstruction for a small to moderate size of osteoradionecrotic bone in the oral cavity. Keywords: osteoradionecrosis, bony defect, buccal pad of fat flap P59 Mandibular re-education after treatment for a head and neck cancer M.Y. Louis *, Y. Souquieres, J. Launay, S. Theillier, J. Somoza, P. Jean Pierre. Centre Fran¸cois Baclesse, France After treatment (surgery, radiotherapy) for a head and neck cancer, patients have problems to open correctly the mouth. So they have difficulties to eat, to speak, . . . Their quality of life is perturbed. We can’t look after their initial cancer. We’ve been realising mandibular reeducation to increase that for two years. Nurses realise massages of head and neck, explain and look after exercises to open the mouth. Patients must repeat these exercises at home. They come back once a week and we measure the opening of the mouth, we note the increasing, the way they eat, the way they speak. We also note if they have pain. Sometimes we use mobilisator to help patients at home. The beginning and the end of this reeducation is organised by the doctor. We note a real increasing of the quality of life about few sessions. Keywords: mandibular, reeducation, quality of life, oral cancer P60 Evaluation of the concurrent intraaterial chemo-radiotherapy for locally advanced oral cavity cancer S.L. Lian *, C.J. Huang, C.M. Huang, C.F. Wu, C.H. Chen, H.E. Lee. Kaohsiung Medical University, Taiwan The aim of the present study was to evaluate DNA damage (micronucleus) in cytokinesis-blocked lymphocytes and exfoliated buccal mucosa cells from children with malignant tumors and under chemotherapy. Micronucleated cells were assessed from children before, during and after chemotherapy. A total of 21 healthy children (controls), matched for gender and age were used as control. The results pointed out higher frequencies of micronucleated lymphocytes in children with malignant tumor before any therapy when compared to healthy probands. Furthermore, it was detected an increase of micronucleated lymphocytes during and after chemotherapy when compared to the data obtained before chemotherapy. No statistically significant increases of micronucleated cells were noticed in buccal mucosa cells in all of the moments evaluated. Taken together, these data indicate that the presence of malignant tumors may increase the frequency of DNA damage in circulating lymphocytes, being these cells more sensitive for detecting chromosome aberrations caused by anti-cancer drugs. The chromosome damage found herein represents a certain degree of genomic instability, reinforcing the approach to evaluate the side health effects induced by chemotherapy as well as to contribute to the micronucleus database for understanding and/or improving this methodology. Keywords: children, chemotherapy, micronucleus test, oral mucosa cells
Poster abstracts
Poster abstracts, Friday 18 May