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Ranula: review of the literature and report of three cases
Oral Presentation
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Table 4 Duloxetine significantly showed pain-relieving effects and depression effects in AO which was not triggered by dental treatment. AO triggered by dental treatment showed significant difference in pain-relieving effects, but not in depression effects. Visual analog scale (VAS)
Beck Depression Inventory (BDI)
(a) AO which was triggered by dental treatment 0w: 51.8 ± 25.3 12w:35.7 ± 27.5
0w:14.1 ± 10.5
12w:10.1 ± 7.8
(b) AO which was not triggered by dental treatment 0w: 60.0 ± 25.1 12w:37.0 ± 25.0
0w:11.9 ± 7.4
12w:7.4 ± 5.4
Conclusions: Duloxetine worked as an effective agent for chronic orofacial pain during a 12 week treatment. Furthermore, the current results suggested that the treatment pathway triggered by dental treatment is different between BMS and AO. http://dx.doi.org/10.1016/j.ijom.2015.08.834
care centers in last five years period emphasizing on the need of improvements and strategy to strengthen the local capacity. Findings and conclusion: The co-operation with our national and regional professional associations and government sponsored programs for training and exchange of manpower in the field of Oral and Maxillofacial Surgery is the prime need in coming days to develop this speciality in this part of the world.
Opportunities and challenges for the development of oral and maxillofacial surgery in a developing country – Nepal
http://dx.doi.org/10.1016/j.ijom.2015.08.835
C. Upadhyaya
Ranula: review of the literature and report of three cases
Department of Oral and Maxillofacial Surgery, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal
M.W. Utami ∗ , L. Dwi Sulistyani
Background: Disease prevalence is higher in Nepal than it is in other South Asian countries, especially in rural areas due to uneven geographic distribution and poor socio-economic status. Insufficient competencies in providing services, narrow skill mix of the workforce, uneven distribution of trained human resources, and improper HR management are the key issues. Medical facilities and different sub specialties like oral and maxillofacial surgeons are in an infant stage and lacking in most areas of the country due to lack of higher training centers and poor socio-economic status. The various oral and maxillofacial problems are common due to increase in number of road traffic accidents, fall injuries, pathologies due to poor awareness. Objectives: This presentation aims to retrospectively analyze and discuss the incidence and pattern of various maxillofacial conditions specially cranio-facial injuries, oral cancer, etc in Nepal. Methods: Data regarding incidence and pattern of various maxillofacial conditions were collected from five different tertiary
University of Indonesia, Jakarta, Indonesia Background: Ranula occur when salivary duct obstruction results in increased pressure, duct rupture and formation of a retention pseudocyst. Clinically, ranula is a bluish cyst like swelling containing translucent fluid located on floor of the mouth. A detailed medical history, careful examination, and radiograph examination of the ranula allows definitive diagnosis. Objectives: To present 3 cases of ranula, analyzing the clinical characteristics, radiological features, and treatment of these lesions. Methods: The clinical histories of patients diagnosed with ranula at the Oral and Maxillofacial Surgery Unit of Cipto Mangunkusumo Hospital were reviewed. All patients with clinical diagnosis of ranula were included. Findings: Three patients, 1 boy and 2 girls, with mean age of 16.6 years were included in the study. Two cases were located on the left side of the floor of the mouth. The lesion diameter
e156
Oral Presentation
varied between 1 and 3 cm in these cases. All patients had pain on swelling. All lesions were resolved by marsupialization. Sialography was performed and showed dilatation of left wharton’s duct. Conclusions: Marsupialization may be useful as an alternative minimally invasive procedure for ranula. Sialography is one of diagnostic tool, in addition to the clinical examination, for the differential diagnosis.
for the composite radial free flap. There were no flap failures and no returns to theatre for salvage were required. Conclusions: This study shows no difference in the survival rates of four composite free flaps. Defect characteristics are important for making decisions regarding which flap to use but patient factors should also be considered to maximise success rates. http://dx.doi.org/10.1016/j.ijom.2015.08.838
http://dx.doi.org/10.1016/j.ijom.2015.08.836 Analysis of the vascular pedicle of free tissue transfer in head and neck reconstruction: how long does the pedicle last?
A prospective comparison study between autogenous and alloplastic materials for orbital wall fracture reconstruction using cone beam computed tomography
M. Van Genechten ∗ , M. Batstone
K. van Mourik ∗ , K. Tsao, A. Cheng
Royal Brisbane and Women’s Hospital, Brisbane, Australia
Department of Oral and Maxillofacial Surgery, Royal Adelaide Hospital, Adelaide, Australia
Background: Little is understood about what happens to the vascular pedicle following free tissue transfer in the head and neck region. The viability of a free flap completely depends on the vascular supply by its vascular pedicle until neovascularization occurs from surrounding tissues. Aim: The aim of this study is to find out how long a vascular pedicle lasts following free tissue transfer in the head and neck region. Methods: Patients were recruited from the Maxillofacial Unit at the Royal Brisbane & Women’s Hospital. A Doppler ultrasound was used to map the vascular pedicle immediately postoperatively, at 2 weeks, 6 weeks, 3 months and 6 months. Findings: 30 consecutive free flaps underwent color Doppler ultrasonography at the timepoints described demonstrating the status of the vascular pedicle. All the patients underwent reconstructive head and neck surgery with a wide variety of soft tissue and composite free flaps. Conclusions: This study is the first to document the fate of the vascular pedicle over a long time period for a wide variety of head and neck free flaps. The information is important when undertaking revision surgery to the free flap, or planning the vascular supply for a second or third free flap to the head and neck region. http://dx.doi.org/10.1016/j.ijom.2015.08.837 The relative survival of different composite free flaps M. Van Genechten ∗ , M. Batstone Royal Brisbane and Women’s Hospital, Brisbane, Australia Introduction: Various composite free flaps are available for the reconstruction of bony head and neck defects. Some authors have claimed that one type of flap is more successful than another. Aim: The aim of this study is to compare the relative success of 4 different bony free flaps. Methods: We retrospectively reviewed 173 patients who received microvascular composite free flap reconstruction for bony defects of the head and neck region from April 2008 to January 2015. The variables that were reviewed include the type of free flap, the indication for free flap reconstruction, the age at harvesting the free flap, the use of pre- or postoperative radiotherapy and free flap failure. Findings: Head and neck reconstruction was performed in 173 patients. 84 fibular, 43 iliac crest, 32 scapula and 14 composite radial free flaps were harvested. The mean age at the time of harvesting was 40.7 years for the DCIA free flap, 57.3 years for the fibula free flap, 64.3 years for the scapula free flap and 73.9 years
Purpose: A trichotomy of approaches prevails for orbital wall reconstruction with graft materials. These include: predominate use of autogenous grafts, predominate use of alloplastic materials and the use of both graft materials in relatively equal occurrence. There are advantages and disadvantages to both graft materials. Aspects include possible donor site morbidity and financial cost. Individual patient qualities necessitates that there is no one material which is best suited to all patients. The purpose of this study is to examine objectively the adequacy of surgical reconstruction of orbital wall fractures using either autogenous or allogenic materials. Materials and methods: A prospective study of approximately 12 cases of orbital wall fractures in which surgery was indicated underwent reconstruction with either autogenous or allogenic grafts. All cases were examined by Cone Beam Computed Tomography scan after a minimum of 12 months. Subsequently, reconstructed orbits were assessed by particular objective measures including; graft position and contour, orbital bony volume and fracture reduction. This assessment was compared to the preoperative orbit and contra-lateral orbit. In addition, the results of all reconstructed orbits were evaluated with regard to the type of graft material employed. All cases were assessed clinically for adequacy of reconstruction. Findings and conclusions: The results of this study are pending as we await the 12 month post-operative Cone Beam Computed Tomography image of all cases. We expect all data to be gathered by mid-year. We hope that this study will assist the surgeon with their choice of reconstructive material for orbital wall fractures. http://dx.doi.org/10.1016/j.ijom.2015.08.839 Zygomatic implant – clinical case-series report N.V. Vo National Hospital of Odonto-Stomatology in Ho Chi Minh City, Viet Nam Objectives: To evaluate the outcome of zygomatic implant in rehabilitation for patients with atrophic edentulous maxilla, especially in the posterior region. Methods: 3 patients (2 female and 1 male with a mean age of 52 years) with severely atrophic edentulous maxilla were first Vietnamese patients received zygomatic implant. All patients were investigated the bone volume and sinus pathology by computed tomography and used the Nobel Clinician software (Nobel Biocare, Switzerland) for treatment plans. Using an extended sinus lift with retained bone window introduced by James Chow1 , 1
e155
Table 4 Duloxetine significantly showed pain-relieving effects and depression effects in AO which was not triggered by dental treatment. AO triggered by dental treatment showed significant difference in pain-relieving effects, but not in depression effects. Visual analog scale (VAS)
Beck Depression Inventory (BDI)
(a) AO which was triggered by dental treatment 0w: 51.8 ± 25.3 12w:35.7 ± 27.5
0w:14.1 ± 10.5
12w:10.1 ± 7.8
(b) AO which was not triggered by dental treatment 0w: 60.0 ± 25.1 12w:37.0 ± 25.0
0w:11.9 ± 7.4
12w:7.4 ± 5.4
Conclusions: Duloxetine worked as an effective agent for chronic orofacial pain during a 12 week treatment. Furthermore, the current results suggested that the treatment pathway triggered by dental treatment is different between BMS and AO. http://dx.doi.org/10.1016/j.ijom.2015.08.834
care centers in last five years period emphasizing on the need of improvements and strategy to strengthen the local capacity. Findings and conclusion: The co-operation with our national and regional professional associations and government sponsored programs for training and exchange of manpower in the field of Oral and Maxillofacial Surgery is the prime need in coming days to develop this speciality in this part of the world.
Opportunities and challenges for the development of oral and maxillofacial surgery in a developing country – Nepal
http://dx.doi.org/10.1016/j.ijom.2015.08.835
C. Upadhyaya
Ranula: review of the literature and report of three cases
Department of Oral and Maxillofacial Surgery, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal
M.W. Utami ∗ , L. Dwi Sulistyani
Background: Disease prevalence is higher in Nepal than it is in other South Asian countries, especially in rural areas due to uneven geographic distribution and poor socio-economic status. Insufficient competencies in providing services, narrow skill mix of the workforce, uneven distribution of trained human resources, and improper HR management are the key issues. Medical facilities and different sub specialties like oral and maxillofacial surgeons are in an infant stage and lacking in most areas of the country due to lack of higher training centers and poor socio-economic status. The various oral and maxillofacial problems are common due to increase in number of road traffic accidents, fall injuries, pathologies due to poor awareness. Objectives: This presentation aims to retrospectively analyze and discuss the incidence and pattern of various maxillofacial conditions specially cranio-facial injuries, oral cancer, etc in Nepal. Methods: Data regarding incidence and pattern of various maxillofacial conditions were collected from five different tertiary
University of Indonesia, Jakarta, Indonesia Background: Ranula occur when salivary duct obstruction results in increased pressure, duct rupture and formation of a retention pseudocyst. Clinically, ranula is a bluish cyst like swelling containing translucent fluid located on floor of the mouth. A detailed medical history, careful examination, and radiograph examination of the ranula allows definitive diagnosis. Objectives: To present 3 cases of ranula, analyzing the clinical characteristics, radiological features, and treatment of these lesions. Methods: The clinical histories of patients diagnosed with ranula at the Oral and Maxillofacial Surgery Unit of Cipto Mangunkusumo Hospital were reviewed. All patients with clinical diagnosis of ranula were included. Findings: Three patients, 1 boy and 2 girls, with mean age of 16.6 years were included in the study. Two cases were located on the left side of the floor of the mouth. The lesion diameter
e156
Oral Presentation
varied between 1 and 3 cm in these cases. All patients had pain on swelling. All lesions were resolved by marsupialization. Sialography was performed and showed dilatation of left wharton’s duct. Conclusions: Marsupialization may be useful as an alternative minimally invasive procedure for ranula. Sialography is one of diagnostic tool, in addition to the clinical examination, for the differential diagnosis.
for the composite radial free flap. There were no flap failures and no returns to theatre for salvage were required. Conclusions: This study shows no difference in the survival rates of four composite free flaps. Defect characteristics are important for making decisions regarding which flap to use but patient factors should also be considered to maximise success rates. http://dx.doi.org/10.1016/j.ijom.2015.08.838
http://dx.doi.org/10.1016/j.ijom.2015.08.836 Analysis of the vascular pedicle of free tissue transfer in head and neck reconstruction: how long does the pedicle last?
A prospective comparison study between autogenous and alloplastic materials for orbital wall fracture reconstruction using cone beam computed tomography
M. Van Genechten ∗ , M. Batstone
K. van Mourik ∗ , K. Tsao, A. Cheng
Royal Brisbane and Women’s Hospital, Brisbane, Australia
Department of Oral and Maxillofacial Surgery, Royal Adelaide Hospital, Adelaide, Australia
Background: Little is understood about what happens to the vascular pedicle following free tissue transfer in the head and neck region. The viability of a free flap completely depends on the vascular supply by its vascular pedicle until neovascularization occurs from surrounding tissues. Aim: The aim of this study is to find out how long a vascular pedicle lasts following free tissue transfer in the head and neck region. Methods: Patients were recruited from the Maxillofacial Unit at the Royal Brisbane & Women’s Hospital. A Doppler ultrasound was used to map the vascular pedicle immediately postoperatively, at 2 weeks, 6 weeks, 3 months and 6 months. Findings: 30 consecutive free flaps underwent color Doppler ultrasonography at the timepoints described demonstrating the status of the vascular pedicle. All the patients underwent reconstructive head and neck surgery with a wide variety of soft tissue and composite free flaps. Conclusions: This study is the first to document the fate of the vascular pedicle over a long time period for a wide variety of head and neck free flaps. The information is important when undertaking revision surgery to the free flap, or planning the vascular supply for a second or third free flap to the head and neck region. http://dx.doi.org/10.1016/j.ijom.2015.08.837 The relative survival of different composite free flaps M. Van Genechten ∗ , M. Batstone Royal Brisbane and Women’s Hospital, Brisbane, Australia Introduction: Various composite free flaps are available for the reconstruction of bony head and neck defects. Some authors have claimed that one type of flap is more successful than another. Aim: The aim of this study is to compare the relative success of 4 different bony free flaps. Methods: We retrospectively reviewed 173 patients who received microvascular composite free flap reconstruction for bony defects of the head and neck region from April 2008 to January 2015. The variables that were reviewed include the type of free flap, the indication for free flap reconstruction, the age at harvesting the free flap, the use of pre- or postoperative radiotherapy and free flap failure. Findings: Head and neck reconstruction was performed in 173 patients. 84 fibular, 43 iliac crest, 32 scapula and 14 composite radial free flaps were harvested. The mean age at the time of harvesting was 40.7 years for the DCIA free flap, 57.3 years for the fibula free flap, 64.3 years for the scapula free flap and 73.9 years
Purpose: A trichotomy of approaches prevails for orbital wall reconstruction with graft materials. These include: predominate use of autogenous grafts, predominate use of alloplastic materials and the use of both graft materials in relatively equal occurrence. There are advantages and disadvantages to both graft materials. Aspects include possible donor site morbidity and financial cost. Individual patient qualities necessitates that there is no one material which is best suited to all patients. The purpose of this study is to examine objectively the adequacy of surgical reconstruction of orbital wall fractures using either autogenous or allogenic materials. Materials and methods: A prospective study of approximately 12 cases of orbital wall fractures in which surgery was indicated underwent reconstruction with either autogenous or allogenic grafts. All cases were examined by Cone Beam Computed Tomography scan after a minimum of 12 months. Subsequently, reconstructed orbits were assessed by particular objective measures including; graft position and contour, orbital bony volume and fracture reduction. This assessment was compared to the preoperative orbit and contra-lateral orbit. In addition, the results of all reconstructed orbits were evaluated with regard to the type of graft material employed. All cases were assessed clinically for adequacy of reconstruction. Findings and conclusions: The results of this study are pending as we await the 12 month post-operative Cone Beam Computed Tomography image of all cases. We expect all data to be gathered by mid-year. We hope that this study will assist the surgeon with their choice of reconstructive material for orbital wall fractures. http://dx.doi.org/10.1016/j.ijom.2015.08.839 Zygomatic implant – clinical case-series report N.V. Vo National Hospital of Odonto-Stomatology in Ho Chi Minh City, Viet Nam Objectives: To evaluate the outcome of zygomatic implant in rehabilitation for patients with atrophic edentulous maxilla, especially in the posterior region. Methods: 3 patients (2 female and 1 male with a mean age of 52 years) with severely atrophic edentulous maxilla were first Vietnamese patients received zygomatic implant. All patients were investigated the bone volume and sinus pathology by computed tomography and used the Nobel Clinician software (Nobel Biocare, Switzerland) for treatment plans. Using an extended sinus lift with retained bone window introduced by James Chow1 , 1