Role of computer-assisted navigation in reconstruction of unilateral delayed zygomatic complex fracture: a randomized controlled trial

Oral Presentation Conclusion: Dysplasia at the margin may not be a significant independent prognostic factor; specifically mild and moderate dysplasia. http://dx.doi.org/10.1016/j.ijom.2015.08.568 Role of computer-assisted navigation in reconstruction of unilateral delayed zygomatic complex fracture: a randomized controlled trial X. Gong ∗ , Y. Zhang, Y. He, J.G. An, Y. Yang, Y. Zhao Peking University School and Hospital of Stomatology, Beijing, PR China Background: In surgical reconstruction of the delayed zygomatic complex fractures, the loss of normal anatomic landmarks owing to the malunion of the fracture ends makes it difficult to determine the correct positions of displaced fragments and original zygoma contour. Development of CAD/CAM and following appeared 3-D model surgery and application of the individual designed guiding template greatly relieved surgeons of bewilderment in operating. However, precise deliver of surgical simulation plans is still not realized through the fabricated template. Intraoperative navigation has brought an effective solution to this problem. Objectives: In order to validate the role of navigation technique in improving treatment results, a randomized controlled trial was conducted. Methods: Sixty-two patients with unilateral delayed ZMC fracture were included in this study. Group A (n = 31, using navigation guiding repositioning) and group B (n = 31, using template guiding repositioning). The zygomatic projection and width between bilateral zygomatic arches were measured on CT of 3 month postoperatively. Findings: The postoperative 3-D CT measurement showed that the difference of zygomatic projection on both sides was 1.21 (0.60–2.05) mm in group A, and 2.11 (1.39–2.64) mm in group B, with significant differences between two groups. The difference of zygomatic width on both sides was 1.12 (0.76–1.87) mm in group A, and 1.40 (0.85–2.55) mm in group B, without significant differences between two groups. Follow-up data were obtained for 48 participants. The VAS scores showed significant difference in the two groups (P < 0.01). Conclusions: Navigation guiding surgery can improve the outcome of the unilateral delayed ZMC fracture. http://dx.doi.org/10.1016/j.ijom.2015.08.569 Head and neck skin cancer – a protocol for efficient management D. Goodisson Hawkes Bay Regional Hospital, Hastings, New Zealand Background: The incidence of melanoma (MSC) and nonmelanoma skin cancer (NMSC) is increasing in Australia, New Zealand, United Kingdom and United States of America. By the age of 70, two out of three Australians will have had a skin cancer removed. In Australia and New Zealand, skin cancers consume more health care dollars than any other cancer type. Poorly managed skin cancers may carry significant morbidity and mortality. Accurate diagnosis, treatment and cosmetic and functional reconstruction are the three pillars of management of head and neck

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skin cancer management. With increasing pressures on health care budgets, this should be as cost effective as possible. Objectives: Propose a protocol for the efficient management of NMSC. Methods: 500 skin cancer cases, managed per protocol, were reviewed. Incomplete excision and five year recurrence rates were reported Findings: At 1% 5 year recurrence for primary tumours and 5% recurrence for recurrent tumours, the effectiveness of this technique is similar to Mohs surgery. There were no inappropriate resections Conclusions: Our protocol for management of NMSC is simple and appears to offer efficient tumour clearance. It has 4 intervention points; 1. Dermatocopy allows accurate prediction of significant skin lesions. 2. Incision biopsy on suspicious lesions avoids inappropriate resections. 3. Dermatoscopic assistance at the time of surgery helps with accurate resection margins 4. The staged approach to resection with delayed reconstruction ensures clearance prior to reconstruction http://dx.doi.org/10.1016/j.ijom.2015.08.570 Single institution experience with sentinel lymph node biopsy for early stage oral SCC A. Greenstein 1,∗ , J. McMahon 1 , C. MacIver 1 , C. Wales 1 , D. McLellan 1 , I. Mclaughlin 1 , S. Hislop 2 1 2

Southern General Hospital, Glasgow, Scotland, UK Crosshouse Hospital, Kilmarnock, Scotland, UK

Background: Sentinel lymph node biopsy (SNLBx) for head and neck oncology, such as melanomas, have been utilised for a number of years. However, their application for oral SCC has become more widespread. This study will show that introducing SLNBx into contemporary head and neck practice will significantly reduce neck dissection related morbidity. Aim: To describe the introduction of SNLBx for oral SCC into contemporary head and neck practice and examine patterns of lymph node metastasis encountered and preliminary outcomes. Methods: We will examine a consecutive series of patients undergoing SNLBx for oral cavity primaries between September 2010 to February 2015. The first ten patients also underwent simultaneous selective neck dissections (validation phase). Technical, pathological and clinical aspects will be described. Results: Of a total of 48 patients recruited onto the study it was found that 16 were found to be pN+ on SNLBx. The primary subsites for resection of oral SCC were oral tongue, soft palate, and mandibular alveolus. The median number of SLNBx recovered was 2 with a range from 1 to 6. Levels I to IV were seen on SNLBx. Conclusions: SNLBx is a straightforward procedure to introduce into the practice of an experience head and neck team and has the potential to significantly reduce neck dissection related morbidity as well as identify a subset of patients with early stage disease who could benefit from advent treatment. http://dx.doi.org/10.1016/j.ijom.2015.08.571