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Simulation in maxillofacial trauma – should this be the new way forward?
Oral Presentation group (P < 0.05). No statistically significant results were obtained for the study endpoints (b), (c), and (d). Conclusions: Our study showed that the most effective dose of dexamethasone for BSSOs is 16 mg. http://dx.doi.org/10.1016/j.ijom.2015.08.423 The long-term effects of infant mandibular distraction A. Adhikari 1,∗ , P. Bordbar 2 , A. Heggie 2 , J. Shand 2 , N. Kilpatrick 1
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Results: The results of this show a strong feeling that their training would benefit from such simulation training and have suggestions for how trauma management in maxillofacial surgery might benefit from this additional mode of learning. Findings and conclusion: Simulation training is currently underused in maxillofacial surgery and this review should encourage a debate on the topic and suggest news way to embrace this potential learning resource, which trainees feel will supplement their clinical training in the management of maxillofacial trauma. http://dx.doi.org/10.1016/j.ijom.2015.08.425
1
Murdoch Childrens Research Institute, Melbourne, Australia 2 Royal Children’s Hospital, Melbourne, Australia Background: Mandibular distraction osteogenesis (MDO) has been shown to be an effective technique for the relief of upper airway obstruction in micrognathic infants with few short-term complications. However, there is little published data regarding the long-term effects of MDO on the developing mandible, particularly regarding the developing dentition. Objectives: The aim of this study is to assess the impact of MDO in infancy on the developing mandible, with a particular focus on the developing dentition, inferior alveolar nerve function and scar cosmesis. Methods: All children residing in the state of Victoria who had MDO in infancy between 2001 and 2012 at the Royal Children’s Hospital were invited for review. A standard dental examination including clinical photographs was performed, sensory deficits were explored and scar cosmesis was assessed using the Stony Brook Scar Evaluation Scale. Findings: Sixty-four children were invited for clinical review, of whom thirty-nine attended (median age 5.1 years [3.9, 6.5 interquartile range]). Twenty-one had a diagnosis of nonsyndromic Robin Sequence while the remaining eighteen were syndromic. Developmental defects of enamel (DDE) were the most common abnormality, affecting 32% of teeth near the osteotomy site. Five patients (13%) had sensory deficits along the cutaneous distribution of the inferior alveolar nerve and thirtyeight (97%) had favourable scar cosmesis. Conclusions: In this cohort, MDO carried out in infancy was associated with favourable scar cosmesis and a low rate of neurosensory deficit. However, many of the mandibular first permanent and second primary molars had DDE. http://dx.doi.org/10.1016/j.ijom.2015.08.424 Simulation in maxillofacial trauma – should this be the new way forward? N. Ahmed Guy’s Hospital, London, UK Background: Simulation training is increasingly being used to augment clinical training in all disciplines following the implementation of the Junior Doctors New Deal and European Working Time Directive. Other surgical specialties have embraced this mode of training for their trainees and incorporated this into the annual assessment process to ensure trainees are competent to manage common surgical emergency scenarios which are cited as surgical drills. Method: We present the results of a web survey undertaken of current maxillofacial trainees at all levels. This was undertaken using a web based questionnaire and disseminated using the Junior Trainee Group (JTG) and Fellows in Training (FiT) mailing lists.
Osteoradionecrosis – a preventable problem? N. Ahmed ∗ , R. Jayaram, R. Singh, V. Patel, L. Cascarini, M. McGurk Guy’s Hospital, London, UK Osteoradionecrosis is a significant and debilitating condition which can present a number of ways with management ranging from medical therapy to surgery requiring vascularised flap reconstruction in extensive cases. Such procedures are complex with a high complication rate, poor healing, and prolonged hospital stay. Despite our advances and improvement in the management of head and neck cancer, we have yet to make advances in preventing and managing patients suffering from this condition. We review all the cases currently having medical management of ORN at Guy’s and St Thomas Head and Neck Unit, and propose a more aggressive approach to its management. Method: Retrospective notes review of all patients treated with medical therapy for ORN since 2008. Patients were identified from pharmacy dispensing records and their notes were obtained. Data was collected retrospectively and entered onto a data collection proforma. Results: 168 patients have been using vitamin E and pentoxifylline within our unit. The majority of patients are prescribed medical therapy to treat ORN after symptoms have started. Conclusion: Having identified the risk factors ORN in this cohort, we suggest an earlier more prophylactic role be adopted for the use of systemic vitamin E and pentoxifylline in order to prevent the establishment and progression of this destructive process. Clearly this is a change and variation from the more prophylactic role of antibiotics in extractions for prevention and the use of vitamin E and pentoxifylline once ORN is established. This is a challenging condition to manage and we would welcome debate on this matter. http://dx.doi.org/10.1016/j.ijom.2015.08.426 Double layer collagen dressing for radial forearm free flap donor sites K.M. Ahn University of Ulsan, College of Medicine, Asan Medical Center, South Korea Background: Radial forearm free flap is the most reliable flap for intraoral soft tissue reconstruction after cancer ablation surgery. However, unaesthetic scar of the donor site and the need for second donor site for skin graft are major disadvantages of the forearm flap. Objectives: The purpose of this study was to report the clinical results of double layered collagen graft to the donor site of the forearm free flap without skin graft.
e21
Results: The results of this show a strong feeling that their training would benefit from such simulation training and have suggestions for how trauma management in maxillofacial surgery might benefit from this additional mode of learning. Findings and conclusion: Simulation training is currently underused in maxillofacial surgery and this review should encourage a debate on the topic and suggest news way to embrace this potential learning resource, which trainees feel will supplement their clinical training in the management of maxillofacial trauma. http://dx.doi.org/10.1016/j.ijom.2015.08.425
1
Murdoch Childrens Research Institute, Melbourne, Australia 2 Royal Children’s Hospital, Melbourne, Australia Background: Mandibular distraction osteogenesis (MDO) has been shown to be an effective technique for the relief of upper airway obstruction in micrognathic infants with few short-term complications. However, there is little published data regarding the long-term effects of MDO on the developing mandible, particularly regarding the developing dentition. Objectives: The aim of this study is to assess the impact of MDO in infancy on the developing mandible, with a particular focus on the developing dentition, inferior alveolar nerve function and scar cosmesis. Methods: All children residing in the state of Victoria who had MDO in infancy between 2001 and 2012 at the Royal Children’s Hospital were invited for review. A standard dental examination including clinical photographs was performed, sensory deficits were explored and scar cosmesis was assessed using the Stony Brook Scar Evaluation Scale. Findings: Sixty-four children were invited for clinical review, of whom thirty-nine attended (median age 5.1 years [3.9, 6.5 interquartile range]). Twenty-one had a diagnosis of nonsyndromic Robin Sequence while the remaining eighteen were syndromic. Developmental defects of enamel (DDE) were the most common abnormality, affecting 32% of teeth near the osteotomy site. Five patients (13%) had sensory deficits along the cutaneous distribution of the inferior alveolar nerve and thirtyeight (97%) had favourable scar cosmesis. Conclusions: In this cohort, MDO carried out in infancy was associated with favourable scar cosmesis and a low rate of neurosensory deficit. However, many of the mandibular first permanent and second primary molars had DDE. http://dx.doi.org/10.1016/j.ijom.2015.08.424 Simulation in maxillofacial trauma – should this be the new way forward? N. Ahmed Guy’s Hospital, London, UK Background: Simulation training is increasingly being used to augment clinical training in all disciplines following the implementation of the Junior Doctors New Deal and European Working Time Directive. Other surgical specialties have embraced this mode of training for their trainees and incorporated this into the annual assessment process to ensure trainees are competent to manage common surgical emergency scenarios which are cited as surgical drills. Method: We present the results of a web survey undertaken of current maxillofacial trainees at all levels. This was undertaken using a web based questionnaire and disseminated using the Junior Trainee Group (JTG) and Fellows in Training (FiT) mailing lists.
Osteoradionecrosis – a preventable problem? N. Ahmed ∗ , R. Jayaram, R. Singh, V. Patel, L. Cascarini, M. McGurk Guy’s Hospital, London, UK Osteoradionecrosis is a significant and debilitating condition which can present a number of ways with management ranging from medical therapy to surgery requiring vascularised flap reconstruction in extensive cases. Such procedures are complex with a high complication rate, poor healing, and prolonged hospital stay. Despite our advances and improvement in the management of head and neck cancer, we have yet to make advances in preventing and managing patients suffering from this condition. We review all the cases currently having medical management of ORN at Guy’s and St Thomas Head and Neck Unit, and propose a more aggressive approach to its management. Method: Retrospective notes review of all patients treated with medical therapy for ORN since 2008. Patients were identified from pharmacy dispensing records and their notes were obtained. Data was collected retrospectively and entered onto a data collection proforma. Results: 168 patients have been using vitamin E and pentoxifylline within our unit. The majority of patients are prescribed medical therapy to treat ORN after symptoms have started. Conclusion: Having identified the risk factors ORN in this cohort, we suggest an earlier more prophylactic role be adopted for the use of systemic vitamin E and pentoxifylline in order to prevent the establishment and progression of this destructive process. Clearly this is a change and variation from the more prophylactic role of antibiotics in extractions for prevention and the use of vitamin E and pentoxifylline once ORN is established. This is a challenging condition to manage and we would welcome debate on this matter. http://dx.doi.org/10.1016/j.ijom.2015.08.426 Double layer collagen dressing for radial forearm free flap donor sites K.M. Ahn University of Ulsan, College of Medicine, Asan Medical Center, South Korea Background: Radial forearm free flap is the most reliable flap for intraoral soft tissue reconstruction after cancer ablation surgery. However, unaesthetic scar of the donor site and the need for second donor site for skin graft are major disadvantages of the forearm flap. Objectives: The purpose of this study was to report the clinical results of double layered collagen graft to the donor site of the forearm free flap without skin graft.