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Submental intubation: a modification of current techniques
e144
Oral Presentation
from pre-operative to post-operative third day. No effect on tooth vitality and no significant root resorption were noted. No statistically significant difference was seen in VAS mean scores of Group A and Group B. Conclusion: Rate of retraction was faster in Corticotomy as compared to fiberotomy and conventional orthodontics. Reported pain levels were same for Corticotomy and Fiberotomy. Corticotomy was found to be a safe procedure leading to no significant root resorption of the teeth, but resulted in more post-operative swelling as compared to fiberotomy. http://dx.doi.org/10.1016/j.ijom.2015.08.803 Submental intubation: a modification of current techniques C. Patel, O. Sheikh ∗ , M. Perry, R. Pabla London North West Healthcare NHS Trust, Northwick Park Hospital, Watford Road, Harrow, United Kingdom The surgical management of midface and panfacial injuries can pose challenges for appropriate airway management. Unlike orotracheal intubation, nasal intubation provides unimpeded access to the oral cavity, allowing inter-maxillary fixation (IMF) intraoperatively. Nasotracheal intubation is, however, contraindicated in those with skull base and nasal fractures, complicating its use in several types of maxillofacial trauma. Alternative options for airway management include tracheostomies, although, they are often associated with significant morbidities including haemorrhage, scarring and nerve damage. Submental intubation is a well-recognised technique first suggested in 1986.1 It differs from orotracheal intubation in that the proximal end of the tube is passed through an orocutaenous opening in the submental region and connected extra orally. As well as avoiding the complications of nasal intubation or tracheostomies, the technique allows unobstructed intraoral access and intra-operative IMF. The procedure consists of an extra oral incision and blunt dissection through the submental triangle, which carries a risk of postoperative bleeding and scarring. Percutaneous dilatational tracheostomy kits offer an alternative method where the opening is widened with the passage of dilators of increasing sizes.2 We present a case where we used a modified method of percutaneous dilatation. Using a single staged sharply curved dilator; adequate dilatation to accommodate the oral tube was achieved. The soft tip aimed to reduce trauma to the soft tissues. The potential for reducing postoperative complications makes it an attractive modification of the current submental intubation techniques.
References Altemir, F. H. (1986). The submental route for endotracheal intubation. J Maxillofac Surg, 14, 64–65. Biswas, B. K., Joshi, S., Bhattacharyya, P., Gupta, P. K., & Baniwal, S. (2006). Percutaneous dilational tracheostomy kit: an aid to submental intubation. Anesth Analg, 103(4), 1055.
http://dx.doi.org/10.1016/j.ijom.2015.08.804
Establishment of CoCl2 induced hypoxic cell model of oral squamous cell carcinoma and a preliminary study on the biological behaviour change H. Shengwei 1,∗ , H. Wei 1 , N. Yanhong 2 , H. Qingang 1 1
Institute and Hospital of Stomatology, Nanjing University, Nanjing, China 2 Central Laboratory, Institute and Hospital of Stomatology, Nanjing University, Nanjing, China Objective: To investigate the best condition by using chemical agent CoCl2 to mimic oral squamous cell carcinoma cell hypoxia and explore its biological behaviour change. Methods: Oral squamous cell carcinoma cell lines HSC-3 and SCC-4 were exposed to different concentration of CoCl2 . Expression of hypoxia inducible factor-1␣ (HIF-1␣), vascular endothelial growth factor (VEGF) and B-cell lymphoma-2 (BCL-2) were measured by Real time PCR and western blotting in both mRNA and protein level. Cell proliferation, cell apoptosis and cell cycle were detected to analyze its biological behaviour change. Both wound healing and Transwell assay were applied to test the ability of cell migration. Results: The OSCC cell hypoxia can be induced successfully with the treatment of 150 M CoCl2 for 24 h. Compared with the cells cultured in normoxia, the expression level of HIF-1␣, VEGF and BCL-2 were increased significantly. Hypoxia microenvironment might decrease the cell growth and promote cell apoptosis. Moreover, it could also inhibit cell migration. Conclusion: The hypoxic cell model of OSCC could be induced by CoCl2 . The expression level of hypoxic markers were upregulated significantly and the cells biological behaviour were changed. The establishment of this model will lay a foundation for further study about the initiation and development of OSCC in tumor microenvironment. http://dx.doi.org/10.1016/j.ijom.2015.08.805 Evaluation of nasolabial symmetry after cheiloplasty and primary rhinoplasty B. Shi ∗ , X. Yi Department of Cleft Lip and Palate Surgery, West China Stomatological Hospital, Sichuan University, Chengdu, China Objective: Secondary cleft nasolabial deformities can result in permanent impact to a child’s self-esteem. The purpose of this study was to identify the most comment deformities seen postoperatively in primary cheiloplasty and rhinoplasty patients by evaluation of gradual alteration about facial symmetry Method: A retrospective chart review of 30 patients was performed, who were with unilateral incomplete cleft lip (11) or unilateral complete cleft lip (19) from 2005 to 2009 in our hospital. Standard photographs were employed for evaluation in full-face front view and submental oblique view. Patients were selected by the following standard: non-syndromic unilateral cleft lip patients; received operation using West China technique and treated by the same experienced surgeon; not receive any non-surgical orthodontic treatment pre or post operation, and annual return-visit in three years so on Result: The data showed there was no statistical significant difference about lip width (p = 0.475 > 0.05), but obvious statistical difference on lip height (p = 0.001 < 0.05). Especially compared with the group immediately after operation, the first and second revisit groups showed significant differences (p = 0.016 < 0.05,
Oral Presentation
from pre-operative to post-operative third day. No effect on tooth vitality and no significant root resorption were noted. No statistically significant difference was seen in VAS mean scores of Group A and Group B. Conclusion: Rate of retraction was faster in Corticotomy as compared to fiberotomy and conventional orthodontics. Reported pain levels were same for Corticotomy and Fiberotomy. Corticotomy was found to be a safe procedure leading to no significant root resorption of the teeth, but resulted in more post-operative swelling as compared to fiberotomy. http://dx.doi.org/10.1016/j.ijom.2015.08.803 Submental intubation: a modification of current techniques C. Patel, O. Sheikh ∗ , M. Perry, R. Pabla London North West Healthcare NHS Trust, Northwick Park Hospital, Watford Road, Harrow, United Kingdom The surgical management of midface and panfacial injuries can pose challenges for appropriate airway management. Unlike orotracheal intubation, nasal intubation provides unimpeded access to the oral cavity, allowing inter-maxillary fixation (IMF) intraoperatively. Nasotracheal intubation is, however, contraindicated in those with skull base and nasal fractures, complicating its use in several types of maxillofacial trauma. Alternative options for airway management include tracheostomies, although, they are often associated with significant morbidities including haemorrhage, scarring and nerve damage. Submental intubation is a well-recognised technique first suggested in 1986.1 It differs from orotracheal intubation in that the proximal end of the tube is passed through an orocutaenous opening in the submental region and connected extra orally. As well as avoiding the complications of nasal intubation or tracheostomies, the technique allows unobstructed intraoral access and intra-operative IMF. The procedure consists of an extra oral incision and blunt dissection through the submental triangle, which carries a risk of postoperative bleeding and scarring. Percutaneous dilatational tracheostomy kits offer an alternative method where the opening is widened with the passage of dilators of increasing sizes.2 We present a case where we used a modified method of percutaneous dilatation. Using a single staged sharply curved dilator; adequate dilatation to accommodate the oral tube was achieved. The soft tip aimed to reduce trauma to the soft tissues. The potential for reducing postoperative complications makes it an attractive modification of the current submental intubation techniques.
References Altemir, F. H. (1986). The submental route for endotracheal intubation. J Maxillofac Surg, 14, 64–65. Biswas, B. K., Joshi, S., Bhattacharyya, P., Gupta, P. K., & Baniwal, S. (2006). Percutaneous dilational tracheostomy kit: an aid to submental intubation. Anesth Analg, 103(4), 1055.
http://dx.doi.org/10.1016/j.ijom.2015.08.804
Establishment of CoCl2 induced hypoxic cell model of oral squamous cell carcinoma and a preliminary study on the biological behaviour change H. Shengwei 1,∗ , H. Wei 1 , N. Yanhong 2 , H. Qingang 1 1
Institute and Hospital of Stomatology, Nanjing University, Nanjing, China 2 Central Laboratory, Institute and Hospital of Stomatology, Nanjing University, Nanjing, China Objective: To investigate the best condition by using chemical agent CoCl2 to mimic oral squamous cell carcinoma cell hypoxia and explore its biological behaviour change. Methods: Oral squamous cell carcinoma cell lines HSC-3 and SCC-4 were exposed to different concentration of CoCl2 . Expression of hypoxia inducible factor-1␣ (HIF-1␣), vascular endothelial growth factor (VEGF) and B-cell lymphoma-2 (BCL-2) were measured by Real time PCR and western blotting in both mRNA and protein level. Cell proliferation, cell apoptosis and cell cycle were detected to analyze its biological behaviour change. Both wound healing and Transwell assay were applied to test the ability of cell migration. Results: The OSCC cell hypoxia can be induced successfully with the treatment of 150 M CoCl2 for 24 h. Compared with the cells cultured in normoxia, the expression level of HIF-1␣, VEGF and BCL-2 were increased significantly. Hypoxia microenvironment might decrease the cell growth and promote cell apoptosis. Moreover, it could also inhibit cell migration. Conclusion: The hypoxic cell model of OSCC could be induced by CoCl2 . The expression level of hypoxic markers were upregulated significantly and the cells biological behaviour were changed. The establishment of this model will lay a foundation for further study about the initiation and development of OSCC in tumor microenvironment. http://dx.doi.org/10.1016/j.ijom.2015.08.805 Evaluation of nasolabial symmetry after cheiloplasty and primary rhinoplasty B. Shi ∗ , X. Yi Department of Cleft Lip and Palate Surgery, West China Stomatological Hospital, Sichuan University, Chengdu, China Objective: Secondary cleft nasolabial deformities can result in permanent impact to a child’s self-esteem. The purpose of this study was to identify the most comment deformities seen postoperatively in primary cheiloplasty and rhinoplasty patients by evaluation of gradual alteration about facial symmetry Method: A retrospective chart review of 30 patients was performed, who were with unilateral incomplete cleft lip (11) or unilateral complete cleft lip (19) from 2005 to 2009 in our hospital. Standard photographs were employed for evaluation in full-face front view and submental oblique view. Patients were selected by the following standard: non-syndromic unilateral cleft lip patients; received operation using West China technique and treated by the same experienced surgeon; not receive any non-surgical orthodontic treatment pre or post operation, and annual return-visit in three years so on Result: The data showed there was no statistical significant difference about lip width (p = 0.475 > 0.05), but obvious statistical difference on lip height (p = 0.001 < 0.05). Especially compared with the group immediately after operation, the first and second revisit groups showed significant differences (p = 0.016 < 0.05,