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Two week wait cancer referrals: an audit
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Abstracts / British Journal of Oral and Maxillofacial Surgery 52 (2014) e75–e127
more adverse reactions. Complex and expensive measures requiring outpatient and in-hospital treatments to safely diagnose and treat these complications represent a potentially huge strain on the NHS. Conclusion: The growing popularity of non-surgical cosmetic treatment calls for a more comprehensive understanding of complications, and more importantly, management of procedures. Practitioners of such treatments must be held more accountable. A clear hospital pathway to efficiently investigate, diagnose and treat complications would be beneficial to hospital units and patients alike. Limiting the use of dermal fillers to prescription-only medical devices should be considered to reduce potentially debilitating and costly implications. http://dx.doi.org/10.1016/j.bjoms.2014.07.104 P3 Self retaining retractor in endoscopic assisted approach to the forehead - another use for the Foley’s catheter Sheena Vyas ∗ , Vyomesh Bhatt
issued guidance in 2005, which aimed to highlight conditions, which should be treated with a high level of suspicion. Aims: To ensure the department is compliant with national guidelines regarding urgent referrals. Objectives: Assess when patients are seen within the 14 day period Improve quality of referrals Investigate the number of appropriate refferals Standard: 100% of patient referred as urgent should be seen within 14 days Methods: Retrospective case note review of all urgent referrals (40 patients) within a 3 month period (2013) Results: All 40 patients were seen within 14days, the majority were seen in the second week. Of these 40 patients, 8 presented as suspicious of oral cancer and 4 were diagnosed histologically as squamous cell carcinoma. This gives a predicitive value of 10% for the referraos but a depratmental predeictive value of 50%. The national predicitive value for urgent referrals was 3.71%. Intervention: A letter was sent to GP’s to encourage better use of the guidance and more appropriate referrals to encourage a more predictive urgent referral.
Mid Essex Introduction: The removal of forehead osteomas via an endoscopic approach is well favoured due to its minimally invasive nature, fast recovery and improved aesthetic result. Traditionally, traction sutures or elevators are used to provide access and retract the tissues before introduction of the endoscope. The use of a Foley catheter can enable endoscopic resection with improved access and an increased operating field without the need for handheld retraction. Coupled with a suction catheter it allows the surgeon to use both hands with minimal assistance Method: A Foley catheter is inserted through a hairline slit incision, advanced and then inflated to allow for adequate visualization of the osteoma with the endoscope. A suction catheter is then fed alongside the Foley tubing, enabling continuous suction without operating assistance. Conclusion: This technique can also be applied to assist in brow-lift procedures and the removal of other bone and soft tissue lesions in the forehead or brow region. Foley catheterassisted endoscopic removal of osteomas, increase operator visibility and ease and can result in a reduced operating time without any implication on safety. http://dx.doi.org/10.1016/j.bjoms.2014.07.105 P4 Two week wait cancer referrals: an audit Ian Blewitt Great Western Hospital Introduction: All patients with suspected oral cancer must be seen within 14 days of referral being received. NICE
http://dx.doi.org/10.1016/j.bjoms.2014.07.106 P5 Do you know your skins? A National Pilot Study and Audit of Knowledge Laura Bryce ∗ , J. Kirby, R. Taylor, J. McManners, J. Downie Glasgow Dental Hospital Introduction: Skin pathology is a common finding on OMFS clinics. The British Association of Dermatologists (BAD) guidelines are generally accepted within the UK as the basic standard for treatment of skin cancers. Aim: To quantify and audit the diagnostic accuracy and planned excision margins used by OMFS clinicians in relation to skin cancer. Methods: OMFS clinicians throughout Scotland were invited to complete a questionnaire. Participants provided a clinical diagnosis for 25 different lesions, detailed which guidelines they used in relation skin malignancy management and identified what excision margins they would use in 5 different scenarios. Targeted teaching was then provided to a group of senior house officers (SHOs) and the questionnaire repeated. Results: The initial response rate was 53% (n = 32) with 69% of clinicians stating they used BAD guidelines. 87% of SHOs did not identify any real guideline and had a poorer overall diagnostic ability (p < 0.05). All grades demonstrated a good overall sensitivity in identifying malignant lesions however SHOs had a significantly lower sensitivity in identifying malignant melanomas as malignant lesions (P < 0.05). Following teaching, SHO results improved.
Abstracts / British Journal of Oral and Maxillofacial Surgery 52 (2014) e75–e127
more adverse reactions. Complex and expensive measures requiring outpatient and in-hospital treatments to safely diagnose and treat these complications represent a potentially huge strain on the NHS. Conclusion: The growing popularity of non-surgical cosmetic treatment calls for a more comprehensive understanding of complications, and more importantly, management of procedures. Practitioners of such treatments must be held more accountable. A clear hospital pathway to efficiently investigate, diagnose and treat complications would be beneficial to hospital units and patients alike. Limiting the use of dermal fillers to prescription-only medical devices should be considered to reduce potentially debilitating and costly implications. http://dx.doi.org/10.1016/j.bjoms.2014.07.104 P3 Self retaining retractor in endoscopic assisted approach to the forehead - another use for the Foley’s catheter Sheena Vyas ∗ , Vyomesh Bhatt
issued guidance in 2005, which aimed to highlight conditions, which should be treated with a high level of suspicion. Aims: To ensure the department is compliant with national guidelines regarding urgent referrals. Objectives: Assess when patients are seen within the 14 day period Improve quality of referrals Investigate the number of appropriate refferals Standard: 100% of patient referred as urgent should be seen within 14 days Methods: Retrospective case note review of all urgent referrals (40 patients) within a 3 month period (2013) Results: All 40 patients were seen within 14days, the majority were seen in the second week. Of these 40 patients, 8 presented as suspicious of oral cancer and 4 were diagnosed histologically as squamous cell carcinoma. This gives a predicitive value of 10% for the referraos but a depratmental predeictive value of 50%. The national predicitive value for urgent referrals was 3.71%. Intervention: A letter was sent to GP’s to encourage better use of the guidance and more appropriate referrals to encourage a more predictive urgent referral.
Mid Essex Introduction: The removal of forehead osteomas via an endoscopic approach is well favoured due to its minimally invasive nature, fast recovery and improved aesthetic result. Traditionally, traction sutures or elevators are used to provide access and retract the tissues before introduction of the endoscope. The use of a Foley catheter can enable endoscopic resection with improved access and an increased operating field without the need for handheld retraction. Coupled with a suction catheter it allows the surgeon to use both hands with minimal assistance Method: A Foley catheter is inserted through a hairline slit incision, advanced and then inflated to allow for adequate visualization of the osteoma with the endoscope. A suction catheter is then fed alongside the Foley tubing, enabling continuous suction without operating assistance. Conclusion: This technique can also be applied to assist in brow-lift procedures and the removal of other bone and soft tissue lesions in the forehead or brow region. Foley catheterassisted endoscopic removal of osteomas, increase operator visibility and ease and can result in a reduced operating time without any implication on safety. http://dx.doi.org/10.1016/j.bjoms.2014.07.105 P4 Two week wait cancer referrals: an audit Ian Blewitt Great Western Hospital Introduction: All patients with suspected oral cancer must be seen within 14 days of referral being received. NICE
http://dx.doi.org/10.1016/j.bjoms.2014.07.106 P5 Do you know your skins? A National Pilot Study and Audit of Knowledge Laura Bryce ∗ , J. Kirby, R. Taylor, J. McManners, J. Downie Glasgow Dental Hospital Introduction: Skin pathology is a common finding on OMFS clinics. The British Association of Dermatologists (BAD) guidelines are generally accepted within the UK as the basic standard for treatment of skin cancers. Aim: To quantify and audit the diagnostic accuracy and planned excision margins used by OMFS clinicians in relation to skin cancer. Methods: OMFS clinicians throughout Scotland were invited to complete a questionnaire. Participants provided a clinical diagnosis for 25 different lesions, detailed which guidelines they used in relation skin malignancy management and identified what excision margins they would use in 5 different scenarios. Targeted teaching was then provided to a group of senior house officers (SHOs) and the questionnaire repeated. Results: The initial response rate was 53% (n = 32) with 69% of clinicians stating they used BAD guidelines. 87% of SHOs did not identify any real guideline and had a poorer overall diagnostic ability (p < 0.05). All grades demonstrated a good overall sensitivity in identifying malignant lesions however SHOs had a significantly lower sensitivity in identifying malignant melanomas as malignant lesions (P < 0.05). Following teaching, SHO results improved.