Author(s): Khattak O.; Cousin G.

Source: British Journal of Oral and Maxillofacial Surgery; Dec 2016; vol. 54 (no. 10)

Publication Date: Dec 2016

Publication Type(s): Journal: Conference Abstract

Abstract:Outline: Breastfeeding confers significant health benefits to mother and baby. Restrictive tongue ties have been reported to cause difficulties in beastfeeding infants, and recently it has been reported that releasing the tongue tie can aid breast feeding. Five years ago a tongue tie releae service was started at our hospital. Several surgeons participate, and this paper will present the results of the first 500 cases performed by one surgeon.Methodology: Prospective audit data collection for all infant frenulotomies performed by one surgeon. This includes demographics, specific difficulties reported by the mothers prior to frenulomy, intended feeding outcomes and complication rates.Summary: Breastfeeding mothers who reported problems with breastfeeding in tongue-tied infants noted an improvement in immediate post-frenulotomy feeding scores. A significant number of bottle-fed infants were also referred but it is very difficult to quantify feeding improvements in them. The complication rate was low, and maternal satisfaction high.Conclusion: Frenulotomy in infants is safe, and improves breast feeding. An outline of how our service developed and evolved will also be presented.
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Database: EMBASE

Author(s): Walker E.; Palmer D.; Siddiqui N.; Patterson D.

Source: British Journal of Oral and Maxillofacial Surgery; Dec 2016; vol. 54 (no. 10)

Publication Date: Dec 2016

Publication Type(s): Journal: Conference Abstract

Abstract: Introduction:Lentigo maligna is a melanoma-in-situ which typically develops on chronically sun damaged skin in older patients. The reported risk of progression to malignant melanoma is between 5% and 20%. Complete surgical excision with a 5 mm to 10 mm margin is the standard treatment for lentigo maligna (Hou et al., 2015).Aims:We aim to assess the adequacy of a predetermined 5 mm clinical excision margin for lentigo maligna with respect to complete excision and histological margin.Methods: Patients who have undergone excision of facial lentigo maligna with a predetermined 5 mm margin within our unit since 2011 are included in this ongoing audit. The data collection sheet documented patient demographics, surgical margin, and completeness of excision, histological margin and skin MDT recommendation.Results: Of the first 21 patients who have undergone excision of lentigo maligna, 20 were completely excised. The closest mean histological margin was 2.74 mm. Skin MDT recommended that 2 patients with completely excised lentigo maligna undergo further excision because the closest histological margin was less than 2 mm.Discussion: In our unit, excision of lentigo maligna with a predetermined 5 mm surgical margin resulted in an excision rate of 95%. There is a lack of evidence correlating histological margin and recurrence rate however Akhtar et al reported a recurrence rate of 1.4% with a histological margin less than 2 mm (Akhtar et al., 2014).The face is a cosmetically sensitive area which is challenging to reconstruct and this small ongoing audit suggests that wider excision is not necessary to achieve a safe histological margin.

Database: EMBASE