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.
​
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

​Citation: The British journal of oral & maxillofacial surgery, Jan 2016, vol. 54, no. 1, p. 94-96 (January 2016)
 
Author(s): Tay, Brian Diaz, Prabhu, I S, Cousin, C H S, Cousin, G C S
 
Abstract: Exposure to excessive noise could impair surgical performance and communication, and lead to long-term hearing loss, but it is only recently that studies on occupational exposure to noise in operating theatres have been published. The aim of this prospective study was to assess mean and peak levels of noise during maxillofacial operations. We found that both were comparable to those in other surgical specialties such as orthopaedics in which power tools are used. Copyright © 2015. Published by Elsevier Ltd.
 
Source: Medline

​Citation: The British journal of oral & maxillofacial surgery, Feb 2016, vol. 54, no. 2, p. 120-131 (February 2016)
 
Author(s): Langton, Steve, Siau, Derrick, Bankhead, Clare
 
Abstract: The fast-track system in the UK for patients with suspected cancer - the two-week rule - states that if cancer is suspected there should be a maximum of 14 days between referral from primary care and consultation with a specialist. This approach is valued by patients, ensures a universal standard of diagnosis, and speeds up the overall management of cancer. However, some say that the rule has had little or no effect on survival, results in a diagnosis of cancer in only a small proportion of patients referred, and is expensive. We have made a systematic review of the effectiveness of the two-week rule in patients with head and neck cancer with the aid of electronic searches of databases. including MEDLINE, EMBASE, the Cochrane Database of Systematic Reviews CINAHL, and CANCERLIT up to the end of 2014. This was supplemented by searching conference proceedings and contacting experts. Retrospective and prospective studies that included either conversion rate (proportion of two-week referrals who were diagnosed with cancer - positive predictive value), or detection rate (proportion of diagnosed cancers referred under the two-week rule - sensitivity), or both, were included. Two reviewers assessed studies for inclusion, and extracted data independently. Heterogeneity was assessed by inspection of the overlap of 95% CI in the forest plot and calculation of I(2). We made a random-effects meta-analysis of 17 studies. All reported the conversion rate, and 10 also reported the detection rate. Meta-analysis indicated an overall pooled conversion rate of 8.8% (95% CI 7.0% to 10.7%) and a pooled detection rate of 40.8% (95% CI 25.7% to 55.8%) Subgroups in which maxillofacial (OFMS) and otolaryngology (ENT) were assessed showed no significant difference in conversion rate (8.3% and 8.8%; p=0.73). Subgroup analyses of early studies (before the end of 2008) and later studies (2009-14), showed a significant reduction in conversion rates from 10.6% to 6.6%, p=<0.0001. These early and late subgroups showed a significant increase in detection rate (35.0% to 49.7%, p=0.0008). The conversion and detection rates were similar to those for a number of other cancer sites that relied on a list of signs and symptoms for referral and were similar in both ENT and OMFS units. There is evidence that two-week referral conversion rates are falling, while detection rates are rising because of an increased number of referrals. The influence of the two-week referrral on outcomes, particularly survival, is not well known. Copyright © 2015 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
 
Source: Medline

​Citation: The British journal of oral & maxillofacial surgery, Jan 2016, vol. 54, no. 1, p. 111-112 (January 2016)
 
Author(s): Atwal, A, Cousin, G C S
 
Abstract: Bismuth is a heavy metal used in bismuth iodoform paraffin paste (BIPP) antiseptic dressings and in a number of other medical preparations. It can be absorbed systemically and cause toxicity. We report 2 cases of such neurotoxicity after it was used in operations on the jaws. Copyright © 2015. Published by Elsevier Ltd.
 
Source: Medline

Citation: Head and Neck, July 2015, vol./is. 37/(E134-E135), 1043-3074 (July 2015)

Author(s): Owais K., Morton M.E.

Institution: (Owais) Speciality Registrar, Oral and Maxillofacial surgery, North Manchetser General Hospital, Penine Acute Hospitals NHS Trust, Crumpsall, Manchester, United Kingdom, (Morton) Conslutant Oral and Maxillofacial Surgery, Royal Blackburn Hospital, East Lancashire Hospitals NHS Trust Blackburn, United Kingdom

Language: English

Abstract: Management of osteoradionecrosis is a debilitating complication following management of head and neck cancers. It can be difficult to manage and often patients suffer with the complication after successful treatment of the primary disease. Speech, swallowing, pain and appearance can all be affected. We present a chronological history of case with serial radiographs and photographs of a patient whose primary cancer was successfully treated with radical radiotherapy. He went on to develop osteoradionecrosis of his mandible. This was treated with serial debridement leading to almost complete loss of the entire body of the mandible. After two failed composite free flaps this patient was treated with distraction osteogenesis. This has resulted in restoration of form and function. The patient is pain free almost 10 years on with normal swallowing. We also present the relevant literature on the use of distraction osteogenesis in cases of osteoradionecrosis.

Conference Information: 5th World Congress of the International Academy of Oral Oncology, IAOO 2015 Sao Paulo Brazil. Conference Start: 20150708 Conference End: 20150711

Publisher: John Wiley and Sons Inc.

Publication Type: Journal: Conference Abstract

Source: EMBASE

Citation: British Journal of Oral & Maxillofacial Surgery, March 2015, vol./is. 53/3(298), 0266-4356;1532-1940 (2015 Mar)

Author(s): Hasan A, Cousin GC

Institution: Hasan,A. University of Glasgow, Glasgow, Scotland, United Kingdom. Electronic address: asifgmhasan@googlemail.com., Cousin,G C S. Consultant Oral and Maxillofacial Surgeon, Royal Blackburn Hospital, Lancashire BB2 3HH, United Kingdom.

Language: English

Country of Publication: Scotland

Publication Type: Journal Article

Subject Headings:

Source: MEDLINE