1
|
Vuity D, McMahon J, Hislop S, McCaul J, Wales C, Ansell M, Thomson E, McGarvie J, McLaughlin I, Nicol A, McLellan D. Response to letters regarding sentinel lymph node biopsy for early oral cancer - Accuracy and considerations in patient selection. Br J Oral Maxillofac Surg 2023; 61:253-254. [PMID: 36828671 DOI: 10.1016/j.bjoms.2022.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 12/10/2022] [Indexed: 01/15/2023]
Affiliation(s)
- Drazsen Vuity
- Department of Oral and Maxillofacial Surgery, University Hospital Crosshouse, Kilmarnock Rd, Crosshouse, Kilmarnock KA2 0BE, UK.
| | - Jeremy McMahon
- Department of Oral and Maxillofacial Surgery, Queen Elizabeth University Hospital, 1345 Govan Road, Glasgow G51 4TF, UK
| | - Stuart Hislop
- Department of Oral and Maxillofacial Surgery, University Hospital Crosshouse, Kilmarnock Rd, Crosshouse, Kilmarnock KA2 0BE, UK
| | - James McCaul
- Department of Oral and Maxillofacial Surgery, Queen Elizabeth University Hospital, 1345 Govan Road, Glasgow G51 4TF, UK
| | - Craig Wales
- Department of Oral and Maxillofacial Surgery, Queen Elizabeth University Hospital, 1345 Govan Road, Glasgow G51 4TF, UK
| | - Mark Ansell
- Department of Oral and Maxillofacial Surgery, Queen Elizabeth University Hospital, 1345 Govan Road, Glasgow G51 4TF, UK
| | - Ewen Thomson
- Department of Oral and Maxillofacial Surgery, Forth Valley Royal Hospital, Stirling Rd, Larbert FK5 4WR, UK
| | - Jim McGarvie
- Department of Medical Physics, University Hospital Crosshouse, Kilmarnock Rd, Crosshouse, Kilmarnock KA2 0BE, UK
| | - Ian McLaughlin
- Department of Radiology & Nuclear Medicine, Queen Elizabeth University Hospital, 1345 Govan Road, Glasgow G51 4TF, UK
| | - Alice Nicol
- Department of Nuclear Medicine, Queen Elizabeth University Hospital, 1345 Govan Road, Glasgow G51 4TF, UK
| | - Douglas McLellan
- Department of Pathology, Queen Elizabeth University Hospital, 1345 Govan Road, Glasgow G51 4TF, UK
| |
Collapse
|
2
|
McMahon JD, Zubair F, McNicol S, Stuart Hislop S, Salem S, Howard D, Utam D, Wales C, McCaul J. Survival in node positive early oral SCC: Sentinel Node Biopsy versus Elective Neck Dissection. Br J Oral Maxillofac Surg 2022; 60:890-895. [DOI: 10.1016/j.bjoms.2022.01.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 01/08/2022] [Accepted: 01/12/2022] [Indexed: 11/29/2022]
|
3
|
Vuity D, McMahon J, Hislop S, McCaul J, Wales C, Ansell M, Thomson E, McGarvie J, McLaughlin I, Nicol A, McLellan D. Sentinel lymph node biopsy for early oral cancer - accuracy and considerations in patient selection. Br J Oral Maxillofac Surg 2022; 60:830-836. [PMID: 35331563 DOI: 10.1016/j.bjoms.2021.12.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 11/03/2021] [Accepted: 12/13/2021] [Indexed: 11/29/2022]
Abstract
Sentinel lymph node biopsy (SLNB) for staging oral squamous cell carcinoma (OSCC) patients presenting with early (T1 and T2 N0) disease in preference to elective neck dissection (END) remains controversial worldwide. A retrospective analysis of 145 patients who underwent sentinel lymph node biopsy for a previously untreated early oral cancer between 2010 and 2020 was performed. The primary outcome measures were predictors of occult metastases, accuracy of SLNB and disease specific plus overall survival. The negative predictive value, the false negative rate, and sensitivity for SLNB were 97%, 7.8%, and 92%, respectively. Depth of invasion (DOI) was a significant predictor of N status, overall survival, and disease specific survival. There was a significant difference in the incidence of the neck node metastasis in patients with DOI <5mm compared to those with DOI >5mm. For tumours >5mm there was a moderate to good correlation between radiological depth on contrast enhanced computed tomography (CECT) and histopathological DOI. Preoperative estimation of DOI may be a useful tool in the counselling of patients in the selection of either SLNB or END for N staging purposes in early OSCC.
Collapse
Affiliation(s)
- Drazsen Vuity
- Department of Oral and Maxillofacial Surgery, University Hospital Crosshouse, Kilmarnock Rd, Crosshouse, Kilmarnock KA2 0BE, UK.
| | - Jeremy McMahon
- Department of Oral and Maxillofacial Surgery, Queen Elizabeth University Hospital, 1345 Govan Road, Glasgow G51 4TF, UK
| | - Stuart Hislop
- Department of Oral and Maxillofacial Surgery, University Hospital Crosshouse, Kilmarnock Rd, Crosshouse, Kilmarnock KA2 0BE, UK
| | - James McCaul
- Department of Oral and Maxillofacial Surgery, Queen Elizabeth University Hospital, 1345 Govan Road, Glasgow G51 4TF, UK
| | - Craig Wales
- Department of Oral and Maxillofacial Surgery, Queen Elizabeth University Hospital, 1345 Govan Road, Glasgow G51 4TF, UK
| | - Mark Ansell
- Department of Oral and Maxillofacial Surgery, Queen Elizabeth University Hospital, 1345 Govan Road, Glasgow G51 4TF, UK
| | - Ewen Thomson
- Department of Oral and Maxillofacial Surgery, Forth Valley Royal Hospital, Stirling Rd, Larbert FK5 4WR, UK
| | - Jim McGarvie
- Department of Medical Physics, University Hospital Crosshouse, Kilmarnock Rd, Crosshouse, Kilmarnock KA2 0BE, UK
| | - Ian McLaughlin
- Department of Radiology & Nuclear Medicine, Queen Elizabeth University Hospital, 1345 Govan Road, Glasgow G51 4TF, UK
| | - Alice Nicol
- Department of Nuclear Medicine, Queen Elizabeth University Hospital, 1345 Govan Road, Glasgow G51 4TF, UK
| | - Douglas McLellan
- Department of Pathology, Queen Elizabeth University Hospital, 1345 Govan Road, Glasgow G51 4TF, UK
| |
Collapse
|
4
|
Vuity D, McMahon J, Hislop S, McCaul J, Wales C, Ansell M, Thomson E, McGarvie J, Nicol A, McLellan D. Sentinel Lymph Node Biopsy for Oral Cancer – When to use it? Br J Oral Maxillofac Surg 2022. [DOI: 10.1016/j.bjoms.2021.12.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
5
|
Steele P, McMahon J, Dickson K, Zubair F, Puglia F, McMahon G, Wales C, McCaul J, Ansell M, Hislop S, Thomson E, Subramaniam S. Applying the British Association of Oral and Maxillofacial Surgeons quality outcomes metrics to a UK oncology and reconstructive surgery service - benchmarking the data. Br J Oral Maxillofac Surg 2021; 59:1079-1084. [PMID: 34275677 DOI: 10.1016/j.bjoms.2021.03.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 03/16/2021] [Indexed: 11/15/2022]
Abstract
The British Association of Oral and Maxillofacial Surgery is soon to implement the Quality Outcomes in Oral in Maxillofacial Surgery (QOMS) to provide a platform for quality management across the specialty in the UK. The initial oncology and reconstruction audits for QOMS involves data collection on specific procedures and metrics. The aim of this report is to determine their appropriateness using extant audit datasets in our institution that overlap substantially with the QOMS audits. Pre-existing datasets comprising information on patients treated for oral cavity SCC with curative intent were analysed. Data on surgical margins, lymphadenectomy lymph node yield, delay between surgery and adjuvant radiotherapy, duration of hospital stay, and complications including flap failures were analysed. All statistical analyses were performed with SPSS 25. Run charts describing longitudinal data were generated using SPC for Excel version 6. Twenty three patients (3.1%) of 701 resections had a positive surgical margin reported. Seventeen (4.3%) of patients had less than 18 LNs in the ND specimen analysed. Mean time to start date of adjuvant therapy was 62 days. Only 9% of patients commenced adjuvant therapy within 6 weeks. The median duration of stay was 18 days. In 1153 free flaps a failure rate of 4.3% was identified. A total of 1349 complications (CD I-V) were recorded in the 1111 patients undergoing major surgery with free flap reconstruction. The QOMS selected metrics for oncology and reconstruction are clinically relevant, readily measurable, and likely to be actionable by the surgical team.
Collapse
Affiliation(s)
- P Steele
- Oral and Maxillofacial Surgery Department, Queen Elizabeth University Hospital Glasgow, United Kingdom.
| | - J McMahon
- Oral and Maxillofacial Surgery Department, Queen Elizabeth University Hospital Glasgow, United Kingdom.
| | - K Dickson
- Oral and Maxillofacial Surgery Department, Queen Elizabeth University Hospital Glasgow, United Kingdom.
| | - F Zubair
- University of Glasgow Medical School, Faculty of Life Sciences, United Kingdom.
| | - F Puglia
- BAOMS Royal College of Surgeons of England, 35/43 Lincoln's Inn Fields, London, United Kingdom.
| | - G McMahon
- Oral and Maxillofacial Surgery Department, Queen Elizabeth University Hospital Glasgow, United Kingdom.
| | - C Wales
- Oral and Maxillofacial Surgery Department, Queen Elizabeth University Hospital Glasgow, United Kingdom.
| | - J McCaul
- Oral and Maxillofacial Surgery Department, Queen Elizabeth University Hospital Glasgow, United Kingdom.
| | - M Ansell
- Oral and Maxillofacial Surgery Department, Queen Elizabeth University Hospital Glasgow, United Kingdom.
| | - S Hislop
- Oral and Maxillofacial Surgery Department, Queen Elizabeth University Hospital Glasgow, United Kingdom.
| | - E Thomson
- Oral and Maxillofacial Surgery Department, Queen Elizabeth University Hospital Glasgow, United Kingdom.
| | - S Subramaniam
- Oral and Maxillofacial Surgery Department, Queen Elizabeth University Hospital Glasgow, United Kingdom.
| |
Collapse
|
6
|
McMahon J, Steele P, Kyzas P, Pollard C, Jampana R, MacIver C, Subramaniam S, Devine J, Wales C, McCaul J. Operative tactics in floor of mouth and tongue cancer resection - the importance of imaging and planning. Br J Oral Maxillofac Surg 2020; 59:5-15. [PMID: 33143945 DOI: 10.1016/j.bjoms.2020.08.118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 08/06/2020] [Indexed: 11/19/2022]
Abstract
Complete tumour resection (R0 margin) is an axiom of surgical oncology. Oral cancer ablation is challenging, due to anatomical, functional, and aesthetic considerations. R0 margin is strongly linked to better survival outcomes with great variation in the R0 % across units. This is commonly attributed to disease biology. Without disputing the importance of biological characteristics, we contend that image-based anatomical surgical planning has an important role to play in achieving complete resection. Here, we present our approach utilising cross-sectional imaging, anatomical characteristics and spatial awareness in planning resections for floor of mouth (FOM) and oral tongue cancers. We highlight the challenge of controlling the deep tumour margin lingual to mandible due to anterior vector constraints and emphasise the importance of resecting the genial muscles in a planned fashion and that any rim resection should be obliquely sagittal. In resecting lateral FOM tumours, assessing extension to the parapharyngeal fat is crucial; and mandibular rim resection at a sagittal plane below the mylohyoid line is often required. Assessing the proximity of the contralateral neurovascular pedicle, pre-epiglottic space and hyoid bone are crucial parameters to determine the extent of tongue tumour resection. Our cohort included 173 patients with FOM SCC and 299 patients with tongue SCC. Six patients (3.5%) from the FOM group and eight patients (3%) from the tongue group had involved (R1) margins following surgery. This was associated with local relapse (p<0.05). In conclusion, we demonstrate that image-based planning can aid achieving R0 resections and reduce disease relapse.
Collapse
Affiliation(s)
- J McMahon
- Dept of Maxillofacial Surgery, Queen Elizabeth University Hospital, 1345 Govan Rd, Glasgow, G51 4TF.
| | - P Steele
- Dept of Maxillofacial Surgery, Queen Elizabeth University Hospital, 1345 Govan Rd, Glasgow, G51 4TF.
| | - P Kyzas
- Dept of OMFS/H&N Surgery, Royal Blackburn Teaching Hospital, East Lancashire Hospitals Trust, BB2 3HH.
| | - C Pollard
- Dept of Neuroradiology, Institute of Neurosciences, Queen Elizabeth University Hospital, 1345 Govan Road, Glasgow G51 4TF.
| | - R Jampana
- Dept of Neuroradiology, Institute of Neurosciences, Queen Elizabeth University Hospital, 1345 Govan Road, Glasgow G51 4TF.
| | - C MacIver
- Maxillofacial/Head and Neck Unit, SSMC Hospital in partnership with Mayo Clinic, Abu Dhabi.
| | - S Subramaniam
- Dept of Maxillofacial Surgery, Queen Elizabeth University Hospital, 1345 Govan Rd, Glasgow, G51 4TF.
| | - J Devine
- Maxillofacial/Head and Neck Unit, SSMC Hospital in partnership with Mayo Clinic, Abu Dhabi.
| | - C Wales
- Dept of Maxillofacial Surgery, Queen Elizabeth University Hospital, 1345 Govan Rd, Glasgow, G51 4TF.
| | - J McCaul
- Dept of Maxillofacial Surgery, Queen Elizabeth University Hospital, 1345 Govan Rd, Glasgow, G51 4TF.
| |
Collapse
|
7
|
McMahon J, MacAuley D, Hislop S, McCaul J, MacIver C, Wales C, Thomson E, Ansell M. Unscheduled Return to the Operating Theatre after Major Head and Neck Surgery and Free Flap Repair. Br J Oral Maxillofac Surg 2018. [DOI: 10.1016/j.bjoms.2018.10.175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
8
|
McMahon J, Hislop S, Nicol A, McLaughlin I, McLellan D, Garvie J, MacIver C, Wales C, Ansell M, Thomson E. West of Scotland Experience with Sentinel Lymph Node Biopsy In Early Oral Cancer 2010 - 2017. Br J Oral Maxillofac Surg 2018. [DOI: 10.1016/j.bjoms.2018.10.210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
9
|
Thomas LH, Wales C, Wilson CC. Selective preparation of elusive and alternative single component polymorphic solid forms through multi-component crystallisation routes. Chem Commun (Camb) 2018; 52:7372-5. [PMID: 27079688 DOI: 10.1039/c6cc01027j] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
A transferable, simple, method for producing previously elusive and novel polymorphic forms of important active pharmaceutical ingredients (APIs; paracetamol (acetaminophen), piroxicam and piracetam) is demonstrated. Nitrogen heterocyclic co-molecules are employed to influence the self-assembly crystallisation process in a multi-component environment. Previously unknown solvates have also been synthesised by this method.
Collapse
Affiliation(s)
- Lynne H Thomas
- Department of Chemistry, University of Bath, Bath BA2 7AY, UK.
| | - Craig Wales
- Department of Chemistry, University of Bath, Bath BA2 7AY, UK. and School of Chemistry, University of Glasgow, Glasgow G12 8QQ, UK
| | - Chick C Wilson
- Department of Chemistry, University of Bath, Bath BA2 7AY, UK. and CMAC, EPSRC Centre for Continuous Manufacturing and Crystallisation, Department of Chemistry, University of Bath, Bath BA2 7AY, UK
| |
Collapse
|
10
|
McAuley D, Sheikh R, McMahon J, Hislop S, MacIver C, Thomson E, Wales C. Predictors of unplanned returns to the operating theatre following major head and neck surgery with free flap reconstruction. Br J Oral Maxillofac Surg 2017. [DOI: 10.1016/j.bjoms.2017.08.116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
11
|
Touyz SJ, Langley B, Syyed N, Wales C, McIver C, McMahon J. Post Operative C-Reactive Protein (CRP) Serum Concentration Predicts Postoperative Pulmonary Complications in Major Head and Neck Cancer Operations; A retrospective study. Br J Oral Maxillofac Surg 2016. [DOI: 10.1016/j.bjoms.2016.11.253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
12
|
Langley B, Touyz S, Syyed N, McIver C, Wales C, McMahon J. A Retrospective Study: Maxillofacial Free Flap Take-Back Incidence and Preoperative Albumin Levels As A Predictor of Flap Take-Back and Successful Flap Salvage, 2009–2014. Br J Oral Maxillofac Surg 2016. [DOI: 10.1016/j.bjoms.2016.11.216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
13
|
McMahon J, Handley T, Bobinskas A, Elsapagh M, Wales C, MacIver C, Ross E. Can a peri-operative multimodal care (ERAS) program reduce postoperative complications in patients undergoing major head and neck surgery with flap repair? Br J Oral Maxillofac Surg 2015. [DOI: 10.1016/j.bjoms.2015.08.215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
14
|
McMahon JD, Crowther J, Taylor WM, Wong LS, Paterson T, Devine J, Wales C, MacIver C. Anterolateral corridor approach to the infratemporal fossa and central skull base in maxillectomy: rationale and technical aspects. Br J Oral Maxillofac Surg 2015. [PMID: 26212419 DOI: 10.1016/j.bjoms.2015.06.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
We describe the technical aspects and report our clinical experience of a surgical approach to the infratemporal fossa that aims to reduce local recurrence after operations for cancer of the posterior maxilla. We tested the technique by operating on 3 cadavers and then used the approach in 16 patients who had posterolateral maxillectomy for disease that arose on the maxillary alveolus or junction of the hard and soft palate (maxillary group), and in 19 who had resection of the masticatory compartment and central skull base for advanced sinonasal cancer (sinonasal group). Early proximal ligation of the maxillary artery was achieved in all but one of the 35 patients. Access to the infratemporal fossa enabled division of the pterygoid muscles and pterygoid processes under direct vision in all cases. No patient in the maxillary group had local recurrence at median follow up of 36 months. Four patients (21%) in the sinonasal group had local recurrence at median follow up of 27 months. Secondary haemorrhage from the cavernous segment of the internal carotid artery resulted in the only perioperative death. The anterolateral corridor approach enables controlled resection of tumours that extend into the masticatory compartment.
Collapse
Affiliation(s)
- Jeremy D McMahon
- Consultant Maxillofacial Head Neck Surgeon, Southern General Hospital, Glasgow G514TF, UK.
| | - John Crowther
- Consultant ENT Skull Base Surgeon, Southern General Hospital, Glasgow G514TF, UK
| | - William M Taylor
- Consultant Neurosurgeon, Southern General Hospital, Glasgow G514TF, UK
| | - Ling Siew Wong
- Oral and Maxillofacial Surgeon, Hospital Sibu, Sarawak, Malaysia
| | | | - John Devine
- Consultant Maxillofacial head Neck Surgeon, Southern General Hospital, Glasgow G514TF, UK
| | - Craig Wales
- Consultant Maxillofacial head Neck Surgeon, Southern General Hospital, Glasgow G514TF, UK
| | - Colin MacIver
- Consultant Maxillofacial head Neck Surgeon, Southern General Hospital, Glasgow G514TF, UK
| |
Collapse
|
15
|
Hanratty J, Changez H, Smith A, Wales C. Panton-Valentine Leukocidin Positive Staphylococcal aureus Infections of the Head and Neck: Case Series and Brief Review of Literature. J Oral Maxillofac Surg 2015; 73:666-70. [DOI: 10.1016/j.joms.2014.10.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Revised: 10/10/2014] [Accepted: 10/13/2014] [Indexed: 12/01/2022]
|
16
|
Smith A, Changez H, Wright P, Wales C, Holland I, MacIvor C, McMahon J. Oral surgery: The role of microbiology. Br Dent J 2014; 217:161. [PMID: 25146784 DOI: 10.1038/sj.bdj.2014.712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|
17
|
Shujaat S, Khambay BS, Ju X, Devine JC, McMahon JD, Wales C, Ayoub AF. The clinical application of three-dimensional motion capture (4D): a novel approach to quantify the dynamics of facial animations. Int J Oral Maxillofac Surg 2014; 43:907-16. [PMID: 24583138 DOI: 10.1016/j.ijom.2014.01.010] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2012] [Revised: 01/15/2014] [Accepted: 01/20/2014] [Indexed: 11/18/2022]
Abstract
The aim of this pilot study was to evaluate the feasibility of measuring the change in magnitude, speed, and motion similarity of facial animations in head and neck oncology patients, before and after lip split mandibulotomy. Seven subjects (four males, three females) aged 42-80 years were recruited. The subjects were asked to perform four facial animations (maximal smile, lip purse, cheek puff, and grimace) from rest to maximal position. The animations were captured using a Di4D motion capture system, which recorded 60 frames/s. Nine facial soft tissue landmarks were manually digitized on the first frame of the three-dimensional image of each animation by the same operator and were tracked automatically for the sequential frames. The intra-operator digitization error was within 0.4mm. Lip purse and maximal smile animations showed the least amount of change in magnitude (0.2mm) following surgery; speed difference was least for smile animation (-0.1mm/s). Motion similarity was found to be highest for lip purse animation (0.78). This pilot study confirmed that surgery did influence the dynamics of facial animations, and the Di4D capture system can be regarded as a feasible objective tool for assessing the impact of surgical interventions on facial soft tissue movements.
Collapse
Affiliation(s)
- S Shujaat
- Oral & Maxillofacial Surgery, Faculty of Medicine, MVLS College, Glasgow University Dental Hospital and School, Glasgow, UK
| | - B S Khambay
- Oral & Maxillofacial Surgery, Faculty of Medicine, MVLS College, Glasgow University Dental Hospital and School, Glasgow, UK
| | - X Ju
- Oral & Maxillofacial Surgery, Faculty of Medicine, MVLS College, Glasgow University Dental Hospital and School, Glasgow, UK
| | - J C Devine
- Regional Maxillofacial Unit, Southern General Hospital, Glasgow, UK
| | - J D McMahon
- Regional Maxillofacial Unit, Southern General Hospital, Glasgow, UK
| | - C Wales
- Regional Maxillofacial Unit, Southern General Hospital, Glasgow, UK
| | - A F Ayoub
- Oral & Maxillofacial Surgery, Faculty of Medicine, MVLS College, Glasgow University Dental Hospital and School, Glasgow, UK.
| |
Collapse
|
18
|
Thomas LH, Klapwijk AR, Wales C, Wilson CC. Intermolecular hydrogen transfer and solubility tuning in multi-component molecular crystals of the API piroxicam. CrystEngComm 2014. [DOI: 10.1039/c4ce00246f] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Twelve multi-component molecular crystals of the active pharmaceutical ingredient (API) piroxicam (PX) are described contrasting those with basic N-heterocycles with those formed with strong haloanilic acids. The effect on the solubility of this API is discussed, with evidence of enhanced solubility in the multi-component crystals formed.
Collapse
Affiliation(s)
| | | | - Craig Wales
- Department of Chemistry
- University of Bath
- Bath, UK
| | | |
Collapse
|
19
|
McMahon JD, MacIver C, Smith M, Stathopoulos P, Wales C, McNulty R, Handley TP, Devine JC. Postoperative complications after major head and neck surgery with free flap repair—prevalence, patterns, and determinants: a prospective cohort study. Br J Oral Maxillofac Surg 2013; 51:689-95. [DOI: 10.1016/j.bjoms.2013.04.015] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2012] [Accepted: 04/27/2013] [Indexed: 10/26/2022]
|
20
|
McAllister P, MacIver C, Wales C, McMahon J, Devine J, McHattie G, Makubate B. Gastrostomy insertion in head and neck cancer patients: a 3 year review of insertion method and complication rates. Br J Oral Maxillofac Surg 2013; 51:714-8. [DOI: 10.1016/j.bjoms.2013.07.005] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2013] [Accepted: 07/17/2013] [Indexed: 10/26/2022]
|
21
|
Virdi RS, Handley TPB, Wales C, Maciver C. Novel technique to visualise pharyngeal free flap reconstructions. Br J Oral Maxillofac Surg 2013; 52:95-6. [PMID: 24216386 DOI: 10.1016/j.bjoms.2013.05.152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2012] [Accepted: 05/20/2013] [Indexed: 11/24/2022]
Affiliation(s)
- R S Virdi
- Southern General Hospital, 1345 Govan Road, Glasgow, Scotland G51 4TF, United Kingdom.
| | - T P B Handley
- Southern General Hospital, 1345 Govan Road, Glasgow, Scotland G51 4TF, United Kingdom
| | - C Wales
- Southern General Hospital, 1345 Govan Road, Glasgow, Scotland G51 4TF, United Kingdom
| | - C Maciver
- Southern General Hospital, 1345 Govan Road, Glasgow, Scotland G51 4TF, United Kingdom
| |
Collapse
|
22
|
Siddiqui A, Lowe T, Wales C. The accuracy of surface (/topical) anatomic landmarks in predicting the location of the greater auricular nerve: a prospective study. Int J Oral Maxillofac Surg 2013. [DOI: 10.1016/j.ijom.2013.07.423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
23
|
McMahon JD, Wong LS, Crowther J, Taylor WM, McManners J, Devine JC, Wales C, Maciver C. Patterns of local recurrence after primary resection of cancers that arise in the sinonasal region and the maxillary alveolus. Br J Oral Maxillofac Surg 2012; 51:389-93. [PMID: 23089331 DOI: 10.1016/j.bjoms.2012.09.018] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2012] [Accepted: 09/13/2012] [Indexed: 11/27/2022]
Abstract
Local recurrence remains the most important sign of relapse of disease after treatment of advanced cancer of the maxilla and sinonasal region. In this retrospective study we describe patterns of recurrence in a group of patients who had had open resection for cancer of the sinonasal region and posterior maxillary alveolus with curative intent. Casenotes and imaging studies were reviewed to find out the pattern of any relapse, with particular reference to local recurrence. The minimum follow-up period was 12 months. Of 50 patients a total of 16 developed recurrences, 11 of which were local. Of those 11, a total of 8 were in posterior and superior locations (the orbit, the infratemporal and pterygopalatine fossas, the traversing neurovascular canals of the body of the sphenoid to the cavernous sinus, the Gasserian ganglion, and the dura of the middle cranial fossa). Advanced cancer of the midface often equates with disease at the skull base. Treatment, including surgical tactics, should reflect that.
Collapse
|
24
|
Wales C, Thomas LH, Wilson CC. Tautomerisation and polymorphism in molecular complexes of piroxicam with mono-substituted benzoic acids. CrystEngComm 2012. [DOI: 10.1039/c2ce26069g] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
|
25
|
Thomas LH, Boyle B, Kallay AA, Wales C, Wilson CC. Structural diversity in layered organic materials through templating co-crystallisation. Acta Crystallogr A 2011. [DOI: 10.1107/s0108767311090866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
|
26
|
Colgan L, Cross J, Morrison J, Wales C, Markose G, Currie W, Hislop W. An audit of visual acuity recording in mid-face trauma. Br J Oral Maxillofac Surg 2011. [DOI: 10.1016/j.bjoms.2011.03.061] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
27
|
Paterson T, McMahon J, Wales C, Fogg Q. Anterolateral corridor approach to extended maxillectomy. Br J Oral Maxillofac Surg 2011. [DOI: 10.1016/j.bjoms.2011.04.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
28
|
Kesting MR, Hölzle F, Wales C, Steinstraesser L, Wagenpfeil S, Mücke T, Rohleder NH, Wolff KD, Hasler RJ. Microsurgical reconstruction of the oral cavity with free flaps from the anterolateral thigh and the radial forearm: a comparison of perioperative data from 161 cases. Ann Surg Oncol 2011; 18:1988-94. [PMID: 21311983 DOI: 10.1245/s10434-011-1584-8] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2010] [Indexed: 11/18/2022]
Abstract
BACKGROUND Free flaps are commonly used for reconstruction of extensive tumor resection defects in the oral cavity. The radial forearm free flap (RFFF) is the most frequent choice. However, a major problem of RFFF is a limitation in its size. The anterolateral thigh free flap (ALTFF) has become popular as an alternative donor site in maxillofacial surgery. We have compared patient data after reconstructions of the oral cavity using the RFFF or ALTFF. MATERIALS AND METHODS Perioperative data of 161 oral cancer patients with ALTFF (45) or RFFF (116) reconstructions were reviewed and statistically analyzed for the following characteristics: sex, histology, primary tumor localization, defect type, American Society of Anesthesiology score, success rates, revisions, wound healing disorders, fistula rates, type of reconstruction, prolonged stay in an intensive care unit (ICU) and in hospital, donor site, flap size, length of operation, and number of follow-up visits. RESULTS Flap success was 97.8% (44 of 45) in the ALTFF group and 97.4% (113 of 116) for RFFF. The mean size was higher in ALTFF than in RFFF (110 vs. 29 cm(2); P < 0.001). ALTFF needed less postoperative care and developed fewer wound healing disorders (P = 0.005 and P = 0.035). Operative time was significantly shorter in RFFF reconstructions (P = 0.020). Intraoperative arterial spasm was the most significant complication in ALTF and postoperative venous thrombosis in RFFF. CONCLUSIONS ALTFF has distinct advantages over RFFF with respect to intraoral reconstruction. However, the RFFF remains as a very reliable flap because of the minimal variability in its anatomy.
Collapse
Affiliation(s)
- Marco Rainer Kesting
- Department of Oral and Maxillofacial Surgery, Technische Universität München, Munich, Germany.
| | | | | | | | | | | | | | | | | |
Collapse
|
29
|
Liew C, Liew C, McMahon J, Wales C, Morrison J, Robertson G, Devine J. Correlates and patterns of nodal disease in head and neck cancer. Do they validate the tenets of head and neck surgery. Br J Oral Maxillofac Surg 2009. [DOI: 10.1016/j.bjoms.2009.06.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
30
|
Martin C, Jibson A, Wales C, Parkin A. Controlling the formation of co-crystal polymorphs. Acta Crystallogr A 2008. [DOI: 10.1107/s0108767308084328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
|
31
|
Wales C, Markose G, Hislop W, Currie W. Visual acuity in midface maxillofacial injuries. Br J Oral Maxillofac Surg 2007. [DOI: 10.1016/j.bjoms.2007.07.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
32
|
Siotia AK, Morton AC, Mofidi S, Wales C, Newman C, Gunn J. Targeting drug-eluting stents to lesions at high risk of restenosis: a flawed approach? Heart 2007; 93:251-2. [PMID: 17228076 PMCID: PMC1861370 DOI: 10.1136/hrt.2006.089243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
|
33
|
Varley I, Wales C, Carter L. Minerva. West J Med 2006. [DOI: 10.1136/bmj.39038.654213.47] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
34
|
Pollard SD, Munks K, Wales C, Crossman DC, Cumberland DC, Oakley GDG, Gunn J. Position and Mobilisation Post-Angiography Study (PAMPAS): a comparison of 4.5 hours and 2.5 hours bed rest. Heart 2003; 89:447-8. [PMID: 12639880 PMCID: PMC1769276 DOI: 10.1136/heart.89.4.447] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
35
|
Abstract
A policy of selective implantation of drug eluting stents, in a minority of lesions most likely to benefit, seems to be a rational way to employ this new and currently costly technology.
Collapse
Affiliation(s)
- J Gunn
- Cardiovascular Research Group, Division of Clinical Sciences (Northern General Hospital), University of Sheffield, Sheffield,
| | | | | | | | | | | |
Collapse
|
36
|
Abstract
OBJECTIVE To investigate a population of elderly people for atrial fibrillation and to determine how many of the cases identified might benefit from treatment with anticoagulants. METHODS From a practice of four primary care physicians, 1422 patients aged 65 years and over were identified, of whom 1207 (85% of the total population) underwent electrocardiographic screening to detect the presence of atrial fibrillation. Patients with the arrhythmia were further evaluated by echocardiography and interview, to stratify their risk of stroke based on echocardiographic and clinical risk factors, their perceived risk from anticoagulation, and their attitude towards this treatment. Their primary care physician was also interviewed to determine the factors influencing the prescription of anticoagulants. RESULTS The arrhythmia occurred in 65 patients (5.4% overall), its prevalence increasing markedly with age (2.3% in 65 to 69 years age group; 8.1% in those over 85). Warfarin was being prescribed to 21.4% of these patients, although the findings of the study indicate that a further 20% were eligible for this treatment. Symptoms suggestive of cardiac failure were common (32.1%) and coexisting pathology was often identified by cardiac ultrasound in these patients (left ventricular hypertrophy, 32.1%; impaired left ventricular contractility, 21.4%; left atrial dilation, 80.4%; mitral annular calcification, 42.9%; mitral stenosis, 7.1%; mitral regurgitation, 48.2%; aortic stenosis, 8.9%). In all but one case, the decision to anticoagulate was based on the clinical rather than the echocardiographic findings. CONCLUSIONS Individual risk-benefit assessment in elderly patients with atrial fibrillation suggests that almost half (41.4%) are eligible for full anticoagulation with warfarin, whereas presently only one fifth are receiving this treatment. The decision to anticoagulate can be made on clinical grounds in most cases. If these results are confirmed, a doubling of the current number of patients taking anticoagulants can be anticipated.
Collapse
Affiliation(s)
- N M Wheeldon
- Cardiothoracic Unit, Northern General Hospital, Sheffield, UK
| | | | | | | | | | | |
Collapse
|
37
|
|
38
|
Siegel RJ, Gunn J, Ahsan A, Fishbein MC, Bowes RJ, Oakley D, Wales C, Steffen W, Campbell S, Nita H. Use of therapeutic ultrasound in percutaneous coronary angioplasty. Experimental in vitro studies and initial clinical experience. Circulation 1994; 89:1587-92. [PMID: 8149525 DOI: 10.1161/01.cir.89.4.1587] [Citation(s) in RCA: 45] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
BACKGROUND Previous studies have shown the feasibility of peripheral arterial ultrasound angioplasty. METHODS AND RESULTS In this report, we describe the use of percutaneous therapeutic ultrasound for coronary angioplasty. In vitro, 11 postmortem, atherosclerotically occluded coronary arteries were obtained to assess catheter-delivered ultrasound for arterial recanalization as well as for assessment of the size of particulate debris. Clinically, coronary ultrasound angioplasty was performed in 19 patients (mean age, 56 years) to assess safety and feasibility for the treatment of obstructive coronary atherosclerosis. Three patients with unstable angina and 16 with exercise-induced myocardial ischemia were treated with a prototype 4.6F coronary catheter ultrasound ablation device with a 1.7-mm diameter ball tip. The ultrasound coronary catheter delivered ultrasound energy at 19.5 kHz, with a power output of 16 to 20 W at the transducer. Energy is delivered in a pulsed mode with a 50% duty cycle of 30 milliseconds. Patients were treated for a mean of 493 seconds (range, 130 to 890) with intracoronary ultrasound ablation. All lesions were treated with adjunctive balloon angioplasty. All 11 postmortem coronary occlusions were recanalized, and 99% of the particulates generated were < 10 microns in diameter. We found that after ultrasound, mean (+/- SD) coronary arterial stenosis fell from 80 +/- 12% to 60 +/- 18% (P < .001) and to 26 +/- 11% (P < .001) after adjunctive balloon angioplasty. Mean pressures required to achieve full balloon inflation were 2.7 atm (range, 1 to 5.5) with a median of 3.0-mm balloon size (2.5 to 3.5). No ultrasound-related complications were identified. CONCLUSIONS Intracoronary ultrasound plaque ablation appears to be safe. Our findings suggest that catheter-delivered high-intensity, low-frequency ultrasound may be useful for lesion debulking and enhancing arterial distensibility, allowing balloon dilation at relatively low pressures.
Collapse
Affiliation(s)
- R J Siegel
- Division of Cardiology, Cedars-Sinai Medical Center, Los Angeles, CA 90048
| | | | | | | | | | | | | | | | | | | |
Collapse
|