Does screening for oral cancer saves lives?

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doi:10.1016/j.ijom.2011.07.855

010 ICOMS 2011—Abstracts: Invited P

ultidisciplinary pre-surgical examinationor a well-established treatment planning.he primary curative intent of the onco-

ogical treatment and the prognosis forater prosthodontic rehabilitation have toe taken into account too.

oi:10.1016/j.ijom.2011.07.852

3tate of the art in implantnchored facial prosthesis.S. Konstantinovic

Clinic of Maxillofacial Surgery, Universityf Belgrade, Belgrade, Serbia

he main problem in maxillofacialrosthodontic is retention of prosthesis.he introduction of implants improvesrosthesis stability and therefore the qual-ty of the life of the patients. However therere certain problems in everyday practice.here are some specifics of maxillofacial

mplantology: explicit anatomical relationo the intracranial structures; less boneuality and quantity; more compact bone;rradiated tissues.

Lack of the bone limits use of conven-ional screw like implants. Also, implanturvival in irradiated tissues is much lower.mplantation during the primary surgicalrocedure is not recommended in patientsho will undergo postoperative irradia-

ion. According to the literature, theres no type of implant which could beonsidered as superior for the implanta-ion in the irradiated bone. Many studieshows, that the increasing of time inter-al between irradiation and implantationould be of great importance for implanturvival. However, there are only few stud-es performed in humans, so there is nonique protocol concerning to the time ofmplant placement. Basally oseointegratedmplants (disk implants) present excellentlternative in irradiated patients. Patientsith auricular, nasal and orbital implant

nchored prosthesis will be presented.

oi:10.1016/j.ijom.2011.07.853

4oes screening for oral cancer

aves lives?. Chaturvedi

Head and Neck Surgery, Tata Memorialospital, Mumbai, India

ral cancer is one of the commonest cancern Indian men (12.6 per 100 000) and com-on in women also. It is the leading cause

f cancer related deaths in Indian men.

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Internationally it is the eighth most com-mon malignancy reported associated withhigh mortality rate. It is common amongilliterates and those with low income, poorhygiene, poor nutrition and tobacco/arecanut users. Though Oral cancer is one of thebest model of screening amongst all humancancers, most of the patients present at alate stage of disease and die in the sameyear as the year of diagnosis. A cluster ran-domized trial in south of India showed thatscreening of oral cancer reduced mortalitydue to oral cancer in high risk popula-tion. The screening test used in that trialwas “visual examination by health work-ers”. Such an intervention is most suited forimpoverished nations because it is cheapand reasonably accurate. The sensitivityand specificity are generally of a highorder with the pooled average of six stud-ies have yielded a reasonable sensitivityand specificity. The accuracy of the visualinspection can be improved by appropri-ate standardization and training of thescreening individual. Needless to say that,research to develop non invasive diagnostictools (spectroscopy, salivary test, etc.) thatcan not only improve but also expedite thediagnosis are need of the hour. It seems thatscreening and subsequent prompt diagno-sis may lead to significant reduction of oralcancer incidence and mortality rate.

doi:10.1016/j.ijom.2011.07.854

15Contemporary management ofparanasal sinus tumorsR.A. OrdOral and Maxillofacial Surgery, Universityof Maryland, Baltimore, MD, USA

This presentation will review the com-plex anatomy of the paranasal sinuseswith emphasis on the maxillary sinus. Thediverse nature of the tumours of this region,surgical approaches and classification isdiscussed. Specific areas of controversyto be examined are the management ofthe neck, management of the globe/orbit,and the role of craniofacial resection. Thepresentation will also discuss the currentemergence of primary reconstruction of themaxillectomy defect utilizing microvascu-lar free flaps.

16Management of lip malignancies

J.C. Roldán 1,2

1 Cranio-Maxillo-Facial Plastic Surgery,University of Regensburg, Regensburg,Germany2 Facial Plastic Reconstructive andAesthetic Surgery, Clinic for Facial PlasticSurgery, Hamburg, Germany

Lips are commonly involved by non-melanoma skin cancer. Basal cell carci-noma (BCC) involves predominantly theupper lip (skin), whereas squamous cellcarcinoma (SSC) the lower lip (vermil-ion). Lip cancer in the earlier stages has agood prognosis. Advanced stages of BCCwith bone infiltration are surgically andoncologically very challenging. SCC of thelower lip with lymph node metastasis hasa poor prognosis. Surgical techniques fortumour resection play a critical role onthe functional and aesthetic outcome. Thevermilionectomy, as a supplementary treat-ment of lower lip carcinoma in presence ofactinic cheilitis, improves the oncologicaloutcome.

An algorithm for lip reconstruction willbe presented. The concept is based onthe length of the resulted lip defect. Theauthors choose a rectangular excision anda bilateral step stair technique according toJohanson for lower lip defects up to 2/3 ofthe lip length. For lower lip defects >2/3 anAbbe flap is supplemented with Johansonplasty. In subtotal lower lip defects a doubleAbbe flap and a Johanson plasty is the firstchoice. For an upper lip defect up to 1/3 ofthe lip a rectangular resection with inclu-sion of a crescentic peri-alar skin excisionis recommended. Upper lip defects >than1/3 of the lip are repaired with an Abbeflap and a Johanson plasty in the lower lip(donor area). Upper lip defects includingmore than 2/3 of the lip are reconstructedwith the techniques mentioned before andsupplemented by nasolabial flaps.

doi:10.1016/j.ijom.2011.07.856

17Long-term outcomes in completeuclp and bclpU. JoosCranio-Maxillofacial Surgery, MuensterUniversity Hospital, Muenster, Germany

Anyone who has treated CLP knows theproblems associated with skeletal growth