21st ICOMS 2013 - Abstracts: Oral Papers 1301

T19.OR051

Medial sural artery perforator flap in tongue reconstruction

I. Zubillaga ∗ , M. Redondo, R. Gutiérrez, G. Sánchez

University Hospital, United States

Background and objectives: Different free flaps have been used to reconstruct medium-sizeddefects after tongue cancer ablation. More recently, free medial sural artery perforator flap (MSAPF)has been used as an alternative. The authors investigated the outcome and donor-site morbidity ofMSAPF used for tongue reconstruction.

Methods: Between October of 2009 and January of 2013, 17 patients (10 men and 7 women)underwent tongue reconstruction with MSAPF in the Oral and Maxillofacial Surgery Department at‘12 de Octubre’ University Hospital (Madrid, Spain).

Results: Success rate of MSAPF was 94.11%. Defects were classified as mobile tongue (n = 13)and base of tongue (n = 4). Flap harvest mean time was 89 min. Average pedicle length was 12 cm(10–16 cm). Mean flap thickness was 0.9 cm (0.8–1.2 cm). Flap dimensions ranged from 5 to 14 cm inlength and flap width was always less than 6 cm to allow direct closure. Overall donor site complicationrate was 11.7% (2 patients presented suture dehiscence in lower limb).

Conclusions: MSAPF is an adequate alternative to reconstruct medium sized tongue defects inthe Caucasian population. Pedicle anatomy and length are reliable.

Key words: perforator flap; medial sural artery; glossectomy; radial forearm flap

http://dx.doi.org/10.1016/j.ijom.2013.07.435

T19.OR052

Risk factors associated with neuropathic pain following trigeminal nerve repair

J. Zuniga

University of Texas Southwestern, United States

Neuropathic pain is nerve pain may occur following mechanical, chemical, metabolic or thermalinjury of a sensory nerve. Microneurosurgery of the trigeminal nerve is an elective injury of a sensorynerve to treat sensory deficits, and sometime to treat neuropathic pain. The risk of developing neu-ropathic pain following trigeminal nerve repair has never been examined. The objective of this studywas to determine which risk factors might be associated with the development of neuropathic painfollowing trigeminal nerve microneurosurgery. A retrospective review and prospective evaluation of44 patients who underwent trigeminal nerve repair, including both the inferior alveolar nerve (IAN)and lingual nerve (LN), was performed. Each record was reviewed to account for age, gender, presenceof neuropathic pain, site of nerve injury, etiology of the nerve injury, classification of the nerve injury,duration of the nerve injury, and type of repair performed. The primary end point was the presenceor absence of neuropathic pain at 3, 6, and 12 months after surgery. The presence of neuropathic painprior to microneurosurgery was the significant risk factor associated with the presence of neuropathicpain after trigeminal nerve surgery (p < 0.0001). Pain prior to surgery had the following: sensitivity72.7%, specificity 100%, positive predictive value 100%, negative predictive value 91%. In 100% ofpatients, if there was no neuropathic pain prior to surgery, there was none after surgery. The presenceof neuropathic pain prior to trigeminal microneurosurgery is the major risk factor for developing post-operative neuropathic pain. These findings suggest that trigeminal nerve surgery is not a risk factorfor developing neuropathic pain in the absence of neuropathic pain before surgery.

http://dx.doi.org/10.1016/j.ijom.2013.07.436

T20.OR001

T20. Miscellaneous

Clinical characteristics of temporomandibular disorders in patients admitted to the oral surgerydepartment of a dental school in Turkey

C. Alpaslan 1,∗ , N. Erbasar 2, B. Yilmaz 2

1 Professor, DDS, PhD, Gazi University Faculty of Dentistry Department of Oral Surgery, Turkey2 PhD Student, Gazi University Faculty of Dentistry Department of Oral Surgery, Turkey

Background and objectives: This study was undertaken to observe the prevalence of differentdiagnostic groups for temporomandibular disorders (TMD) in patients who sought treatment for TMDin the outpatient clinic of a dental faculty.

Methods: Files of the patients who received a diagnosis of TMD in a period of 24 months wereevaluated. Clinical and demographic data from 213 patient files providing the inclusion criteria wasanalyzed.

Results: The distribution of TMD patients according to gender was 80.2% women, 19.7% men.The chief presenting complaint was pain, followed by restriction in mouth opening and finally jointsounds in minority of patients. Patients received diagnosis of myofascial pain (46.9%9) presenting thehigher amount, disc displacement with reduction (37.5%) and, disc displacement without reduction(15.49%). The rate of patients reported bruxism was 59% and, distributed according to the diagnosisthey received as 61% (myofascial pain), 60% (disc displacement with reduction) and 51% (discdisplacement without reduction) respectively.

Conclusions: In a series of patients admitted to the oral surgery clinic with the signs and symp-toms of temporomandibular disorders, presentation was high among women and pain was the chiefcomplaint. Myofascial pain was the most prevalent diagnosis among the patients seeking treatment.

http://dx.doi.org/10.1016/j.ijom.2013.07.437

T20.OR002

Clinical applicability of robot guided contact-free laser osteotomy—a comparative study inminipigs

K.W. Baek 1,∗ , M. Dard 2, W. Deibel 3, D. Marinov 3, M. Griessen 3, P. Cattin 4, H.F. Zeilhofer 1,P. Juergens 1

1 University Hospital of Basel, Department of Oral and Maxillofacial Surgery, Switzerland2 New York University, College of Dentistry, Department of Periodontology and Implant Dentistry,United States3 Advanced Osteotomy Tools AG, Switzerland4 University of Basel, Medical Image Analysis Center, Switzerland

Bone tissue ablation with laser became successful only recently: Er:YAG laser systems are usedin dentoalveolar surgery. Besides experimentally proven increase of bone healing, major advantagesof laser osteotomy are the freedom of cutting geometries and the high accuracy given by the cuttingwidth of 200 �m. These advantages can be effective only when the system is coupled to a roboticguidance. Due to the size of laser systems and surgical robots, a merge leads to an unergonomic setuphindering a routine use in an OR setup. In this work we present first experiences with an integratedminiaturized laser system mounted on top of a surgical light-weight robotic arm. The computer-assisted and robot-guided laser osteotome was used in an OR environment to create different shapesof defects in the mandible of 6 minipigs. Similar defects were created on the contralateral side bypiezo osteotome and conventional drill. Geometric accuracy and bone healing were compared. It wasshown that the miniaturized robot-guided laser osteotome can be ergonomically integrated into theOR setup without hindering surgeon’s range of motion. The computer-assisted and robot-guided laserosteotome is proved to be a suitable device for all kinds of ostetomies requiring a high accuracy andindividual shape.

http://dx.doi.org/10.1016/j.ijom.2013.07.438