Clinical Service Line 04 - Opthalmology, Dermatology, Plastics, Outpatients, ENT/Audiology, OMFT/Dental

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    Establishing and integrating a transoral robotic surgery programme into routine oncological management of head and neck cancer – a UK perspective
    (2022) Arora, A; Brunet, A; Oikonomou, G; Tornari, C; Faulkner, J; Jeyarajah, J; Touska, P; Sandison, A; Rovira, A; Simo, R; Jeannon, J.P
    Background The introduction of transoral robotic surgery into routine management of patients is complex. It involves organisational, logistical and clinical challenges. This study presents our experience of implementing such a programme and provides a blueprint for other centres willing to establish similar services. Methods Implementation of the robotic surgery programme focused on several key domains: training, logistics, governance, multidisciplinary team awareness, pre-operative imaging, anaesthesia, post-operative care, finance, patient selection and consent. Programme outcomes were evaluated by assessing operative outcomes of the first 117 procedures performed. Results The success of the transoral robotic surgery programme has been possible because of the scrupulous planning phase before the first procedure, and the time invested on team awareness and training. Conclusion Implementation of a new transoral robotic surgery service has led to: the development of a dedicated transoral robotic surgery patient care protocol, the performance of progressively more complex procedures, the inclusion of transoral robotic surgery training and the establishment of several research projects.
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    Establishing and integrating a transoral robotic surgery programme into routine oncological management of head and neck cancer – a UK perspective
    (2022) Arora, A; Brunet, A; Oikonomou, G; Tornari, C; Faulkner, J; Jeyarajah, J; Touska, P; Sandison, A; Rovira, A; Simo, R; Jeannon, J-P
    Abstract Background: The introduction of transoral robotic surgery into routine management of patients is complex. It involves organisational, logistical and clinical challenges. This study presents our experience of implementing such a programme and provides a blueprint for other centres willing to establish similar services. Methods: Implementation of the robotic surgery programme focused on several key domains: training, logistics, governance, multidisciplinary team awareness, pre-operative imaging, anaesthesia, post-operative care, finance, patient selection and consent. Programme outcomes were evaluated by assessing operative outcomes of the first 117 procedures performed. Results: The success of the transoral robotic surgery programme has been possible because of the scrupulous planning phase before the first procedure, and the time invested on team awareness and training. Conclusion: Implementation of a new transoral robotic surgery service has led to: the development of a dedicated transoral robotic surgery patient care protocol, the performance of progressively more complex procedures, the inclusion of transoral robotic surgery training and the establishment of several research projects. Keywords: Hypopharynx; Larynx; Oropharynx; Robotics; Safety; Technology. PubMed Disclaimer Similar articles Establishing and integrating a transoral robotic surgery programme into routine oncological management of head and neck cancer - a UK perspective - ERRATUM. Arora A, Brunet A, Oikonomou G, Tornari C, Faulkner J, Jeyarajah J, Touska P, Sandison A, Rovira A, Simo R, Jeannon JP. J Laryngol Otol. 2023 Jan;137(1):118. doi: 10.1017/S0022215122002249. Epub 2022 Nov 22. PMID: 36411962 Free PMC article. No abstract available. History and Acceptance of Transoral Robotic Surgery. Thaler ER. Otolaryngol Clin North Am. 2020 Dec;53(6):943-948. doi: 10.1016/j.otc.2020.07.006. Epub 2020 Aug 21. PMID: 32838969 Review. Prospective clinical trial to evaluate safety and feasibility of using a single port flexible robotic system for transoral head and neck surgery. Chan JYK, Tsang RK, Holsinger FC, Tong MCF, Ng CWK, Chiu PWY, Ng SSM, Wong EWY. Oral Oncol. 2019 Jul;94:101-105. doi: 10.1016/j.oraloncology.2019.05.018. Epub 2019 May 28. PMID: 31178203 Compared Outcomes of Concurrent versus Staged Transoral Robotic Surgery with Neck Dissection. Frenkel CH, Yang J, Zhang M, Altieri MS, Telem DA, Samara GJ. Otolaryngol Head Neck Surg. 2017 Nov;157(5):791-797. doi: 10.1177/0194599817706499. Epub 2017 May 9. PMID: 28485196 Robotic-Assisted Surgery in the Head and Neck. Burton J, Wong R, Padhya T. Cancer Control. 2015 Jul;22(3):331-4. doi: 10.1177/107327481502200311. PMID: 26351889 Review. See all similar articles Cited by Establishing and integrating a transoral robotic surgery programme into routine oncological management of head and neck cancer - a UK perspective - ERRATUM. Arora A, Brunet A, Oikonomou G, Tornari C, Faulkner J, Jeyarajah J, Touska P, Sandison A, Rovira A, Simo R, Jeannon JP. J Laryngol Otol. 2023 Jan;137(1):118. doi: 10.1017/S0022215122002249. Epub 2022 Nov 22. PMID: 36411962 Free PMC article. No abstract available. MeSH terms Head and Neck Neoplasms* / surgery Humans Robotic Surgical Procedures* / methods United Kingdom Related information MedGen LinkOut - more resources Full Text Sources Cambridge University Press Medical MedlinePlus Health Information
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    Role of Thyroidectomy in Recurrent Laryngeal Carcinoma
    (2022) Brunet, A; Tornari, C; Ezebuiro, A; Kennedy, R; Connor, S; Oakley, E.J; Jeannon, J-P; Arora, A; Rovira, A; Simo, R
    Abstract Objective: Management of recurrent laryngeal cancer presents a major challenge, and salvage laryngectomy is complicated by previous oncologic treatments. Thyroidectomy as part of salvage laryngectomy adds a nonnegligible degree of morbidity. The purpose of this study is to assess the rate of thyroid gland invasion in patients undergoing salvage laryngectomy to determine relevant predictive factors. Study design: Case series with chart review. Setting: Department of Otorhinolaryngology, Head and Neck Surgery, Guy's Hospital, London, United Kingdom. Methods: A retrospective review of patients undergoing salvage laryngectomy between 2009 and 2019 was undertaken. Preoperative cross-sectional imaging and histopathological analysis were performed to define evidence and predictors of thyroid gland invasion (TGI). Results: Fifty-one patients had salvage laryngectomy. Histological evidence of TGI was found in 4 patients (7.8%). No significant relationship was found between histological TGI and subsite of primary carcinoma, degree of differentiation, T staging, or radiological TGI. Preoperative computed tomography had a high negative predictive value for TGI. Conclusion: Thyroidectomy should be carefully considered in patients undergoing salvage laryngectomy, and its extent should be defined on an individual basis. Total thyroidectomy should not routinely be performed in salvage laryngectomy or pharyngolaryngectomy in patients with no preoperative radiological evidence of TGI on cross-sectional imaging, unless there is intraoperative evidence of TGI. Keywords: laryngeal squamous cell carcinoma; laryngectomy; thyroid gland. PubMed Disclaimer Similar articles Incidence of thyroid gland invasion in advanced laryngeal cancers and its impact on disease-specific survival; a retrospective review at a tertiary care center. Muhammad T, Dhanani R, Mohtasham S, Hussain M, Faisal M, Malik KI, Jamshed A, Hussain R. Acta Otolaryngol. 2020 Oct;140(10):882-885. doi: 10.1080/00016489.2020.1778786. Epub 2020 Jul 7. PMID: 32633590 Review. The incidence of thyroid gland invasion in advanced laryngeal squamous cell carcinoma. Al-Hakami HA, Al Garni MA, AlSubayea H, AlOtaibi Y, Neazy A, Jameel W, Albouq M, Alnufaie A, Fatani N. Braz J Otorhinolaryngol. 2021 Sep-Oct;87(5):533-537. doi: 10.1016/j.bjorl.2019.11.003. Epub 2019 Dec 9. PMID: 31879196 Free PMC article. Management of the thyroid gland during laryngectomy. Li SX, Polacco MA, Gosselin BJ, Harrington LX, Titus AJ, Paydarfar JA. J Laryngol Otol. 2017 Aug;131(8):740-744. doi: 10.1017/S0022215117001244. Epub 2017 Jun 8. PMID: 28592347 Free PMC article. Evidence-based management of the thyroid gland during a total laryngectomy. Gorphe P, Ben Lakhdar A, Tao Y, Breuskin I, Janot F, Temam S. Laryngoscope. 2015 Oct;125(10):2317-22. doi: 10.1002/lary.25417. Epub 2015 Jun 24. PMID: 26108451 Thyroid gland management in total laryngectomy: meta-analysis and surgical recommendations. Mendelson AA, Al-Khatib TA, Julien M, Payne RJ, Black MJ, Hier MP. Otolaryngol Head Neck Surg. 2009 Mar;140(3):298-305. doi: 10.1016/j.otohns.2008.10.031. PMID: 19248932 Review. See all similar articles Publication types Research Support, Non-U.S. Gov't MeSH terms Carcinoma, Squamous Cell* / pathology Humans Laryngeal Neoplasms* / pathology Laryngeal Neoplasms* / surgery Laryngectomy / methods Neoplasm Invasiveness Retrospective Studies Salvage Therapy Thyroidectomy Related information MedGen Grants and funding DH_/Department of Health/United Kingdom LinkOut - more resources Full Text Sources Atypon Ovid Technologies, Inc. Wiley
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    Titanium miniplate removal after joint orthodontic-orthognathic surgery treatment: A 10-year retrospective hospital-based audit
    (2022) Adatia, A; Padashi-Fard, M; Adali, N S; Camilleri, A C
    Abstract Introduction: The reported incidence of titanium miniplate removal after orthognathic surgery varies widely, making delivery of risk information to patients problematic. This variation relates to potential biases introduced during the study design, for example, with the pooling of different patient types, creating heterogeneous study samples. This study reduces sampling bias by limiting the cohort to only consecutive orthognathic cases. The primary aim of the study was to identify the incidence of miniplate removal following orthognathic surgery. The secondary aim was to assess the indications and any risk factors for miniplate removal. Methods: Data from the clinical records of 907 orthognathic surgery cases treated within a centralised oral and maxillofacial hospital service over a 10-year period were collected by two operators and analysed. Every identified case qualified for inclusion. Patient demographics (age, sex, medical comorbidity, smoking), operations (type of surgery, duration, third molar removal, complications) and the indication, timing and site of miniplate removal were analysed. Results: Only 19 patients required postoperative miniplate removal, with the most common indication being infection (63%). There was no significant difference in any of the factors assessed except that significantly more miniplates were removed from female patients (68%) (p<0.001) and from mandibular sites (84.2%) (p=0.003). Conclusions: The incidence of miniplate removal for this sample was 2.1%. Female sex and miniplate location in the mandible were the only statistically significant risk factors for miniplate removal. Keywords: Miniplate removal; Miniplates; Orthognathic surgery; Osteotomy; Postoperative complication; Titanium miniplates. PubMed Disclaimer Similar articles Maxillofacial Trauma Surgery Patients With Titanium Osteosynthesis Miniplates: Remove or Not? Sukegawa S, Masui M, Sukegawa-Takahashi Y, Nakano K, Takabatake K, Kawai H, Nagatsuka H, Furuki Y. J Craniofac Surg. 2020 Jul-Aug;31(5):1338-1342. doi: 10.1097/SCS.0000000000006352. PMID: 32371694 Is the removal of osteosynthesis plates after orthognathic surgery necessary? Retrospective long-term follow-up study. Sukegawa S, Kanno T, Manabe Y, Matsumoto K, Sukegawa-Takahashi Y, Masui M, Furuki Y. Int J Oral Maxillofac Surg. 2018 Dec;47(12):1581-1586. doi: 10.1016/j.ijom.2018.07.001. Epub 2018 Jul 23. PMID: 30049607 Resorbable versus titanium plates for orthognathic surgery. Agnihotry A, Fedorowicz Z, Nasser M, Gill KS. Cochrane Database Syst Rev. 2017 Oct 4;10(10):CD006204. doi: 10.1002/14651858.CD006204.pub3. PMID: 28977689 Free PMC article. Review. Risk factors contributing to symptomatic miniplate removal: a retrospective study of 153 bilateral sagittal split osteotomy patients. Kuhlefelt M, Laine P, Suominen-Taipale L, Ingman T, Lindqvist C, Thorén H. Int J Oral Maxillofac Surg. 2010 May;39(5):430-5. doi: 10.1016/j.ijom.2010.01.016. Epub 2010 Feb 23. PMID: 20181459 Resorbable versus titanium plates for orthognathic surgery. Fedorowicz Z, Nasser M, Newton JT, Oliver RJ. Cochrane Database Syst Rev. 2007 Apr 18;(2):CD006204. doi: 10.1002/14651858.CD006204.pub2. Update in: Cochrane Database Syst Rev. 2017 Oct 04;10:CD006204. doi: 10.1002/14651858.CD006204.pub3. PMID: 17443617 Review. See all similar articles References Kuhlefelt M, Laine P, Suominen-Taipale Let al. . Risk factors contributing to symptomatic miniplate removal: a retrospective study of 153 bilateral sagittal split osteotomy patients. Int J Oral Maxillofac Surg 2010; 39: 430–435. - PubMed Champy M, Loddé JP, Schmitt Ret al. . Mandibular osteosynthesis by miniature screwed plates via a buccal approach. J Maxillofac Surg 1978; 6: 14–21. - PubMed Cawood M. Small plate osteosynthesis of mandibular fractures. Br J Oral and Maxillofac Surg 1985; 23: 77–91. - PubMed O’Connell J, Murphy C, Ikeagwuani Oet al. . The fate of titanium miniplates and screws used in maxillofacial surgery: a 10 year retrospective study. Int J Oral Maxillofac Surg 2009; 38: 731–735. - PubMed Ward Booth P. Discussion: risk factors contributing to symptomatic plate removal in orthognathic surgery patients. J Oral Maxillofac Surg 1999; 57: 682. - PubMed Show all 18 references MeSH terms Bone Plates* / adverse effects Device Removal / adverse effects Female Hospitals Humans Orthognathic Surgery* Retrospective Studies Titanium Substances Titanium Related information PubChem Compound (MeSH Keyword) LinkOut - more resources Full Text Sources Atypon Europe PubMed Central Ovid Technologies, Inc. PubMed Central
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    Piggybacking solo: A solution to decentred sulcus-fixated intraocular lenses in high myopes
    (2022) Laginaf, M; Kim, S E; Barsam, A
    Abstract not available.