P21 / British Journal of Oral and Maxillofacial Surgery 52 (2014) e75–e127 e85

P29

A study to compare the use of wide bore nasogastric feed-ing tubes compared to fine bore nasogastric feeding tubesfor the purpose of feeding and medication administrationinserted peri- operatively for head and neck oncologicalresections

Damian Broderick ∗, L.F.A. Stassen, Kumara Ekanayake

St James’s Hospital Dublin

Introduction: The objective of the study was to determineany clinical or patient perceived benefit to using a wide borenasogastric (NG) tube following a head and neck oncologicalresection. (Ethical approval received). Fine bore tubes getblocked following use and sometimes require removal andreplacing. Wide bore tubes have the advantage of minimalblockage they can be more uncomfortable. Variation existsbetween head and neck surgeons as to which NG is used.

Materials/Methods: Patients assigned randomly to thosehaving a wide bore NG tube or a fine bore tube. There aretwo treatment groups. Collection of information required theuse of three forms. The first form was completed by sur-geon/anaesthetist placing NG tube, the second by nursingstaff on the ward and the third by patients on removal of theNG tube. Each form has a study reference number to allowthe information to be collated. 32 patients were included inthe study. 17 had a wide bore tube, 15 had narrow bore.

Results/Statistics: Statistical analysis is ongoing, how-ever the trend reveals that wide bore tubes never blocked andnever needed to be replaced for this reason. Patients howeverfound them more uncomfortable. Narrow bore tubes fre-quently blocked with increased time demands on nurses/teamto unblock/replace, with increased radiographical exposure.

Conclusion/relevance: Given the increased risk of block-ing of narrow bore NG tubes it is our view that where tolerateda wide bore NG tube should be used for feeding purposes inthe post operative period.

http://dx.doi.org/10.1016/j.bjoms.2014.07.131

P30

A review of 1500 consecutive skin malignancy excisions:the East Lancashire experience

Kenneth Corsar ∗, C. Sweet, C. Johnston, K. Mcalister, G.Chiu

Royal Blackburn Hospital

Introduction: basal cell carcinoma is the most com-mon skin malignancy in Western World with Squamous cellcarcinoma being the second most common. Despite othertreatment being available surgery still plays the major role intreatment of these cancers.

Materials and methods: This was a retrospective studyof all malignant head and neck skin lesions that were excised

between Jan 2009-Dec 2013. Potential cases were identifiedby the pathology laboratory and recorded and stored on theEast Lancashire skin database.

All incisional and punch biopsies were excluded from thestudy.

Excisions were defined as “incomplete” when the tumourwas reported as being present at the lateral or deep resectionmargins.

Results: 1500 malignant skin neoplasms were excisedfrom 1312 patients. 94% of these malignancies were basalcell carcinoma, 16% were squamous cell carcinoma. Of theselesions <5% were incompletely excised

Conclusions: Our incomplete excision rate comparesfavourably with previously published results which variesbetween 5-20%.

Incompletely excised lesions were more commonly seenin the central face region and were of “high risk” as definedby BAD guidelines.

Reasons for this were due to narrower margins takenin these areas due to a lack of available tissues forreconstruction, more aggressive histological subtypes oftumour and subclinical spread occurring in the centralface.

Our study did not look at the grade of surgeon carryingout these procedures which may have influenced the results.

All lesions which were incompletely excised were dis-cussed at the local skin MDT and patients offered furtherexcision.

http://dx.doi.org/10.1016/j.bjoms.2014.07.132

P31

Intensity Modulated Radiation Therapy (IMRT) in Headand Neck Cancer

Louise Dunphy ∗, S. Parmar, T. Martin, P. Praveen.

The Queen Elizabeth Hospital, Birmingham

Introduction: Intensity modulated radiation therapy rep-resents a novel treatment option with a potential capacityfor better loco-regional recurrence in inoperable disease.Organ motion is virtually absent in the head and neck, sowith proper immobilization, treatment can be accuratelydelivered.Improved loco-regional outcome following IMRThas been reported for nasopharyngeal and oropharyngealtumours. Despite this, toxicities still remain.

Aim: To assess toxicities in head and neck squamous cellcarcinoma following IMRT.

Methods: A retrospective review of head and neck can-cer patients treated with IMRT from January 1st-December31st 2013. General indications for postoperative radiationincluded locally advanced disease, positive surgical margins,involvement of 2 or more lymph nodes or extra-capsularextension,respectively.If simultaneous chemotherapy wasprovided it was documented.