reported complicat ions after the operati ons. We therefore recom- mend that our intraoral remova l method replace SMG resection asthe primary procedure for the removal of proximal submandi bular stones.

doi:10.1016/j.oraloncolo gy.2013.03.408

PP166

Intraoral excision of the subman dibular neurilemmo maKi Hwan Hong, Yun Su Yang

Dept. of Otolaryngo logy-HNS, Chonbuk Nationa l University, Chonbuk,Republic of Korea

Neurilemm omas (Schwannomas) are neurogen ic tumors arising from cells of the neural sheath characte rizing as slow growing and benign nature. Neurilemm omas of the salivary gland is a particular yrare form of an extracran ial neurogeni c tumor, with most presentin gin the parotod gland originating from a peripher al branch of the facial nerve. The tumor was mistaken clinically for an enlarged submandib -ular gland as pleomorp hic adenom a. For surgery of this tumor the skin incision on the neck has been general ly made by most of head and neck surgeons. An alternative to the standard transcervi cal approach has been reported such as an intraoral approach. Wereport a case of a submandi bular neurilemm oma misdiagn osed preoperati vely as a pleomorp hic adenoma treated with intraoral excision . An unusal case of neurilemm oma of the submandi bular gland is presented, and the literature concerning this subject isreviewed.

doi:10.1016/j.oraloncolo gy.2013.03.409

PP167

New surgical technique for treatmen t of Oro/fac ial infection ,swelling (abscess)Javad Bigdeli

Oral Surgery , Elmsford, NY, USA

Introduction: Patients that are being seen by Oral/Maxillofac ial sur- geons for treatment of Oro/facia l swelling (abscess) with dental ori- gin under local anesthesia, are being seen for 2 or 3 visits. First visit for Incision & drainage and placem ent of drain, second visit for the eradicatio n of source of infection (extraction of infected tooth), some- time 3rd visit become necessar y due to patien t discomfort and pain,and percentage of patien ts even do not return for extraction.

Purpose: This clinical study fully discussed this new techniqu e for the treatment of Oro/facial abscess, for this purpose, to reducing patient, pain, discomfort , anxiety, time and numbers of visit and decreasi ng the cost of treatmen t.

Method: This procedure is based on clinical experi ence and was developed and led to completio n over the years, will discuss and dif- ferentiate the kind of local anesthesia, anesthetic agent, and vaso- constric tors and its relations hip to the existing patholog ic and anatomic condition of our operative field and nature of our surgical procedure that we want to perform.

Result: This procedure will allow us to eliminate the source ofinfection immediately and improve the systemic health of patien tas soon as possible, as a result long term antibioti c and analgesic therapy will not be necessary and patient will be able to resume his or her routine daily life.

Conclusion: Reviewi ng the history of medicin e will manife st this fact, that service to people and helping the suffering patients has been the goal of clinicians and medica l experts from ancient days,however these days, the cost of medical care and econom y are inter- connected and inseparabl e parts and commodity. This procedure provide us with an opportuni ty and a tool to help patient and med- ical establishmen t and health organizat ions econom ically.

doi:10.1016/j.oraloncology.2013.03.410

PP168

Should TP3 form part of the surgical algorithm for treatmen t ofchyle leaks in the neck? Craig E. Miller, Catherine Lau, Leo Cheng

Oral and Maxillofac ial Surgery, The Royal London Hospital, London, UK

Introductio n: Chylous leakage is not an uncommo n complicatio nafter neck dissection. It occurs in 1–2.5% of radical neck dissection,with the majority (75–92%) on the left side. There is currently norecognis ed surgical algorith m for the treatment of chyle leak in the neck. Conservative treatment protocols have been establis hed and include closed vacuum drainage, nutrition modification and somato- statin analog 1. We present a case of right sided chyle leak treated successfu lly with a sternocleid omastoid muscle flap and TP3.

Case History: A 57 year old female with SCC was treated with right sided partial glossecto my, mandibuloto my, unilateral selective neck dissection and radial forearm free flap reconstructi on. A right sides neck swelling was noted 12 days post operatively. Radiological investig ation revealed an 8 � 3 cm heterogen ous noncompress ible collecti on with no signs of infection. This swelling gradually increased in size over the next 48 h. Therefore, the decisio n was made for surgical exploratio n and a right sided chylous leak was found but there was no obvious source of leakage.

TP3 was used in conjunctio n to a sternocle idomastoid muscle flapto help tissue adhesio n. The chylous leak was successful ly treated through this surgical approach with dietary modification without compromi sing the viability of her original free flap reconstru ction.

Conclusions : The use of TP3 forms to form an air/blood and fluidtight barrier can assist the muscle flap in containing a chylous leak.The authors will use intra surgical and radiolog ical imaging to illus- trate the surgical usage of TP3. We would recomm end TP3 to be used an adjunct in the surgic al algorithm in the treatment of such condit ions.

doi:10.1016/j.oraloncology.2013.03.411

PP169

Negative prognosti c implicati on of fibrotic pattern in papillary thyroid cancer Yoon Se Lee a, Yun-Sung Lim b, Chang-Gi Woo b, Jin-Choon Lee b,Soo-Geu n Wang b, Byung-Joo Lee b

a Departme nt of Otorhino laryngology–Head and, Neck Surgery, Research Institute for Convergence of, Biomedica l Science and Technolog y, Pusan Nationa l, University Yangsan Hospital, Yangsan, Republic of Korea b Department of Otorhinolar yngology–Head, and Neck Surgery , Pusan Nationa l University, Hospital and Medical Researc h Institute, Pusan,Republic of Korea

Purpose: Lymph node metastas is in papillary thyroid cancer (PTC)occurs 40–60%. Extrathyro idal extensio n and large tumor size are

S150 Abstracts / Oral Oncology 49 (2013) S93–S156