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Article ; Online: Re: Sentinel lymph node biopsy for early oral cancer - accuracy and considerations in patient selection.

Schilling, Clare

The British journal of oral & maxillofacial surgery

2023 Volume 61, Issue 3, Page(s) 251–252

MeSH term(s)	Humans ; Female ; Sentinel Lymph Node Biopsy ; Patient Selection ; Mouth Neoplasms/surgery ; Mouth Neoplasms/pathology ; Lymphatic Metastasis/diagnosis ; Lymphatic Metastasis/pathology ; Lymph Nodes/pathology ; Sentinel Lymph Node/pathology ; Neoplasm Staging ; Lymph Node Excision ; Breast Neoplasms/pathology
Language	English
Publishing date	2023-01-13
Publishing country	Scotland
Document type	Letter ; Comment
ZDB-ID	605685-4
ISSN	1532-1940 ; 0266-4356
ISSN (online)	1532-1940
ISSN	0266-4356
DOI	10.1016/j.bjoms.2022.09.018
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Article: Intraoperative Positioning in Maxillofacial Trauma Patients With Cervical Spine Injury - Is It Safe? Radiological Simulation in a Healthy Volunteer.

Pepper, Thomas / Spiers, Harry / Weller, Alex / Schilling, Clare

Craniomaxillofacial trauma & reconstruction

2022 Volume 15, Issue 4, Page(s) 312–317

Abstract: Study design: Observational.: Objective: To investigate the effects on the cervical spine of positioning patients for maxillofacial procedures by simulating intraoperative positions for common maxillofacial procedures.: Methods: Magnetic resonance ...

Abstract	Study design: Observational. Objective: To investigate the effects on the cervical spine of positioning patients for maxillofacial procedures by simulating intraoperative positions for common maxillofacial procedures. Methods: Magnetic resonance imaging was used to assess the effects of head position in common intraoperative configurations - neutral (anterior mandible position), extended (tracheostomy position) and laterally rotated (mandibular condyle position) on the C-spine of a healthy volunteer. Results: In the tracheostomy position, maximal movement occurred in the sagittal plane between the cervico-occipital junction and C4-C5, as well as at the cervico-thoracic junction. Minimal movement occurred at C2 (on C3), C5 (on C6) and C6 (on C7). In the mandibular condyle position, C-spine movements occurred in both rotational and sagittal planes. Maximal movement occurred above the level of C4, concentrated at atlanto-occipital and atlanto-axial (C1-2) joints. Conclusions: Neck extension is likely to be relatively safe in injuries that are stable in flexion and extension, such as odontoid peg fracture and fractures between C5 and C7. Head rotation is likely to be relatively safe in fractures below C4, as well as vertebral body fractures, and laminar fractures without disc disruption. Early dialogue with the neurosurgical team remains a central tenet of safe management of patients with combined maxillofacial and C-spine injuries.
Language	English
Publishing date	2022-01-03
Publishing country	United States
Document type	Journal Article
ISSN	1943-3875
ISSN	1943-3875
DOI	10.1177/19433875211053091
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Article ; Online: A training tool for clinicians in segmenting medical images to make 3D models.

Chegini, Soudeh / Tahim, Arpan / Liu, Mingjun / Chooi, Yean / Edwards, Eddie / Clarkson, Matthew / Schilling, Clare

Annals of surgery open : perspectives of surgical history, education, and clinical approaches

2023 Volume 4, Issue 2, Page(s) e275

Abstract: Introduction: 3D models produced from medical imaging can be used to plan treatment, design prosthesis, teach and for communication. Despite the clinical benefit, few clinicians have experience of how 3D models are produced.This is the first study ... ...

Abstract	Introduction: 3D models produced from medical imaging can be used to plan treatment, design prosthesis, teach and for communication. Despite the clinical benefit, few clinicians have experience of how 3D models are produced.This is the first study evaluating a training tool to teach clinicians to produce 3D models and reporting the perceived impact on their clinical practice. Method: Following ethical approval, 10 clinicians completed a bespoke training tool, comprising written and video material alongside online support. Each clinician and 2 technicians (included as control) were sent 3 CT scans and asked to produce 6 fibula 3D models using an open-source software (3Dslicer). The produced models were compared to those produced by the technicians using Hausdorff distance calculation. Thematic analysis was used to study the post-intervention questionnaire. Results: The mean Hausdorff distance between the final model produced by the clinicians and technicians was 0.65mm SD0.54mm. The first model made by clinicians took a mean time of 1hr 25mins and the final model took 16:04mins (5:00-46:00mins). 100% of learners reported finding the training tool useful and will employ it in future practice. Discussion: The training tool described in this paper is able to successfully train clinicians to produce fibula models from CT scans. Learners were able to produce comparable models to technicians within an acceptable timeframe. This does not replace technicians. However, the learners perceived this training will allow them to use this technology in more cases, with appropriate case selection and they appreciate the limits of this technology.
Language	English
Publishing date	2023-05-23
Publishing country	United States
Document type	Journal Article
ISSN	2691-3593
ISSN (online)	2691-3593
DOI	10.1097/AS9.0000000000000275
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Article ; Online: What is the optimum operative approach for the N0 neck in patients with early mouth cancer - a review of current status.

McGurk, Mark / Chegini, Soudeh / Schilling, Clare / Lai, Stephen Y

The British journal of oral & maxillofacial surgery

2021 Volume 60, Issue 7, Page(s) 864–867

MeSH term(s)	Humans ; Mouth Neoplasms/pathology ; Mouth Neoplasms/surgery ; Neck Dissection ; Neoplasm Staging
Language	English
Publishing date	2021-10-30
Publishing country	Scotland
Document type	Journal Article ; Review
ZDB-ID	605685-4
ISSN	1532-1940 ; 0266-4356
ISSN (online)	1532-1940
ISSN	0266-4356
DOI	10.1016/j.bjoms.2021.08.011
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Article ; Online: Image-guided surgery: from classical techniques to novel aspects and approaches.

Buckle, Tessa / Schilling, Clare / Maurer, Tobias / Vidal-Sicart, Sergi

The quarterly journal of nuclear medicine and molecular imaging : official publication of the Italian Association of Nuclear Medicine (AIMN) [and] the International Association of Radiopharmacology (IAR), [and] Section of the Society of...

2021 Volume 65, Issue 3, Page(s) 187–189

MeSH term(s)	Humans ; Image Processing, Computer-Assisted/methods ; Surgery, Computer-Assisted/methods
Language	English
Publishing date	2021-06-09
Publishing country	Italy
Document type	Journal Article
ZDB-ID	1281687-5
ISSN	1827-1936 ; 0392-0208 ; 1125-0135 ; 1824-4661 ; 1824-4785
ISSN (online)	1827-1936
ISSN	0392-0208 ; 1125-0135 ; 1824-4661 ; 1824-4785
DOI	10.23736/S1824-4785.21.03388-4
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Article ; Online: Machine learning methods applied to risk adjustment of cumulative sum chart methodology to audit free flap outcomes after head and neck surgery.

Tighe, David / McMahon, Jeremy / Schilling, Clare / Ho, Michael / Provost, Simon / Freitas, Alex

The British journal of oral & maxillofacial surgery

2022

Abstract: We describe a risk adjustment algorithm to benchmark and report free flap failure rates after immediate reconstruction of head and neck defects. A dataset of surgical care episodes for curative surgery for head and neck cancer and immediate ... ...

Abstract	We describe a risk adjustment algorithm to benchmark and report free flap failure rates after immediate reconstruction of head and neck defects. A dataset of surgical care episodes for curative surgery for head and neck cancer and immediate reconstruction (n = 1593) was compiled from multiple NHS hospitals (n = 8). The outcome variable was complete flap failure. Classification models using preoperative patient demographic data, operation data, functional status data and tumour stage data, were built. Machine learning processes are described to model free flap failure. Overall complete flap failure was uncommon (4.7%) with a non-statistical difference seen between hospitals. The champion predictive model had acceptable discrimination (AUROC 0.66). This model was used to risk-adjust cumulative sum (CuSUM) charts. The use of CuSUM charts is a viable way to monitor in a 'Live Dashboard' this quality metric as part of the quality outcomes in oral and maxillofacial surgery audit.
Language	English
Publishing date	2022-09-29
Publishing country	Scotland
Document type	Journal Article
ZDB-ID	605685-4
ISSN	1532-1940 ; 0266-4356
ISSN (online)	1532-1940
ISSN	0266-4356
DOI	10.1016/j.bjoms.2022.09.007
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Article ; Online: Systematic review of techniques used to validate the registration of augmented-reality images using a head-mounted device to navigate surgery.

Chegini, Soudeh / Edwards, Eddie / McGurk, Mark / Clarkson, Matthew / Schilling, Clare

The British journal of oral & maxillofacial surgery

2022 Volume 61, Issue 1, Page(s) 19–27

Abstract: Augmented-reality (AR) head-mounted devices (HMD) allow the wearer to have digital images superposed on to their field of vision. They are being used to superpose annotations on to the surgical field akin to a navigation system. This review examines ... ...

Abstract	Augmented-reality (AR) head-mounted devices (HMD) allow the wearer to have digital images superposed on to their field of vision. They are being used to superpose annotations on to the surgical field akin to a navigation system. This review examines published validation studies on HMD-AR systems, their reported protocols, and outcomes. The aim was to establish commonalities and an acceptable registration outcome. Multiple databases were systematically searched for relevant articles between January 2015 and January 2021. Studies that examined the registration of AR content using a HMD to guide surgery were eligible for inclusion. The country of origin, year of publication, medical specialty, HMD device, software, and method of registration, were recorded. A meta-analysis of the mean registration error was conducted. A total of 4784 papers were identified, of which 23 met the inclusion criteria. They included studies using HoloLens (Microsoft) (n = 22) and nVisor ST60 (NVIS Inc) (n = 1). Sixty-six per cent of studies were in hard tissue specialties. Eleven studies reported registration errors using pattern markers (mean (SD) 2.6 (1.8) mm), and four reported registration errors using surface markers (mean (SD) 3.8 (3.7) mm). Three studies reported registration errors using manual alignment (mean (SD) 2.2 (1.3) mm). The majority of studies in this review used in-house software with a variety of registration methods and reported errors. The mean registration error calculated in this study can be considered as a minimum acceptable standard. It should be taken into consideration when procedural applications are selected.
MeSH term(s)	Humans ; Surgery, Computer-Assisted/methods ; Software ; Equipment Design
Language	English
Publishing date	2022-10-07
Publishing country	Scotland
Document type	Systematic Review ; Meta-Analysis ; Journal Article ; Review
ZDB-ID	605685-4
ISSN	1532-1940 ; 0266-4356
ISSN (online)	1532-1940
ISSN	0266-4356
DOI	10.1016/j.bjoms.2022.08.007
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Article ; Online: Incidental Thyroid Tissue in Sentinel Nodes From Oral Squamous Cell Carcinoma.

Schilling, Clare / Collins, Lisette / Farrow, Adrian / McGurk, Mark / Bisase, Brian / Kerawala, Cyrus / Wan, Simon / Hall, Gill / Thavaraj, Selvam

The Laryngoscope

2023 Volume 134, Issue 3, Page(s) 1278–1281

Abstract: Objective: Sentinel node biopsy (SNB) is a surgical staging test in which sentinel nodes (SNs) undergo intensive histological analysis. SNB diagnoses early cancer spread, but can also reveal unexpected findings within the SNs. We review cases of ... ...

Abstract	Objective: Sentinel node biopsy (SNB) is a surgical staging test in which sentinel nodes (SNs) undergo intensive histological analysis. SNB diagnoses early cancer spread, but can also reveal unexpected findings within the SNs. We review cases of incidental thyroid cells (TC) found in SNs from patients with oral squamous cell carcinoma (OSCC) to assess the prevalence of TC, and the clinical significance of these. Methods: Multicenter retrospective review of SNB performed for cT1-T2N0 OSCC. Incidental TC were identified by TTF-1 or thyroglobulin positivity. Anatomical location of nodes containing TC, TC morphology, and ongoing management/follow up of this incidental finding was recorded. Neck dissections performed during the same period were reviewed to establish the expected incidence of TC in neck nodes without serial sectioning analysis. Results: 278 SNB cases were reviewed. Ten procedures detected TC in nine patients (10/278, 3.6%). During the same time period 725 neck dissections were performed, six containing TCs (6/725, 0.8%). One patient underwent SNB twice with TC identified on both occasions. Three patients had both OSCC metastasis and thyroid cells. All SNB patients with TC identified underwent thyroid USS with no primary tumours identified. Three patients underwent thyroidectomy, in all cases no primary thyroid tumour was found. Conclusion: Prevalence of incidental TC in SNs appears to be higher than that reported in neck dissections, these are not likely to be clinically relevant and can be managed on a conservative basis in the absence of clear metastatic features. Level of evidence: Multicentre retrospective cohort study, 3 Laryngoscope, 134:1278-1281, 2024.
MeSH term(s)	Humans ; Carcinoma, Squamous Cell/pathology ; Head and Neck Neoplasms/surgery ; Mouth Neoplasms/surgery ; Mouth Neoplasms/pathology ; Multicenter Studies as Topic ; Neck Dissection/methods ; Neoplasm Staging ; Retrospective Studies ; Sentinel Lymph Node Biopsy/methods ; Squamous Cell Carcinoma of Head and Neck/pathology ; Thyroid Gland/pathology
Language	English
Publishing date	2023-08-23
Publishing country	United States
Document type	Journal Article
ZDB-ID	80180-x
ISSN	1531-4995 ; 0023-852X
ISSN (online)	1531-4995
ISSN	0023-852X
DOI	10.1002/lary.30996
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Article ; Online: PET- and SPECT-based navigation strategies to advance procedural accuracy in interventional radiology and image-guided surgery.

Boekestijn, Imke / Azargoshasb, Samaneh / Schilling, Clare / Navab, Nassir / Rietbergen, Daphne / van Oosterom, Matthias N

2021 Volume 65, Issue 3, Page(s) 244–260

Abstract: Introduction: Nuclear medicine has a crucial role in interventional strategies where a combination between the increasing use of targeted radiotracers and intraprocedural detection modalities enable novel, but often complex, targeted procedures in both ... ...

Abstract	Introduction: Nuclear medicine has a crucial role in interventional strategies where a combination between the increasing use of targeted radiotracers and intraprocedural detection modalities enable novel, but often complex, targeted procedures in both the fields of interventional radiology and surgery. 3D navigation approaches could assist the interventional radiologist or surgeon in such complex procedures. Evidence acquisition: This review aimed to provide a comprehensive overview of the current application of computer-assisted navigation strategies based on nuclear imaging to assist in interventional radiology and image-guided surgery. This work starts with a brief overview of the typical navigation workflow from a technical perspective, which is followed by the different clinical applications organized based on their anatomical organ of interest. Evidence synthesis: Although many studies have proven the feasibility of PET- and SPECT-based navigation strategies for various clinical applications in both interventional radiology and surgery, the strategies are spread widely in both navigation workflows and clinical indications, evaluated in small patient groups. Hence, no golden standard has yet been established. Conclusions: Despite that the clinical outcome is yet to be determined in large patient cohorts, navigation seems to be a promising technology to translate nuclear medicine findings, provided by PET- and SPECT-based molecular imaging, to the intervention and operating room. Interventional Nuclear Medicine (iNM) has an exciting future to come using both PET- and SPECT-based navigation.
MeSH term(s)	Humans ; Nuclear Medicine ; Positron-Emission Tomography ; Radiology, Interventional ; Surgery, Computer-Assisted ; Tomography, Emission-Computed, Single-Photon
Language	English
Publishing date	2021-06-09
Publishing country	Italy
Document type	Journal Article ; Review
ZDB-ID	1281687-5
ISSN	1827-1936 ; 0392-0208 ; 1125-0135 ; 1824-4661 ; 1824-4785
ISSN (online)	1827-1936
ISSN	0392-0208 ; 1125-0135 ; 1824-4661 ; 1824-4785
DOI	10.23736/S1824-4785.21.03361-6
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Article ; Online: Single-photon emission computed tomography (SPECT/CT) images of sentinel node distribution in oral cancer.

Karamchandani, Searan / Wan, Simon / Gnanasegaran, Gopinath / Dasgupta, Dhruba / Schilling, Clare / McGurk, Mark

The British journal of oral & maxillofacial surgery

2021 Volume 59, Issue 10, Page(s) 1313–1319

Abstract: This audit describes the lymphatic flow from oral tumours seen on single-photon emission computed tomography (SPECT/CT) to help sentinel node (SN) identification. A total of 95 consecutive sentinel node biopsies (SNB) were taken between 2010 and 2019. ... ...

Abstract	This audit describes the lymphatic flow from oral tumours seen on single-photon emission computed tomography (SPECT/CT) to help sentinel node (SN) identification. A total of 95 consecutive sentinel node biopsies (SNB) were taken between 2010 and 2019. Eligibility criteria for SNB were patients over 18 years of age with a T
MeSH term(s)	Adolescent ; Adult ; Head and Neck Neoplasms ; Humans ; Lymph Nodes/diagnostic imaging ; Lymphadenopathy ; Lymphatic Metastasis ; Mouth Neoplasms ; Neoplasm Staging ; Sentinel Lymph Node Biopsy ; Tomography, Emission-Computed, Single-Photon ; Tomography, X-Ray Computed
Language	English
Publishing date	2021-07-29
Publishing country	Scotland
Document type	Journal Article
ZDB-ID	605685-4
ISSN	1532-1940 ; 0266-4356
ISSN (online)	1532-1940
ISSN	0266-4356
DOI	10.1016/j.bjoms.2021.07.015
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