Type of publication:
*Pilkington R.; *Chundoo S.; *Rollings L.; *Messahel A.; *Thomas S.; *Bhatia S.
British Journal of Oral and Maxillofacial Surgery; Dec 2019; vol. 57 (no. 10)
Introduction: Giant cell or temporal arteritis (GCA) is a vasculitis mainly affecting patients over 50yrs. Diagnosis is facilitated by a temporal artery biopsy (TAB). Due to the increased risk loss of visual loss, patients are started on high dose steroids to reduce this risk. However, a timely diagnosis with the aid from a TAB can help steer the patient into a more medically directed pathway of an appropriate reduction or prolonged use of steroids. We used British Society of Rheumatology (BSR) guidelines to audit our harvest length (recommend > 20 mm) and a telephone questionnaire to follow up patients. Method Retrospective audit over 2.5 years, 146 patients underwent a TAB performed at the Princess Royal and Royal Shrewsbury Hospital.
Results: Male:female (30:70), average age 69yrs.We had a 99.3% TAB harvest of the artery and harvest length > 10 mm was 100% and > 20 mm was 87%. Mean length 24 mm. A positive diagnosis of GCA was made from 24.6% of the TAB. A telephone questionnaire was conducted with a 44% response. 11% reported some postoperative bleeding and 4% some discomfort from the sutures. 0% reported any ongoing problems from the surgical site or concerns from the scar. Clinical relevance In our unit we provide a comprehensive service to a large geographical region. In line with Clinical Commissioning Groups (CCG) this audit shows that we are providing a quality service to the practitioners who refer their patients for this treatment provision. Hopefully this audit can be used to further improve our service.