Reconstruction of buccal defect using free anterolateral thigh flaps after radical resection of buccal cancer / 中华整形外科杂志

Objective@#To explore the value of different designed anterolateral thigh flaps(ALT) in the reconstruction of buccal defect after radical resection of buccal cancer.@*Methods@#From March 2009 to May 2016, 142 cases were diagnosed as buccal cancer in the Department of Oral and Maxillofacial Surgery of Nanjing University. All patient underwent radical resection, followed by reconstruction with different anterolateral thigh flaps. The clinical date were retrospectively analyzed.@*Results@#Among 142 cases, the muscuiocutaneous ALT flaps were used in 60 cases, the fasciocutaneous ALT flaps in 60, and the thin ALT flaps in 22. The size of the flaps ranged from 4 cm×5 cm to 14 cm×10 cm. Operative exploration during the perioperative period were performed in 4 patients, including 2 flaps with thrombotic events and 2 flaps with venous thrombosis. Among them, 2 flaps survived completely and 2 flaps were failure. The mean follow-up period was 37 months(range: 3 to 85 months).@*Conclusions@#The different designed anterolateral thigh flap for the buccal defects resulting from tumour excision is an ideal choice for reconstruction of buccal defects.

Application of surgical navigation system in the operation for maxillofacial fibrous dysplasia / 实用口腔医学杂志

Objective:To present our experience of the surgical treatment of maxillofacial fibrous dysplasia(FD) using surgical navigation technology.Methods:14 patients with maxillofacial FD were included.Preoperative CT scanning data were obtained and a virtual plan based on the patient's mirrored anatomy was realized.Intraoperatively,a digital reference frame was fixed rigidly to patient's forehead or mandible depending on the location of the lesion.During operation each patient and the virtual image were matched through individual registration technique.A pointing device was constantly used to determine whether the extent of resection was consistent with the preoperative design.The surgical outcome was assessed through fusion of the preoperative planning and postoperative CT reconstruction image.Results:The application of surgical navigation system enhanced the safety and the accuracy of the surgery for the resection of the focal lesion and for the recontour of the profile.There was no complications during 1-3 years follow up.Conclusion:Surgical navigation based on a virtual plan proves to be safe and accurate,and is of great value in managing maxillofacial fibrous dysplasia.

Surgical management of temporomandibular joint ankylosis under the guidance of navigation / 中华整形外科杂志

<p><b>OBJECTIVE</b>To assess the safety and the accuracy of surgical navigation technology in the resection of severe ankylosis of the mandibular condyle with the middle cranial fossa.</p><p><b>METHODS</b>The CT scan data was transferred to a Windows-based computer workstation, and the patient' s individual anatomy was assessed in multiplanar views at the workstation. In the operation, the patient and the virtual image were matched by individual registration with the reference points which were set on the skull bone surface and the teeth. Then the real time navigation can be performed.</p><p><b>RESULTS</b>The acquisition of the data sets was uncomplicated, and image quality was sufficient to assess the operative result in three cases. The operations were performed successfully with the guidance of real-time navigation. The application of surgical navigation have enhanced the safety and the accuracy of the surgery for bony ankylosis of temporomandibular joint.</p><p><b>CONCLUSIONS</b>The application of surgical navigation can improve the accuracy and safety of surgical excision of the ankylosed skull base tissue.</p>

Clinical application of decompression in the treatment of jaw large cystic lesions / 实用口腔医学杂志

Objective:To investigate the clinical value of decompression in the treatment of jaw large cystic lesions.Methods:42 patients with jaw large cystic lesions were treated with decompression.Imaging examination was taken and compared before and after the treatment.The influence of frequency of cyst cavity washing on the effect of decompression was observed.Results:3 moths after de-compression the border of the cyst cavity became ambiguous and the size of the cavity reduced.12 months after decompression the size of cyst cavity was stable,when second surgery was taken to remove the left cyst wall.There was no recurrence of the cystic lesion after 1 ~2 year follow-up.Cyst cavity was washed everyday,but the effect and treatment course were not influenced by the daily washing times.Conclusion:Decompression is effective in the treatment of the jaw large cystic lesions.

Reconstruction of extensive full thickness cheek defects with free anterolateral thigh flap / 中华显微外科杂志

Objective To assess the clinical features and therapeutic efficacy of extensive full thickness cheek defects reconstruction with free anterolateral thigh flap.Methods From December,2008 to June,2014,a total of 17 patients underwent simultaneous tumor radical resection and full thickness cheek defects reconstruction with free anterolateral thigh flap.In these 17 patients,12 patients had undergone the reconstruction of full thickness cheek defects with the folded anterolateral thigh flap (two skin islands and an intervening de-epithelialized zone); 5 patients had undergone the reconstruction of full thickness cheek defects with the two separate skin paddles anterolateral thigh flap in one single pedicle.Results All of 17 free anterolateral thigh flaps survived,besides 1 case resulted in partial loss of flap adge due to diabetes.After 3 to 12 months' follow-up,all cases of free anterolateral thigh flap were good in color,shape and texture,and patients were satisfied with oral morphological and functional reconstruction.Conclusion The free anterolateral thigh flap is one of versatile soft tissue flaps in the extensive full thickness cheek defects reconstruction.

Comparative study in reconstruction of tongue defect with thin anterolateral flap and forearm flap / 中华整形外科杂志

<p><b>OBJECTIVE</b>To compare the thin anterolateral flap with forearm flap in tongue defect repairing, and to introduce our methods and experiences in the tongue reconstruction with the thin anterolateral flap.</p><p><b>METHODS</b>The clinicopathologic data of 46 cases with tongue carcinoma were obtained from School of Stomatology, Nanjing University Medical Center, Nanjing University from December 2009 to December 2011. To compare two methods of incidence of vascular crisis, tongue shape, language and swallowing functional recovery.</p><p><b>RESULTS</b>46 patients with tongue carcinoma were performed the tongue reconstruction in 12 month, which 12 cases were used the thin anterolateral flap and 34 cases were used the forearm flap. In the thin anterolateral flap group, All cases were succeeded. 1 case occurs vascular crisis. In the forearm flap group, 33 cases were succeeded, and 1 case occurs necrosis. 3 cases occurs vascular crisis. The results of comparing two methods showed that: no obvious differences in the tongue shape, and no obvious differences in the function of language and swallowing.</p><p><b>CONCLUSIONS</b>There no obvious differences in the reconstruction of tongue defect between the thin anterolateral flap and the forearm flap. The thin anterolateral flap have some advantages: little influence is on the donor site, the flap extent is abundant, the donor site is not spectacular. The thin anterolateral flap should be piror method for the tongue defect repairing.</p>

Treatment of chronic prolonged mandibular dislocations / 实用口腔医学杂志

5 patients with chronic prolonged mandibular dislocations(CPMD)were examined by CT scan.The patients were treated by manual reduction under general anaesthesia and muscle relaxants.Traction was performed with ligaturing steel wires on fixation titanium screws intermaxillaryly and wrapping up the skull-jaw bone with elastic bandages for 3 weeks.After 1 month,a maximal mouth opening of o-ver 30 mm was noted and no episode of redislocation occurred in 3 -34 month follow-up.

Rehabilitation of the front palate fistula with adjuvant derma transplantation in Japanese big ear rabbits / 实用口腔医学杂志

Objective: To study the rehabilitation efficiency of adjuvant derma transplantation in treatment of front palate fistula. To find a better way to solve the problem of correcting the front fistula in short of the nearby tissue. Methods: Established the front fistula model in the oral and nasal cavity in the front of the palate with surgery. 30 Japanese big ear rabbits were divided into 2 groups. One month after operation, 15 rabbits were operated with the nearby tissue into the inner of nasal cavity and by transplanting their back skin while the others were treated only with the nearby tissues. The rehabilitation process and the histological changes of the palate were observed. Results: All dermal flaps survived after transplantation. This surgical method got a satisfying effect(P<0.05). The rate of success for correcting with single nearby tissues was lower. Conclusion: Adjuvant derma transplantation for rehabilitation of the front palate fistula is effective and reliable in the rabbits. The combination of the nearby tissue and homeochronous derma transplantation might be a good mode for correcting the front fistula in short of the nearby tissues.