Evaluation of oncological outcomes in patients with oral cavity cancer treated in a lowvolume hospital

Introduction: Oral cavity cancer (OCC) is one of the 10 most common types of tumors in the world. Surgical resection is the most indicated initial treatment, followed by adjuvant therapy, depending on tumor stage. A few studies have suggested that patients treated in high-volume hospitals present better oncologic outcomes; however, particularly in continental countries, some patients are treated in regional hospitals. Objective: To evaluate the results of OCC patients treated in low-volume regional hospitals. Methods: This is a retrospective longitudinal study conducted with patients diagnosed with OCC and operated on in a low-volume hospital between January 2003 and December 2018. Results: 174 patients with OCC were treated at the institution - an average of 11 patients/year. The most common tumor location was the tongue (48.2%), followed by the lip (18.2%). Squamous cell carcinomas were the most frequent (94.7% of patients). Adjuvant radiotherapy and chemotherapy were performed in 46.7 and 31.9% of patients, respectively. Almost 21% of patients had some postoperative complication. Specific survival of 62.6% and global survival of 58.2% after 3 years were similar to the results reported in high-volume centers. Disease-free survival was 45.8% in the same period. Conclusion: Low-volume hospitals qualified for oncological treatments can present outcomes similar to those of high-volume centers, and are thus a regional option for patients with OCC.

Surgical Management of Ranula- Floor of Mouth by Marsupialization: A Case Series.

Introduction: The extravasation of saliva from the sublingual gland on the floor of the mouth results in a ranula. The most typical presenta?on is swelling under the tongue. The mylohyoid muscle may allow it to herniate, Causing a plunging ranula. Ranula can be treated in many ways, including ranula excision alone, excision of the sublingual gland with or without ranula, aspira?on of cys?c fluid, sclerotherapy, marsupializa?on, incision and drainage. Material and methods: This case study includes six pa?ents with ranula who underwent surgical treatment by marsupializa?on. The indica?ons, age and sex distribu?on, Marsupializa?on methods, pathology reports, recurrence rates, and complica?ons were seen. Results: Out of 6 pa?ents in our case series, no one pa?ent has shown to be any recurrence or complica?ons of marsupializa?on. Conclusions: Management of Ranula by Marsupializa?on is a good op?on, but if it recurs a?er marsupializa?on, Excision of the lesion and the affected gland is the best course of act?on.

Prevention of hematoma on the floor of the mouth during dental implant surgery in the anterior mandible / 口腔疾病防治

Objective@# To explore the cause and preventive measures of floor-of-mouth hematoma after dental implant placement. @*Methods@#The prevention of hematoma of the floor of the mouth in a case of lower anterior teeth implant placement was analyzed, and the literature was reviewed.@*Results@# Four mandibular vascular canals were found on the lingual side of the anterior mandible before dental surgery in the reported case. Two of them were quite thick (1.4 mm and 1.0 mm, respectively) and were located adjacent to the crest of the alveolar bone and superior to the mental spine. These two thick endosseous branches from the sublingual artery were dissected and ligated , and there was no obvious hematoma in the patients immediately after the operation and at the postoperative 3 d review. The results of the literature review show that the incidence of endosseous branches from the lingual vascular canal of the mandible is 90%-100%. The distribution of the vessels on the lingual side of the mandible is highly variable and adjacent to the lingual cortical plate. Accidental injury of the lingual cortical plate during implant surgery would probably lead to bleeding or hematoma on the floor of the mouth. @*Conclusion @#Mastering the anatomy of blood vessels on the floor of the mouth, elaboratively examining preoperative three-dimensional radiographic imaging, and cautiously exploring the lower jaw bone morphology after flap elevation are preventive measures to avoid damage to the arterial supply on the lingual side of the anterior lower jaw and to prevent complications of hematoma in the floor of the mouth.

Finding a Mass Within the Oral Cavity: What Are the Common Causes and How Should A GP Manage them?

@#A 24-year-old male presented with worsening right buccal pain and numbness of the anterior right tip of the tongue. A fixed, hard, non-tender mass was found on the right floor of the mouth. Subsequently, maxillofacial surgery evaluation, MRI scan of the head and neck, and biopsy confirmed a low-grade hyalinising clear cellcarcinoma, likely of salivary gland origin. This clinical encounter led to a review for the variety of masses that can occur in each site in the oral cavity and the commonmasses that may present to a GP. A suggested management approach is presented. In addition,common salivary gland pathologies are highlighted, andsalivary gland tumours as was present in this patient are further discussed.

Músculos del piso de boca en TEM vs. IRM / Mouth floor muscles in TEM vs. IRM

El presente artículo de revisión fue realizado para comparar detalles imagenológicos de resonancia magnética y tomografía espiral multicorte de las estructuras anatómicas del piso de boca; esta es una región desafiante de la cavidad oral para el odontólogo ya que se encuentra constituida de tejidos blandos, vasculares, glandulares y nerviosos, a su vez carece de tejidos óseos volviéndola mucho más susceptible a patologías. Por ello la resonancia magnética es el estudio de preferencia para los tejidos blandos pues permite conocer con más facilidad la anatomía y a la tomografía espiral multicorte ideal para el análisis de tejidos duros, sin embargo puede evaluarse el piso de boca sin ser el estudio imagenológico indicado para esta. El presente trabajo es una recopilación de artículos en bases de datos e internet con el fin de comparar detalles imagenológicos entre la resonancia magnética y tomografía espiral multicorte.

This review article was conducted to compare magnetic resonance imaging and multislice spiral tomography of floor of mouth anatomical structures; this is a challenging region of oral cavity for dentist since it is made up of soft, vascular, glandular and nervous tissues, in turn lacks bone tissues, making it much more susceptible to pathologies. Therefore, magnetic resonance is the preference study for soft tissues because it allows knowing more easily anatomy and multislice spiral tomography ideal for hard tissues analysis, however floor of mouth can be evaluated without being the imaging study indicated for is. The present work is a compilation of articles in databases and internet in order to compare both: magnetic resonance and multislice spiral tomography.

A Rare Case Report of Ectopic Tooth in Submandibular Salivary Gland’s Duct

@#This case report highlights mandibular tooth in an ectopic position in the floor of the mouth, associated with submandibular salivary gland, which was completely obliterating the Wharton duct. Very few such cases have been reported in the literatures. Since ectopic tooth may lead to pain, discomfort sensation upon mastication, and even infection (sialadenitis), its diagnosis and treatment is essential.

Dermoid Cyst of the Floor of Mouth in a Pediatric Patient: A Case Report.

Dermoid cysts are rare benign cystic lesions encountered in the head and neck region. Only 7% of dermoid cysts occur in the head and neck area of which only 1.6% appears in the oral cavity. Still rarer is the presentation of the dermoid cyst in the maxillofacial region in a pediatric patient, which is about 0.29%. Herein, we report a pediatric case of a female patient of 13 years old who came with the chief complaint of swelling below the chin since 8 years. Th e purpose of this case report is to emphasis on the rarity of the condition and how important it is to be considered in the differential diagnosis of lesions seen in relation to floor of mouth.

Plunging Epidermoid Cyst of the Floor of the Mouth Mimicking a Ranula

Plunging epidermoid cyst of the floor of mouth is indeed an uncommon entity. A 34-year old Malay gentleman had presented to our centre with a floor of mouth lesion that extended into the submental region. Clinical findings and imaging studies pointed towards the impression of a plunging ranula. Histopathological examination of a completely excised mass via intraoral approach, confirmed the diagnosis of an epidermoid cyst. He was well on follow up with no subsequent recurrence. We discuss the nature of epidermoid cyst and its surgical management.

Quiste dermoide cervical / Cervical dermoid cyst

Los quistes dermoides presentan una incidencia de 1,6 hasta 6,9 % en la región de cabeza y cuello. Se realiza el siguiente reporte de caso clínico con el objetivo de enfatizar en la importancia de un adecuado manejo diagnóstico preoperatorio, para establecer una acertada planificación quirúrgica en la exéresis de este tipo de lesiones de la región cervicofacial. Se presenta el caso clínico de un paciente masculino, de 13 años de edad, quien hacía 3 años se notaba un crecimiento redondeado en región submentoniana, lo cual le ocasionaba molestias al hablar y ligera afectación de su estética facial. Una vez realizados los estudios complementarios preoperatorios, se decide tratamiento quirúrgico, empleando una cervicotomía medial para la extirpación de la lesión quística, dada la ubicación anatómica por debajo del músculo milohiodeo y su gran dimensión. El diagnóstico histopatológico se corresponde con un quiste epidérmico. Se concluye que resulta imprescindible realizar un exhaustivo examen físico e imagenológico, para lograr resultados satisfactorios en el tratamiento quirúrgico del quiste dermoide cervical.

Dermoid cysts have an incidence rate of 1.6 to 6.9 % in the head and the neck. This is the report of a clinical case aimed at making emphasis on the importance of an adequate preoperative diagnostic management in order to set a right surgical planning in the excision of this type of lesions in the cervicofacial region. A 13 years-old patient, who had noticed a rounded growth under his chin for three years, which caused discomfort on speaking and mild effects on its facial esthetics. After the preoperative supplementary studies, it was decided to make surgery by using medial cervicotomy for excision of cystic lesion due to the anatomical location of the cyst below the mylohyoid muscle and to its great dimension. The histopathological diagnosis was epidermal cyst. It was concluded that it is indispensable to make thorough physical and imaging examination to achieve satisfactory results in the surgical treatment of a cervical dermoid cyst.

Lipoma de piso de boca: reporte de un caso / Lipoma of the floor of the mouth: a case report

Los lipomas son tumores de tejido conjuntivo compuestos por células adiposas que pueden aparecen en cualquier parte del cuerpo. En la cavidad bucal es poco frecuente encontrar estos tumores; cuando llegan a presentarse, los sitios más comunes son la mucosa bucal vestibular, lengua, labios y el piso de la boca, siendo este último el menos frecuente. Presentamos el reporte de un caso de lipoma en piso de boca en un paciente masculino de 34 años de edad, quien en la exploración clínica presentaba aumento de volumen en piso de boca del lado derecho, de corta evolución. Se realizó escisión local conservadora bajo anestesia local, con reporte histopatológico de lipoma.

Lipomas are connective tissue tumors composed of adipose cells, which can appear anywhere on the body. Though rare in the oral cavity, when they do appear the most common sites are the buccal mucosa, tongue, lips, and, least commonly, the floor of the mouth. We present a case report of a lipoma of floor of mouth in a 34-year-old male patient, who, upon clinical examination, showed an increase in volume of short evolution on the right side of the floor of the mouth. A conservative local excision was performed under local anesthesia, with the histopathological report of lipoma.

Lipoma in Floor of Mouth.

Lipomas are adipose mesenchymal neoplasms, they are relatively uncommon in the oral cavity, representing about 0.5% to 5% of all benign oral tumors1. The clinical presentation is typically as an asymptomatic yellowish mass. The overlying epithelium is intact, and superficial blood vessels are usually evident over the tumour. We report a case with an unusual and atypical presentation of the lipomas in the floor of mouth, which is quite a rare site in the literature even in the oral cavity lipomas.

A Case of Alveolar Soft Part Sarcoma in Floor of Mouth Mimicking Ranula / 대한이비인후과학회지

Alveolar soft part sarcoma (ASPS) is a rare, aggressive mesenchymal malignancy that comprises of approximately 1% of all soft tissue sarcomas. About 60 cases of ASPS arising in the head and neck have been reported, with most of them occuring in the orbit and tongue. An ASPS found in the mouth floor is extremely rare, with only one single case reported in english literature. Because of its rarity and slow growing feature, it can be misdiagnosed as a benign oral cavity mass or a vascular neoplasm. We herein report a new case of mouth floor ASPS, which mimicked a ranula in a child. In our patient of 12 year-old girl, tumor was located at the floor of mouth. She was successfully treated with surgical excision without adjuvant radiation or chemotherapy.

Sequential Management of Pierre Robin Sequence: Case Report

Free forearm flap and free iliac bone reconstruct the composite tissue defects of the floor of mouth and the lower part of face in the same period / 中华显微外科杂志

ObjectiveTo probe into the clinical efficiency of reconstruction to person who had composite tissue defect of the floor of mouth and the lower part of face with the free forearm flap and free iliac bone in the same term.MethodsBefore the surgery, the surgeon should carefully evaluate the scope and shape of defects in 11 cases who had the composite tissue defects of the floor of mouth and the lower part of face, to design the individual forearm flap, so that it matches with the defect region. During surgery, the first resumption of defects using titanium plates forming the basic shape of mandible and the occlusal relationship,then used to re-sawing to take modeling of the iliac bone,transplanted free iliac bone and fixed after the inside of the titanium plate, thereby restoring the continuity of mandible missing.ResultsFree forearm flap and free iliac bone all survived in 11 cases, the success rate of 100％. The patients were followed up for 6 to 12 months, although the shape of restoration areas were different levels of fat, but eating, swallowing and other oral function had been well improved, 7/11 could enter normal diet, 4/11 to enter liquid diet, At the same time, the patients in social activities can communicate in a language daily, sensory function of skin flap and facial appearance has been satisfactory recovery.ConclusionConformal free forearm flap and free iliac bone is an ideal way to reconstruct the composite tissue defects of the floor of mouth and the lower part of face in the same period, not only safe, practical prognostic effect, and also can significantly improve the patients quality of life, which is worthy of reference and use.

Dermoid Cyst on the Floor of the Mouth: A Case Report

A Case of Angiolipoma in the Floor of the Mouth / 대한이비인후과학회지

Angiolipoma is a rare vascular variant of the benign lipomatous tumors. Especially, angiolipoma of the head and neck is extremely rare. To our knowledge, there are about 19 previously reported cases of angiolipoma of the head and neck in the world literature review. We experienced a case of angiolipoma that developed in the floor of mouth, and the tumor was successfully removed using the transcervical approach without any complications. We report a case of angiolipoma in the floor of mouth with a review of the related literature.

Ultrasonographic Evaluation and Differentiation of Tumorous Lesions in the Floor of the Mouth: / Oral Science International

Ultrasonography may provide some information as to the tissue characteristics of tumorous lesions in the floor of the mouth, which have not been sufficiently clarified. Ultrasonographic imaging characteristics of these lesions are presented and the differential diagnoses are discussed. Ultrasonographic images of 5 patients with metastatic lingual lymph nodes (squamous cell carcinoma), lymphangioma, Schwannoma, ranula and dermoid cyst are presented. The literature on the imaging features of tumorous lesions in the floor of the mouth was searched using Medline. Five cases of tumorous lesions in the floor of the mouth are presented. The differential diagnosis through a review of the references was discussed. Ultrasonographic images clearly showed the internal structures of the mass. The homogeneity varied according to the degree of closeness of the cells and tissues, or the presence of fluid, hemorrhage, cystic degeneration and calculus. The echogenicity was due to the high acoustic impedance of calculus, cholesterol, and so on. The imaging features varied according to the ratio of the tissues, such as fat and fibrous tissue (in lipoma), or cholesterol and keratin (in dermoid cyst). A high vascular mass indicated malignant salivary gland tumors and hemangioma. In conclusion, ultrasonographic images revealed the distinctive features of the lesions and were useful for the differential diagnosis. Therefore, ultrasonography could be used to conjecture the content of the lesions and is considered to be useful for easy and accurate diagnosis prior to treatment.

Treatment Outcomes and Pattern of Failure in the Surgically Treated Squamous Cell Carcinoma of Floor of the Mouth / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Squamous cell carcinoma involving the floor of the mouth remains one of the most aggressive neoplasms of the head and neck. Its propensity to invade the mandible and to involve the lymphatic beds of both necks often makes local and regional control exceedingly difficult. This study reports the oncologic results of the surgically treated squamous cell carcinoma of the floor of mouth. SUBJECTS AND METHOD: From July 1992 to September 2001, 27 previously untreated floor of the mouth squamous cell carcinoma patients were treated with surgery with or without postoperative radiotherapy at Severance Hospital. Survival rates and factors affecting survival were studied using standard statistical analysis to determine statistical significance. RESULTS: The 2 year and 3 year disease-specific free survival rate in early staged carcinomas (stage I and II) were 85% and 77%, respectively, and in advanced staged carcinomas, 75% and 60%, respectively. Significantly decreased survival was seen in the patients with positive pathologic lymph nodes (p=0.001). However, there was no statistical significance for the effects of cT stage (p=0.56), performance of mandibular resection (p=0.755), mandibular invasion (p=0.688), and positive margins (p=0.98) on survival. Thirty-three percent of patients had recurrence. Recurrence was highest at the primary site, followed by the neck, and these were the most common sites of treatment failure. Two cases (67%) of nodal recurrence occurred in the anterior lymphatic chain (level VI). Distant metastasis was noted in 7.4% of the patients. CONCLUSION: Treatment with radical surgery of primary lesions and elective neck dissection including the anterior neck lymphatic chains may improve survival of patients with squamous cell carcinoma of the floor of mouth.

A Case of Multiple Dermoid Cyst of the Floor of the Mouth / 대한이비인후과학회지

A multiple dermoid cyst is a rare tumor in the floor of the mouth. It presents as abnormal cystic development in the midline as a result of displaced or enclaved embryonic epithelium during the midline closure of the first and second bilateral branchial arches. Dermoid cyst is classified inot three categories according to its histological type; dermoid, epidermoid, and teratoma. The treatment of choice is complete surgical excision and prognosis is excellent. We present a recently encountered case of a multiple dermoid cyst in the floor of the mouth; the cyst was removed using the intraoral approach.