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Objective:To evaluate the effect of mixed reality (MR) in the standardized resident training on oral and maxillofacial-head and neck tumor surgery.Methods:Twenty resident doctors, who received standardized training in the department of maxillofacial oncology of our hospital, were randomly divided into experimental group and control group. The MR teaching method was used in the experimental group, while the traditional teaching method was used in the control group. The teaching effect was evaluated by theoretical and operational tests and a questionnaire survey. Statistical analysis was performed with the SPSS 24.0 software. Statistical comparisons were performed by the Students' t-test or the Wilcoxon rank correlation test. Results:The theoretical test results showed that the scores of the experimental group were significantly higher than those of the control group (85.30±3.59 vs. 80.20±5.63, t = 2.41, P = 0.027). The operational test results showed that the scores of the experimental group were significantly higher than those of the control group (89.20±5.07 vs. 82.30±6.36, t = 2.68, P = 0.015). The questionnaire survey results showed that the MR teaching helped to easily acquire the knowledge of head and neck anatomy and operation skills. Besides, the doctors in the experimental group were more active and glad to communicate with others than those in the control group. In addition, the MR teaching method improved the learning interest of doctors. The doctors in the experimental group were more satisfied with the teaching effect than those in the control group, and they recommended that the MR teaching method be used in clinical training and teaching on oral and maxillofacial-head and neck tumor surgery. Conclusion:MR teaching can help doctors understand and master the knowledge of head and neck anatomy and operation skills and improve their learning interest, achieving a good teaching effect, so it has important application value in the standardized resident training on oral and maxillofacial-head and neck tumor surgery.
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Due to the several complex anatomical and functional subunits in the head and neck (H&N) area, early and precise diagnosis with an accurately targeted treatment for H&N tumors is very important to cure the disease and improve overall survival. Radiomics is noninvasive and uses an image information processing technique to transform qualitative and quantitative information from clinical images and clinical data. Radiomics can be used in several stages of H&N tumor diagnosis and treatment, including H&N cancer staging, radiation dose calculations, radiotherapy related side effects, tumor delineation, assessing cervical lymph nodes, and for predicting tumor prognosis and HPV (human papilloma virus) infection status in patients with H&N squamous cell carcinoma. Radiomics has vast potential and can effectively contribute to clinical decision-making and treatment management.
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@#With the development of computer science and biotechnology, medical data has been dramatically increased and demonstrated the properties of variety and complexity. Biological and clinical researchers now face increasingly large and complex data sets. In the era of big data, strategies of diagnosis and treatment of cancer are gradually changed from evidence-based medicine to precision medicine. The promise of the big data paradigm may affect patients with oral cancer by enabling personalized monitoring, diagnosis and treatment. In this article, we will review the advances of diagnosis and treatment modality in oral cancer based on big data platform, which is mainly focused on oral cancer screening, early detection, molecular classification, prediction of metastasis and chemosensitivity.
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Wound healing results in a scar formation, especially in deep skin injury. As a result of injury in the subcutaneous tissue and skin, scar formation is coupled with surgical operation. Improvement in the knowledge about the pathological mechanism and prevention of scarring would help clinicians to better deal with postoperative care and improve the satisfaction of patients. This review put emphasis on discussing the process of scar formation after surgery and the positive factor in this process. And furthermore, This review presented primary interventions with certain therapeutic effect.
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Objective To evaluate the application of microvascular coupler device (MVCD) in the free-tissue flap transfer for head-and-neck defects reconstruction.Methods Its a retrospective study of the clinical data of 743 patients who received 763 free-tissue flap transfer for head and neck defects reconstruction in Hunan Cancer Hospital from January,2014 to January,2016.For microvascular anastomoses,413 were done manually (the manual group) and 350 done with MVCD (the MVCD group),of which the latter included end-to-end venous anastomosis in 159,endto-side venous anastomosis in 190 and end-to-end arterial anastomosis in 1.The time for anastomosis,rate of blood leakage from the anastomosis and venous thrombosis,and the survival rate of flaps were compared between the manual group and the MVCD group.The impacts of types of anastomosis of end-to-end vs end-to-side (both with MVCD),on the formation of venous thrombosis and survival of flaps were also recorded.The analysis was performed under t-test and chi-square test using SPSS software 19.0 with P ＜ 0.05 for differences with a statistical significance.Results Time for anastomosis was significantly shorter in the MVCD group (4.43±0.51min) than in the manual group (14.75± 2.43min,P＜0.05).The rates of anastomosis leakage were 0 in the MVCD group and 9.7％ in the manual group(P＜0.01),flap necrosis were 0.57％ and 1.69％ (P=0.15),the rate of venous thrombosis were 1.15％ and 3.63％(P=0.02),respectively.There was no significant difference in the time for anastomosis,the rate of venous thrombosis and the survival rate of flaps with end-to-end anastomosis and end-to-side anastomosis with MVCD.Conclusion The application of microvascular coupler device is valuable in the reconstruction of head-and-neck defects with free-tissue flaps because it can significantly shorten the time for anastomosis,decrease the ocurrence of anastomosis leakage and venous thrombosis,reduce the risk of flap failure.
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Objective To evaluate the diagnostic value of MR in carotid artery involvement using surgery and pathology as gold standard.Methods 37 patients with suspected neck masses underwent MR scan.One radiologist unaware of the pathological results measured the nine indexes as following:axial surrounding angle(AXA),long axis angle(LAA),the adjacent length of tumor long axis(LLA),the tumor long axis length(TLAL),the ratio of the adjacent length of tumor long axis and the tumor long axis length (LLA/TLAL),the perivascular fatty gap,vascular displacement,vascular deformation and magnetic resonance angiography(MRA) evaluation of artery involvement.The comparison of diagnostic value used ROC curve,sensitivity,specificity and accuracy.The cat-egorical data used Fisher orχ2 test,and measurement data used t test.Results Four indexes (AXA,LAA,LLA/TLAL and MRA) had significantly statistical value for evaluating the arterial invasion.The AUC of AXA,LAA,LLA/TLAL were 0.910,0.775 and 0.766 (P <0.05),respectively.Using 145°,61°,0.553 and MRA to indicate invasion for diagnostic value,the sensitivity and spe-cificity of those four indexes were 100.0% and 89.2%,66.7% and 89.2%,100.0% and 59.5%,33.3% and 100.0%,respective-ly.Conclusion The four indexes including AXA,LAA,LLA/TLAL and MRA evaluation of artery involvement have statistic value but with poor stability.MRA had limited diagnostic value although it’s beneficial to observe the carotid artery.
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Spindle cell lipoma, a rare variant of lipoma, is a benign tumor found in the posterior neck and shoulder. A 24-year-old man with a close family history of malignant lymphoma had presented with a large, firm, nodular mass found in the right supraclavicular area. Excision of the deeply located mass revealed a pale yellow, rubbery nodule which grossly resembled an enlarged lymph node, with a variant of lymphoma as a primary suspect. However, pathological studies revealed the lesion to be a spindle cell lipoma. Although atypical in location, spindle cell lipoma should always be kept in differential diagnosis of a newly-noted soft tissue mass, as this entity may be easily cured by simple excision.
Subject(s)
Humans , Young Adult , Diagnosis, Differential , Lipoma , Lymph Nodes , Lymphoma , Neck , Rare Diseases , ShoulderABSTRACT
Spindle cell lipoma, a rare variant of lipoma, is a benign tumor found in the posterior neck and shoulder. A 24-year-old man with a close family history of malignant lymphoma had presented with a large, firm, nodular mass found in the right supraclavicular area. Excision of the deeply located mass revealed a pale yellow, rubbery nodule which grossly resembled an enlarged lymph node, with a variant of lymphoma as a primary suspect. However, pathological studies revealed the lesion to be a spindle cell lipoma. Although atypical in location, spindle cell lipoma should always be kept in differential diagnosis of a newly-noted soft tissue mass, as this entity may be easily cured by simple excision.
Subject(s)
Humans , Young Adult , Diagnosis, Differential , Lipoma , Lymph Nodes , Lymphoma , Neck , Rare Diseases , ShoulderABSTRACT
Objective To investigate the setup errors of head and neck tumor patients with head mask-ing by TomoTherapy with megavoltage CT (MVCT),and to measure the CTV -PTV margins.Methods There were 34 patients with head and neck tumor .All patients had received MVCT scanning before radiation was deliv-ered.The MVCT images were registered with the kilovoltage CT (kVCT)images,the setup errors of the left -right (x),anterior-posterior(y),superior-inferior(z)and transverse profile rotation(Roll)were obtained by matc-hing MVCT with kVCT,followed by calculating the reasonable CTV -PTV margins with the formula M=2.5∑+0.7σ.Results Six hundred and forty MVCT images in total were received for the patients ,the systemic ±random errors in x,y,z and Roll directions were ( -0.15 ±0.55) mm,(0.30 ±0.56) mm,(0.35 ±0.71) mm and (-0.07 ±0.52)°,the CTV-PTV margin in x,y and z directions were 3.31 mm,5.32 mm and 3.35 mm.Con-clusion we demonstrate a theoretic foundation for our CTV -PTV margins in head and neck tumor patients by analyzing the setup errors ,and it also can provide necessary quality assurance for precise radiation .
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Objective: To discuss the effect of Chinese materia medica on xerostomia of patients with head and neck tumor undergoing radiotherapy. Methods: 56 Cases of xerostomia of patients with head and neck tumor undergoing radiotherapy were treated with Chinese materia medica which had the effect of clearing heat and lowering pathogenic fire, nourishing yinn and promoting fluid production. I Month later, the evaluation of xerostomia was done. Results: The effective rate reached 46.4%,the improved rate was 44.6%,the total effective rate was 91.0%,and the ineffective rate was 9.0%。Conclusion: The Chinese materia medica with effect of clearing heat and lowering pathogenic fire, nourishing yinn and promoting fluid production can promote salivary secretion, relieve the dry mouth, improve the life quality.
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Seventy-five patients with tumors of the head and neck treated with either radiation therapy alone or combined with surgery or chemotherapy were studied prospectively to evaluate the effects of radiation therapy to the neck on thyroid gland between September 1986 and October 1992. All patients were serially monitored for thyroid function tests before and after radiation therapy. Radiation dose to the thyroid gland ranged from 35 to 60 Gy with a median dose of 50 Gy. Median follow-up time was 30 months with a range of 11 to 85 months. The incidence of thyroid dysfunction was 40%; forty-five patients (60%) euthyroid, 2 patients (3%) clinical hypothyroidism, 27 patients (36%) subclinical hypothyroidism and 1 patient (1%) hyperthyroidism. No thyroid nodules or thyroid cancer were detected in any patients. Thyroid dysfunction appeared earlier in patients who underwent surgery than in those patients treated with radiation therapy alone or combination of chemotherapy and radiation therapy (p=0.0013). By multivariate analysis, risk factors that significantly influenced a higher incidence of thyroid dysfunction were female sex (p=0.0293) and combination of total larygectomy and radiation therapy (p=0.0045). In conclusion, evaluation of thyroid function before and after radiation therapy with periodic thyroid function tests are recommended to detect thyroid dysfunction in time and thyroid hormone replacement therapy is recommended whenever thyroid dysfunction develops.