Risk factors of postoperative infection in patients with oral and maxillofacial malignant tumor / 中国感染与化疗杂志

Objective To analyze the factors associated with postoperative surgical site infection(SSI)in patients with oral and maxillofacial malignancy. Methods A retrospective study was performed on 240 patients after surgical treatment of oral and maxillofacial malignancies. The incidence of postoperative SSI was calculated in terms of the location of tumor. Preoperative serum albumin level, preoperative periodontal calculus, surgical approach, intraoperative antibiotic use, intraoperative blood loss, length of surgery, duration of indwelling catheter, length of hospital stay, postoperative drainage tubes, and length of ICU stay were considered as potential risk factors for SSI in patients with oral and maxillofacial malignancy. These factors were compared between the patients with SSI and those without SSI by univariate analysis. The significant factors identified by univariate analysis(P<0.05)were included in multivariate logistic regression analysis to identify the independent risk factors. Results The highest incidence of SSI was found in patients with tongue cancer, followed by patients with carcinoma of buccal mucosa, carcinoma of lip, and carcinoma of gingiva. No infection was found in the patients with carcinoma of palate(P<0.05). Univariate analysis identifid that preoperative serum albumin level ≤ 35 g/L, preoperative periodontal calculus level 3, surgical approach III(extended resection + cervical lymph node dissection + flap repair), intraoperative use of antibiotics, duration ofindwelling catheter ≤ 24 h, length of hospital stay>18 days, postoperative drainage tube were significant factors of SSI(P<0.05). There were no statistically significant differences between the non-infected group and the infected group in intraoperative blood loss, duration of surgery and ICU stay(P>0.05). Multivariate logistic regression analysis found that preoperative periodontal calculus level 3(OR=7.149, P=0.014), preoperative serum albumin level ≤ 35 g/L(OR = 0.059, P=0.034), surgical approach III(OR=4.135, P=0.024), hospital stay>18 days(OR=24.845, P=0.009)were the independent risk factors for postoperative SSI in patients with oral and maxillofacial malignancy. Conclusions Preoperative periodontal calculus level 3, preoperative serum albumin level ≤ 35 g/L, surgical approach III, and hospital stay>18 days are independent risk factors for SSI in patients with oral and maxillofacial malignancy. Such SSI is relatively more prevalent in patients with tongue cancer. Corresponding measures should be taken for prevention of postoperative SSI in such patients.

Trend of incidence of surgical site infection following oral and maxillofacial surgery during 11 years / 中国感染控制杂志

Objective To understand the changing trend of incidence of surgical site infection (SSI) following oral and maxillofacial surgery, and explore the influence of American Society of Anesthesiologists (ASA) score, type of incision, duration of operation and surgical risk index.Methods Data of patients who were hospitalized and underwent oral and maxillofacial surgery in a tertiary dental hospital from 2007 to 2017 were retrospectively analyzed. Trend Chi-square test was used to analyze the changing trend of incidence of SSI, binary logistic regression was used to analyze the risk of SSI.Results From 2007 to 2017, incidence of SSI in patients with oral and maxillofacial surgery was 0.33％-0.93％, with an average of 0.71％; patients with high indexes of ASA score, type of incision, duration of operation and surgical risk had higher incidence and risk of SSI; incidence of SSI was the lowest in 2009. In patients with ASA score of P1, surgical risk index of grade 1, incidence of SSI declined from 0.72％ and 2.79％ in 2011 to 0.42％ and 1.54％ in 2017 respectively, with a decrease of more than 41％.Conclusion Incidence of SSI following oral and maxillofacial surgery decreased and finally remained at a low level during 11 years, with the increase of ASA score, risk indexes score of surgical incision type, duration of surgery and surgical risk, incidence and risk of SSI increased gradually, medical environment may be one of the factors that affected SSI.

Research progress on the treatment of oral and maxillofacial hemangioma / 口腔疾病防治

@#Hemangioma is the most common vascular benign tumor in infants and young children, 60% of which occur in the oral maxillo-facial region. One characteristic of oral and maxillofacial hemangioma is spontaneous regression, which generally does not require treatment; however, a few hemangiomas can produce complications including ulceration, functional disorders and disfigurement, which require active treatments. Currently, the treatment of oral and maxillofacial hemangioma include drug treatment, laser treatment and surgical treatment. The drugs used to treat hemangioma mainly include beta blockers, glucocorticoids, alpha-interferon, imiquimod and antitumor drugs. Drug therapy is suitable for multiple, rapidly proliferating hemangiomas and hemangiomas that affect vital organ function or endanger life. Laser therapy can be applied to the early treatment of rapidly growing hemangiomas at exposed sites. Surgical treatment is suitable for proliferative hemangioma with serious complications, the reconstruction of any external deformity and the repair of a scar after an ulcer. Combined therapy and the development of new technologies provide new directions for the treatment of hemangioma but the efficacy remains to be proven by large sample prospective studies. Clinicians should appropriately evaluate the patients with hemangioma and develop individualized treatment programs for patients with treatment indications. This article reviews the efficacy, mechanism, clinical application and adverse reactions of different treatment methods and provides references for clinical treatment.

Optimized reconstruction of oral and maxillofacial defects with common soft-tissue free flaps / 口腔疾病防治

@#Severe tissue defects in the oral and maxillofacial region are commonly caused by tumor resection and trauma and can impair physiological function and aesthetics in patients. Applying a soft-tissue free flap transfer may avoid exposing important blood vessels and nerves and restore basic anatomical structures and facial features. However, the outcomes of soft-tissue free flap transfer have tended to be unsatisfactory because of the exquisite anatomical structure and complicated functions of the oral and maxillofacial region. Therefore, it is clinically important to choose a proper reconstructive method based on specific tissue defects and to optimize the processes involved in the designing and harvesting of soft-tissue free flaps. In this review, we summarize the application of soft-tissue free flaps in oral and maxillofacial defects and strategies for optimizing the quality of tissue reconstruction.

Application of mind mapping in the teaching of oral and maxillofacial development / 中华口腔医学杂志

Oral and maxillofacial development is the course that the oral students first learn, and their mastery directly influences the study of other courses that follow. The application of mind mapping in the teaching of the development of oral maxillofacial region can make the temporal and spatial features of oral and maxillofacial development in the form of visual presentation, help students build development mode of thinking, stimulate students' interest in learning, improve the quality of teaching of oral histopathology, and promote the new teaching concept in oral pathology teaching.

Application of platysma myocutaneous flap with apron incision in the restoration of oral and maxillofacial defects / 实用口腔医学杂志

Objective:To introduce a new style of platysma myocutaneous flap and to evaluate its application value in the restoration of oral-maxiofacial defects.Methods:Platysma myocutaneous flap with apron incision was used for the restoration of oral-maxiofacial defects after oral lesion ablation in 15 cases from January,2014 to September,2015.The platysma muocutaneous flap was harvested with a U shaped apron incision.The skin above the flap pedicle was preserved.The platysma pedicle was widened to ensure the flap survival.All the patients were followed up form 4 to 33 months.Results:Of the 15 platysma myocutaneous flaps,12 survived completely and 3 had partial flap necrosis.The total survival rate of the flaps at the recipient site of buccal mucosa,tongue and alveolar was 8/9,1/3 and 3/3 respectively.Additionally,there were 2 cases of disturbed wound healing in the neck.Except for 1 case of carcinoma of gingiva which had apparent cervical scar and 1 case of tongue carcinoma which had limited tongue mobility,the other cases showed a satisfactory recovery of oral-maxillofacial contour and fucnction.Conclusion:Compared with the traditional platysma myocutaneous flap,the platysma myocutaneous flap with apron incision can provide a larger skin paddle,and is suitable for the restoration of small and medium sized buccal mucosa and alveloar defects,but not for tongue defect.

Therapeutic effect of external carotid artery catheterization and drug infusion therapy for severe infant hemangiomas in oral and maxillofacial regions / 中华实用儿科临床杂志

Objective To explore the therapeutic effect and the efficacy of external carotid artery catheterization and drug infusion therapy for severe infant hemangiomas in oral and maxillofacial regions.Methods The clinical and follow-up data of 126 cases with severe infant oral and maxillofacial hemangiomas were retrospectively analyzed in Henan Provincial People's Hospital between June 2004 and December 2009.The patients included 45 male and 81 female cases,and the average visiting age of the patients was 3.9 months (ranged 10 days to 1 year and 4 months).Among 126 patients,24 cases occurred with Kasabach-Merritte syndrome (KMS).The patients were treated with ligation of external carotid artery,insertion of a tube inside the lesion and injection of 400 g/L Carbonyldiamide after operation.Methylprednisolone was added in infusion if the patients were combined with KMS.Results The mean follow-up period was 6.1 years (ranged 4.3 to 10.2 years).All of 126 cases were cured through the management including external carotid artery catheterization and drug infusion therapy in 94 cases,and the combination treatment of the infusion and local Carbonyldiamide injection in 32 cases.The size of hemangiomas gradually shrank and disappeared after the therapy.The hemangiomas in 105 cases disappeared completely in 6-12 months,and 21 cases disappeared in 1-2 years.Twenty-four patients were complicated with KMS.The thrombocyte count and blood coagulation function also returned to normal after the therapy.Among the 24 cases,the thrombocyte count in 13 cases was back to normal within 3-7 days,and 7 cases within 8-14 days.In the remaining 4 cases,it normalized within 15-30 days.The weight,height,immunity of the patients were in keeping with the healthy counterparts after long term follow-up.And no serious adverse effect was observed.Conclusions For severe infant hemangiomas in oral and maxillofacial regions,the external carotid artery catheterization and drug infusion therapy can obviously shorten the treatment time,and reduce the drug side effects.It is a better and more reliable treatment method.

Stem Cell Therapy in Dentistry: An Overview.

Cells with a unique capacity for self-renewal and potency are called stem cells. With appropriate biochemical signals stem, cells can be transformed into desirable cells. Regeneration of oral and maxillofacial structures is earned out by using stem cell therapy, and this has gained momentum in recent days. Future tissues like tissue engineered bone grafts, engineered joints and cranial sutures can be developed with stem cell therapy. We have described the properties, types and advantages of dental stem cells. Emphasis is been given to the possibilities of stem cell therapy in the oral and maxillofacial region including regeneration of tooth and craniofacial defects.

Epstein-Barr virus infections and clinicopathologic feature of oral, maxillofacial and neck primary malignant lymphoma in Guangxi / 临床与实验病理学杂志

Purpose To investigate the relation of Epstein-Barr virus ( EBV) infections and malignant lymphoma. Methods EBV-co-ded RNA ( EBER) was detected by in situ hybridization in tumor tissue of 81 cases of malignant lymphoma in oral, maxillofacial and neck regions, with analysis of the clinical pathological features. Results The detection frequencies of EBER was 44. 44%. The posi-tive detection of EBER in Hodgkin′s lymphomas was 40% and that in non-Hodgkin lymphomas was 45. 1%, including 75% in T cell lymphomas, 87. 5% in NK/T cell lymphomas and 2. 9% in B-cell lymphoma. The positive rates of EBER in T cell lymphomas and NK/T cell lymphomas were significantly higher than that in B-cell lymphoma (P0. 05). Conclusion Oral and maxillofacial and neck lymphoma is closely associated with EBV infection in Guangxi region, espe-cially, in which NK/T cell lymphoma most typically occurs in extra-nodal diffuse lymphoid tissues.

Pinyangmycin sclerotherapy for localized low-flow venous malformation in oral and maxillofacial region / 中华医学美学美容杂志

ObjectiveTo investigate an optimal treatment of localized low flow type venous malformation located in the oral and maxillofacial region.MethodsFifty seven patients with localized low-flow venous malformation were treated by intralesional injection of PYM.The injections was repeated at an interval of 10 to 14 days,but not more than 3-5 sessions within a therapeutic period.If necessary,the secondary therapeutic period was performed 1 month later.The general and local adverse responses and the appearance improvement were recorded.The clinical outcomes and aesthetic effects were assessed with a follow-up of 1 to 3 years.ResultsAfter 3-8 injections,complete clinical resolutions were achieved in 52 patients.The deformity disappeared thoroughly.The surface skin and the appearance of lesions showed normal.4 patients received completed lesion control and showed nor mal skin or muco but a little hypertrophy tissue.One venous malformation reduced 2/3 volume after 8injections but improved slowly.The therapeutic time seemed to be related with the size of lesion.Diameter less than 3 cm could be usually cured within 1 treatment period.No ulcerations or scars were presented in injection regions.The function of nerves in oral and maxillofacial region remained normality in all patients.The systematic complication included transient pyrexia and poor appetite appeared in several cases.No allergy was found.No clinical recurrence was observed during the follow-up.ConclusionsTreatment of localized low-flow venous malformations in oral and maxillofacial region with PYM sclerotherapy reveals a high rate of complete clinical resolution,a fair cosmetic and function result,and does not damage facial nerves or form local scars.And it might be regard as an optimal therapeutic method to localized low-flow venous malformations.

Qualitative research on the psychological experience of patients with malignant tumor of oral and maxillofacial region surgery / 中国实用护理杂志

Objective To understand the psychological experience of patients with malignant tu-mor of oral and maxillofaeial region surgery during early diagnosis and perioperative stage in order to supply reference for clinical staff to carry out psychological support. Methods 12 patients with malignant tumor of oral and maxillofacial region surgery participated in the in- depth interview, the data were analyzed, fin-ished and epurated. Results During the whole process of the early diagnosis and perioperative period,the patients showed negative psychological response, they had to bear significant psychological and financial burden as well as lack of social support. Conclusions Patients with malignant tumor of oral and maxillo-facial region surgery needed humanistic care and emotional support, nursing professionals should provide effective measures to release stress and improve negative emotions, make good use of social resources in or-der to assist them to get through the difficult course.

Complications and Outcome of Free Flap Transfers for Oral and Maxillofacial Reconstruction / Oral Science International

Microvascular free flap transfers have become a preferred reconstructive technique; however, rare complications may still prove devastating. This study reviewed 213 consecutive free-tissue transfers in order to assess the incidence and causes of complications in patients undergoing microvascular free flap reconstruction in the oral and maxillofacial region. In most cases, reconstruction was undertaken after resection of a malignant tumor. The flap donor sites were the radial forearm (n=111), rectus abdominis (n=88), scapula (n=13), and latissimus dorsi (n=1). The superior thyroid artery and the external jugular vein were commonly used as recipient vessels for anastomosis. The overall flap success rate was 99%. There were 7 cases of postoperative vascular thrombosis (6 venous and 1 arterial), constituting 3.3% of the entire series. Five flaps were salvaged, representing a 71.4% successful salvage rate in cases of vascular complications. Most of the successful salvage attempts were made within 24 hours of the end of the initial operation, and the successful salvage rate for re-exploration was 100%. Finally, the total flap loss rate was 0.9% and the partial flap loss rate was 2.3%. We conclude that early re-exploration should be the first choice for management of vascular compromised flaps. Complications at the donor site occurred in 17 cases (8.0%), the most common complication of which was partial skin graft loss after harvesting a radial forearm flap (n=10; 9.0%). Recipient and donor site morbidity was limited and considered acceptable.

Analysis on TCM Syndrome Differentiation of 116 Patients After Tumor Surgery of Oral and Maxillofacial Region / 中国中医药信息杂志

0.05). Course of type A was 7.61?5.80 months,and much longer than average course of all patients (7.56?5.95 months),P

Reconstruction of the oral and maxillofacial soft tissue defect by microsurgical technique / 中华医学美学美容杂志

Objective To reconstruct the oral and maxillofacial defects with the radial forearm flaps. Methods 12 patients suffered from the oral and maxillofacial soft tissue defects caused by various reasons had undergone the reconstruction by microsurgical techniques to implant the free radial forearm flaps for repair of the defects. Assessment was given to the results of the reconstructions of the oral and maxillofacial defects. Results The appearance, plump and countenance functions of the maxillofacial region were regained. The oral functions were improved obviously. 11 of 12 patients’ defects (91.66%) were reconstructed successfully. Conclusion The radial forearm flap is an excellent option especially for the repair and reconstruction of the oral and maxillofacial multiple-angle, irregular and complicated defects.

Expression of C-myc protein in oromaxillofacial sarcoma and its biological significance / 实用口腔医学杂志

Objective:To study the correlation between C-myc express io n and clinicopathological characteristics of oromaxillofacial sarcoma. M ethods:C-myc expression was determined by SP method in 37 cases of sarc oma and 14 benign mesenchymal tumors in oral and maxillofacial region. R esults:C-myc expression was detectd in 22 cases (40.54%) of sarcoma and in none of the benign tumor. In sarcoma of gradeⅠ, Ⅱand Ⅲ, the positive r ates of C-myc expression were 16.70%, 30% and 66.67% respectively, and a statis tical significance was only observed in C-myc expression between gradeⅠand Ⅲ( P

Mini-invasive treatment for patients with vascular malformations in oral and maxillofacial region / 中华医学美学美容杂志

Objective To investigate effects of mini-invasive treatment for patients with vascular malformations in oral and maxillofacial region . Methods 8 cases with vascular malformations in oral and maxillofacial deep or special region were injected pingyangmycin into vein lake by color ultrasound-guided needle aspiration. Results All cases were cured and no facial nerve was damaged. Follow-up ranged from 6 months to 1 year, and no recurrence was found. The vascular malformations of 4 cases in maxillofacial deep region were disappeared or instead of fiber tissue with MRI detection 6 months after treatment. Conclusions Injecting pingyangmycin by color ultrasound guided-needle aspiration for patients with vascular malformations in oral and maxillofacial deep or special region is effective, safe and mini-invasive treatment.