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Objective @# To investigate the application of indocyanine green in near-infrared fluorescence imaging to determine the scope of necrotic bone resection in osteoradionecrosis of the jaw and to provide a reference for clinicians@*Methods @#Eight patients with osteoradionecrosis of the jaws were enrolled. Indocyanine green was intravenously injected through the elbow vein 10 minutes before osteotomy. After conservative resection of necrotic bone lesions based on imaging results, the scope of potential dead bone resection in the area of low fluorescence intensity was gradually expanded at an initial distance of 0.3 cm. Near-infrared fluorescence imaging and fluorescence intensity determination of bone cross-section were performed before and after extended resection. Statistical differences were analyzed. All patients with osteonecrosis underwent regular follow-up to evaluate the postoperative efficacy@*Results@#Indocyanine green was injected into all 8 patients with osteoradionecrosis for near-infrared fluorescence imaging and the scans were clear; the fluorescence intensity of fresh bone wounds with an expanded mandibular resection range of (0.95 ± 0.14) cm was (226.2 ± 15.8) au, which was higher than that based on intraoperative macroscopic observation and radiological results (108.8 ± 3.4) au, (t = 20.718, P<0.001). The postoperative follow-up improvement rate of 8 patients was 87.5%.@* Conclusion @#Near-infrared fluorescence imaging with indocyanine green can assist in the successful removal of necrotic bone until fresh bleeding of the jaw wound occurs, which has important clinical value in defining the resection range of osteoradionecrosis of the jaw.
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Objective@#To investigate the feasibility of using a carbon dioxide(CO2) laser in the treatment of facial papilloma in children and to evaluate its curative effect and prognosis.@*Methods @#A case of pediatric facial papilloma treated with a CO2 laser was reported, and the effects of this disease and CO2 laser treatment were reviewed and analyzed in combination with the literature. @* Results@#Under general anesthesia, the lesion tissue of the left lip was excised for pathological biopsy, and the diagnosis was maxillofacial papilloma. The lesions were surgically ablated in stages with a CO2 laser, and erythromycin ointment was applied to the surgical incision after surgery. A total of three rounds of CO2 laser treatment were performed for 3 treatment courses. The child had no complications during or after the operation, the facial appearance was significantly improved, and there was no sign of recurrence during the 6-month follow-up. A literature review showed that CO2 lasers have been widely used in the excision of various surface lesions. In clinical practice, continuous CO2 laser with power of 10-50 W and wavelength of 10.6 μm is used to treat superficial tissue lesions, which can achieve accurate vaporization resection of diseased tissue, less bleeding and a good prognosis.@* Conclusion@#CO2 laser was accurate and minimally invasive for the removal of facial papilloma in children.
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Objective@# To investigate the diagnosis and treatment of synchronous double primary malignant tumours of the tongue and lung.@*Methods@#A case of adenoid cystic carcinoma（ACC） and lung adenocarcinoma with double primary malignancy was retrospectively analyzed.@*Results@#The tumor of patient′s tongue base gradually grew. MRI showed multiple enlarged lymph nodes on both sides of neck. CT of the chest showed obvious lesions in the anterior basal segment of the right lower lobe. The pathological biopsy of the tongue mass identified ACC, and pathological biopsy of the lung mass identified lung adenocarcinoma. The tongue and lung tumors were both surgically resected, and the tongue defect was repaired at the same time. No residue was found after surgery, and no recurrence was found during the follow-up period. The aesthetic and functional restoration of the lingual region was good.@*Conclusion@#There are few cases of adenoid cystic carcinoma and lung adenocarcinoma with double primary malignancies, and the related diagnosis and treatment are very difficult; the simultaneous removal of double primary malignant tumors may achieve good prognosis.
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Objective @#To explore the clinicopathological features, diagnosis, treatment and prognosis of sclerosing polycystic adenosis (SPA) and provide a reference for clinics.@*Methods @#A case of sclerosing polycystic adenosis of the parotid glands was retrospectively analyzed, and the relevant literature was reviewed.@*Results @# A 57-year-old female patient presented with a tumor, which she had noticed for half a month, on the left side of the lower ear, with occasional paroxysmal numbness and no complaint of other discomfort. Resection of the left submandibular area tumor was performed, and the tumor specimen pathological results showed sclerosing polycystic adenosis of the left parotid gland, with no recurrence after six-months follow-up. Sclerosing polycystic adenosis is rare, occurs in the parotid gland and is characterized by a frequently painless, slow-growing mass of the parotid gland. Imaging examination and fine needle aspiration biopsy can only be used as a reference; the diagnosis must include a pathology examination. Histological manifestations showed that abundant sclerotic collagenous stroma was permeated by ductal and acinar lobules, and cystic dilatation of the duct was accompanied by epithelial hyperplasia and diverse ductal cells. Immunohistochemistry of the ductal and acinar cells showed positive expression of cytokeratin (AE1-3 and CAM5.2) and S100 protein. The ducts filled with hyperplastic and dysplastic epithelium were surrounded by an intact myoepithelial layer that was positive for SMA, p63, and calponin, with a Ki-67 index less than 3%. Treatment comprised mainly surgical resection, with a good prognosis. However, one-third of cases relapse: low-grade malignant tumors may occur, with at least one report of invasive cancer.@*Conclusion@#Sclerosing polycystic adenosis of the salivary gland is rare and has a good prognosis, but patients may relapse easily after surgery. The diagnosis depends primarily on pathological examination. The main treatment is surgical resection, the prognosis is good, and follow-up should be strengthened after surgery.
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@#Oral and maxillofacial area constitute an important part of the human appearances, the means of treatment, the size of surgical incision become the concern of patients. With the continuous improvement of minimally invasive surgical instruments and imaging technology, minimal invasive surgery has been rapidly developed in various surgical fields that including oral and maxillofacial surgery. The purpose of minimally invasive surgery is to seek the smallest surgical incision path and the minimal tissue damage to complete the diagnosis and treatment for the patients. In recent years, with broader development and application of minimal invasive surgical techniques in the field of oral and maxillofacial surgery, such as dento-alveolar surgery, maxillofacial tumor, maxillofacial trauma, the operative approach and surgical procedures of these diseases have been changed greatly. This article intends to synthesize the literatures and the author's clinical experiences, describing the application and development of minimally invasive surgery in oral and maxillofacial surgery.
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@#Oral and maxillofacial area constitute an important part of the human appearances, the means of treatment, the size of surgical incision become the concern of patients. With the continuous improvement of minimally invasive surgical instruments and imaging technology, minimal invasive surgery has been rapidly developed in various surgical fields that including oral and maxillofacial surgery. The purpose of minimally invasive surgery is to seek the smallest surgical incision path and the minimal tissue damage to complete the diagnosis and treatment for the patients. In recent years, with broader development and application of minimal invasive surgical techniques in the field of oral and maxillofacial surgery, such as dento-alveolar surgery, maxillofacial tumor, maxillofacial trauma, the operative approach and surgical procedures of these diseases have been changed greatly. This article intends to synthesize the literatures and the author's clinical experiences, describing the application and development of minimally invasive surgery in oral and maxillofacial surgery.
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@#Castleman disease is a rare and complicated disease. A case of Castleman disease (CD) in a 40-year-old woman on the neck was reported and literature review was made to understand the occurrence, clinical characteristics, diagnosis and differential diagnosis, treatment, and prognosis of Castleman disease. Because of the rarity of CD, its occurrence in the general population and the typical clinical manifestations are still lacked. There are two types of CD, namely localized CD and multicentric CD, both of them are not easy to be diagnosised. CT scans in preoperative is helpful for the clinical diagnosis, while histopathological examination and lymph node biopsy are beneficial for the early diagnosis. The treatment result is based on the histopathological examination and lymph node biopsy. The prognosis is different with the type of CD. For the localized CD, the prognosis is usually good, while for the multicentric CD is bad. Both of localized CD and multicentric CD have a certain reoccurrence rate.
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Objective @#To investigate the clinical efficacy of prosthesis retained by metal clasp and flexible clasp in the repair of type Ⅴ maxillary defects after tumor resection. @*Methods@#23 maxillary tumor surgical patients were selected in this study and restored with maxillofacial prosthesis. Total 24 prosthesis combined with metal clasp and flexible dentures were followed up for half a year to 2 years. @*Results @#After the application of prosthesis, better maxillofacial appearances are presented in all of the patients, Watian drinking water tests are improved to grade Ⅰ or Ⅱ from grade Ⅳ or Ⅴ in 21 patients, there was significant difference (P < 0.05); Soft diet can be masticated on affected side in 15 patients; The mean speech intelligibility score with and without prosthesis were (83.2 ± 7.3)% and (36.6 ± 5.6)%, there was significant difference (P < 0.05); Favorable hygienic situations of oral cavity and prosthesis are maintained in 18 patients.@*Conclusion @#Prosthesis combined with metal clasp and flexible denture performed favorable clinical efficacy and contributed to improve the living quality and mental health after tumor resection.