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1.
Clin Oral Investig ; 24(4): 1445-1454, 2020 Apr.
Article in English | MEDLINE | ID: mdl-31814039

ABSTRACT

OBJECTIVE: This study aimed to longitudinally assess the risk of facial nerve injury (FNI) in the surgical repair of mandibular condylar neck and subcondylar fractures (CN/SCFs) and to explore its predictors. MATERIALS AND METHODS: In a retrospective cohort study, the outcome was defined as FNI at 1 week and 1, 3, and 6 months postoperatively. Potential predictors included age, sex, etiology, fracture site and pattern (dislocation/non-dislocation), concomitant facial fractures, interval to surgery, surgeons' experience, plate types, and the marginal mandibular branch-traversing approach (deep/superficial group). We employed generalized estimating equations (GEEs) for repeated measurements throughout the 6-month follow-up period. RESULTS: Among 102 patients with 114 fractures, 27 patients (26.5%) developed FNI within 1 week. Prolonged FNI (≥ 1 month) occurred in 19 (19.2%) of 99 patients. Multivariate GEE analyses revealed that deep surgical approaches (i.e., traditional submandibular and retroparotid approaches; odds ratio [OR], 18.90; p = 0.011), fractures with dislocation (OR, 3.60; p = 0.025), and female gender (OR, 2.71; p = 0.040) were independently associated with the overall FNI risk. Additionally, the deep approaches (OR, 15.91; p = 0.014) and female gender (OR, 3.41; p = 0.035) were correlated with a prolonged FNI risk. Sensitivity analyses for the outcomes identified the same predictors. CONCLUSION: The predictors longitudinally associated with FNI in CN/SCF surgeries included a deep MMB-traversing approach, dislocated fracture, and female gender. CLINICAL RELEVANCE: The superficial surgical approaches (i.e., transparotid, transmasseteric anteroparotid, and high perimandibular approaches) should be adopted for CN/SCF treatment to minimize postoperative morbidity, especially for female patients with dislocated condyles.


Subject(s)
Facial Nerve Injuries/etiology , Fracture Fixation, Internal/adverse effects , Mandibular Fractures/surgery , Adult , Aged , Facial Nerve , Female , Humans , Longitudinal Studies , Male , Mandibular Condyle , Middle Aged , Retrospective Studies , Risk Factors , Treatment Outcome , Young Adult
2.
Gan To Kagaku Ryoho ; 32(5): 625-9, 2005 May.
Article in Japanese | MEDLINE | ID: mdl-15918561

ABSTRACT

We investigated the histological response and toxicities of combination chemotherapy with TS-1 and low-dose CDDP, and evaluated the usefulness of this regimen as a preoperative chemotherapy. Fourteen patients were enrolled in this study (two men and 12 women, with a mean age of 54.5 years). Patients were administered TS-1 80 mg/m2/day (days 1-14) and CDDP 5 mg/m2/day (days 1-5, 8-12) and followed by radical surgery or biopsy within 2 weeks. Ten patients completed 1 cycle of chemotherapy, two received 0.5 cycle and two others 1.5 cycle. The histological antitumor effects were evaluated with Ohboshi & Shimosato's classification using surgical or biopsy specimens of primary tumors. The response rate was 64.3% in clinical evaluation and 50.0% in histological evaluation. The number of patients who showed CR were 7/14 (50.0%) and 5/14 (35.7%) by histological and clinical evaluation, respectively. Two patients showed grade 3 neutropenia. Almost all patients revealed no or mild toxicities. TS-1 with low-dose CDDP represents a highly effective antitumor activity and mild toxicities. Especially, the CR rate was very high. These data suggested that this regimen was useful to avoid surgery or to realize minimal surgery for oral squamous cell carcinoma patients.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Carcinoma, Squamous Cell/drug therapy , Mouth Neoplasms/drug therapy , Adult , Aged , Aged, 80 and over , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Carcinoma, Squamous Cell/surgery , Cisplatin/administration & dosage , Cisplatin/adverse effects , Drug Administration Schedule , Drug Combinations , Female , Humans , Male , Middle Aged , Mouth Neoplasms/surgery , Neutropenia/chemically induced , Oxonic Acid/administration & dosage , Oxonic Acid/adverse effects , Pyridines/administration & dosage , Pyridines/adverse effects , Tegafur/administration & dosage , Tegafur/adverse effects
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