Presentation, Management, and Outcome of Lingual Thyroglossal Duct Cyst in Pediatric and Adult Populations.

Lingual thyroglossal duct cysts (LTDCs) are rare congenital anomalies of the neck. The authors described the presentation, management, and outcome of LTDC in pediatric and adult cases through a retrospective observational analysis between 2008 and 2018. Data included patients' demographics, main complaint, preoperative investigations, surgical management, and recurrences. Seventeen patients were included: 8 pediatric and 9 adult patients. The most common presenting symptom was foreign body sensation (35.3%). In all, 50% (4/8) of the children had respiratory problems, while the most common symptom in adults was difficulty swallowing (8/9). Five patients were of recurrent LTDC; 3 referred patients were suspected of having recurrent epiglottic cysts. The total misdiagnosis rate was 35.3% (6/17): 14.3% (1/7) in children and 55.6% (5/9) in adults. Fiber optic laryngoscopic examination revealed that LTDCs mostly occurred at the base of the tongue (53.3%) and vallecula epiglottica (33.3%). Ultrasound examination revealed low to anechoic masses on the root of the tongue; 50% were regular in shape and 50% were irregular. All pediatric patients had regular masses (100%), but most adults had irregular masses (85.7%). In total, 76.5% of the patients underwent the Sistrunk procedure, and 23.5% underwent marsupialization alone. The mean follow-up length was 37.5 ±â€Š32.8 months. All patients were well at follow-up. In conclusion, direct laryngoscopy and ultrasound examination are essential for diagnosis as LTDCs can be confused with vallecular cysts. Surgical treatment such as marsupialization or the Sistrunk operation must be performed thoroughly.

Whole-exome sequencing identifies a somatic missense mutation of NBN in clear cell sarcoma of the salivary gland.

Clear cell sarcoma (CCS) is a rare, low-grade carcinoma commonly located in the distal extremities of young adults involving tendons and aponeuroses. CCS is characterized by its poor prognosis due to late diagnosis, multiple local recurrence, propensity to late metastases, and a high rate of tumor-related mortality. The genetic cause for CCS is thought to be EWSR1 gene translocation. However, CCS lacking a translocation may have other, as yet uncharacterized, genetic mutations that can cause the same pathological effect. A combination of whole­exome sequencing and Sanger sequencing of cancer tissue and venous blood from a patient diagnosed with CCS of the salivary gland revealed a somatic missense mutation, c.1061C>T (p.P354L), in exon 9 of the Nibrin gene (NBN). This somatic missense mutation led to the conversion of proline to leucine (p.P354L), resulting in deleterious effects for the NBN protein. Multiple-sequence alignments showed that codon 354, where the mutation (c.1061C>T) occurs, is located within a phylogenetically conserved region. In conclusion, we here report a somatic missense mutation c.1061C>T (p.P354L) in the NBN gene in a patient with CCS lacking an EWSR1-ATF1 fusion. Our findings broaden the genotypic spectrum of CCS and provide new molecular insight that should prove useful in the future clinical genetic diagnosis of CCS.

The expression and functional role of a FOXC1 related mRNA-lncRNA pair in oral squamous cell carcinoma.

The Fork head box C1 (FOXC1) gene is overexpressed in multiple malignant tumors and is functionally correlated with tumor progression. However, its' role in oral squamous cell carcinoma (OSCC) is still unclear. Recent studies have revealed that many long non-coding RNA (lncRNAs) cooperate with adjacent coding genes and form a functional "lncRNA-mRNA pair". In this study, we report a new lncRNA FOXC1 upstream transcript (FOXCUT) that was remarkably overexpressed in 23 OSCC patients, as was the adjacent FOXC1 gene. The expressions of FOXC1 and FOXCUT were positively correlated. When the expression of FOXCUT was down-regulated by small interfering RNA (siRNA), the expression of FOXC1 was also decreased. Moreover, in OSCC cells Tca8113 and SCC-9, down-regulation of either FOXC1 or FOXCUT by siRNA could inhibit cell proliferation and cell migration in vitro and was accompanied with a reduction of MMP2, MMP7, MMP9, and VEGF-A. In conclusion, FOXC1 may be co-amplified with FOXCUT in OSCC, and both of them may be functionally involved in the tumor progression of OSCC. This provides evidence that both FOXC1 and FOXCUT may serve as novel biomarkers and therapeutic targets in OSCC patients who overexpress this "lncRNA-mRNA pair".

[Application of absorbable plate in oral maxillofacial fractures].

OBJECTIVE: To explore the biological features and clinical efficacies of absorbable plates and screws for rigid internal fixation. METHODS: From June 2006 to June 2010, 201 FIXSORB(TM)-MX absorbable plates were used in 57 patients, including 41 males and 16 females aged from 11 - 81 years. And 185 plates were used in 53 patients of maxillofacial fracture and 16 plates in 4 undergoing orthognathic operations with rigid internal fixation. RESULTS: All wounds healed primarily and there were no major complications. Forty-five cases were followed up for an average period of 12 months (range: 3 - 36). No obvious adverse effect and absorbable implants rejection were observed. The fracture lines were in the right position in 56 cases. CONCLUSION: As a kind of fine material for internal fixation with strong elasticity and strength, absorbable plate shall be widely used clinically.

[Comparative study of clinical efficacy between surgery by intraoperative MRI navigation versus traditional surgical resection for malignancy of parapharyngeal space].

OBJECTIVE: To investigate the clinical efficacy between mobile intraoperative magnetic resonance imaging (iMRI) navigation with a high field strength and routine surgical resection for malignancy of parapharyngeal space. METHODS: The surgical efficacy indexes of patients at our hospital during the time range from February 2010 to February 2011 were compared between two groups consisting of 29 or 42 individuals undergoing surgery with the assistance of the technique of iMRI navigation with a high field strength 1.5T or routine operation. RESULTS: No difference existed between two groups in terms of age, gender, maximal diameter of tumors, tumor stages, surgical approach or pathologic diagnosis (P > 0.05). The operative duration of the group by iMRI navigation was more than the group of routine operation ((3.1 ± 0.6) h vs (2.7 ± 0.7) h, P < 0.05). And the hemorrhagic loss ((185 ± 20) ml vs (230 ± 22) ml), the volume of drainage in 72 hours, the positive rate of initial surgical margins, the postoperative hospital stay ((9.1 ± 2.1) d vs (10.3 ± 2.3) d) and the complication incidence rate (3.4% vs 9.5%) were less (all P < 0.05). CONCLUSION: The operation by the iMRI navigation offers a much better clinical efficacy than the traditional surgery in the resection of malignancy of parapharyngeal space.

[Experimental study on co-culture of salivary adenoid cystic carcinoma cells and ganglia].

OBJECTIVE: To construct the co-culture models of salivarya denoid cystic carcinoma (SACC) cells and dorsal root ganglia (DRG) of chickens and investigate the promotive effects of SACC on neural tissue. METHODS: Glass-base culture dish was adopted to construct co-culture model of SACC-83 cells and DRG. SACC-83 cells were seeded in the medium pore with DRG around them. Outgrowth of neuronal processes was observed. Then DRG was cultured in the conditioned medium of SACC-83, with the groups of conditioned medium of MC3T3-E1 and HGF, the group of cell lysis buffer, the groups of serum-free medium and serum-plus medium as the controls. Outgrowth of neuronal processes was also recorded and compared with control groups. RESULTS: In the co-culture model of tumor and neuronal tissue, SACC-83 cells produced a suitable microenvironment in which neuronal processes remarkably grow. Neuronal processes of most DRG displayed growth tendency toward SACC. The group of conditioned medium from SACC-83 manifested obvious promotive effects on DRG. CONCLUSIONS: Co-culture model of tumor and neuronal tissue was successfully constructed, with which the promotive effects of tumor on outgrowth of neuronal processes could be observed. So hypothesized that SACC could secrete some neurotrophic factors to guide peripheral nerves gemmating and to trigger the cascade of the neural invasion in succession.

[The preliminary study of the use of MRI navigation in identifying the safe surgical margin of the maxillofacial malignancy].

OBJECTIVE: To evaluate the feasibility of MRI navigation in identifing the safe surgical margin of the maxillofacial malignancy. METHODS: The pathology results of the surgical margin identified by the technique of MRI navigation form 20 patients with maxillofacial malignancy were compared with those of 45 patients with maxillofacial malignancy who underwent the routine operation without MRI navigation. RESULTS: There was no difference between the two groups of patients in age, sex, size of tumor, tumor stages, pathologic diagnosis (P > 0.05). The negative rate of the surgical margin of the lesions treated by surgery with the technique of MRI navigation was significantly lower than that of the lesions treated without MRI navigation (P = 0.007) and highly correspondent with the pathology results. CONCLUSIONS: MRI navigation was helpful in identifying the safe surgical margin of the maxillofacial malignancy.

[Operation plus brachytherapy of iodine 125 seeds implantation for salivary gland malignant tumors].

OBJECTIVE: To evaluate the efficacy and safety of brachytherapy plus operation for salivary gland malignant tumors. METHODS: From June 2006 to June 2011, a total of 105 patients with salivary gland malignant tumors undergone brachytherapy by implantation of iodine 125 seeds. The effectiveness was evaluated by periodical radiological film and computed tomography. The complications were analyzed. RESULTS: Among them, 92 patients were observed for 12 - 60 months. The rates of clinical response rate (CRPR) and no change (NC) were 91.3% (84/92) and 8.7% (8/92) respectively of the patients. Pain, mucosa ulcer, skin darkness and radiation osteomyelitis were common complications. CONCLUSION: The combined regimen of operation and brachytherapy of iodine 125 seed implantation for salivary gland malignant tumors is quite effective and convenient. And it has fewer complications.

[Shielding property of different prosthetic materials to shield radiation of (125)I seed].

OBJECTIVE: To investigation the shielding property to (125)I of several different prosthetic materials used in clinical when prostheses are used as carriers of (125)I seed in tumor treatment. METHODS: (125)I seeds were taken as the radiation sources to establish a model in vitro and the radiation doses were measured by thermoluminescent dosemeters (TLD). The shielding property of titanium plate, cochrome plate, and poly methyl methacrylate (PMMA) plate were detected, calculated and compared with that of plumbum plate in the control group. RESULTS: The radiation doses of the radiation source at 10 mm distance through the following materials were measured, and the results are 2.805 mGy (0.09 mm thick titanium plate), 1.082 mGy (0.48 thick titanium plate), 0.390 mGy (0.41 mm thick cochrome plate), and 0.261 mGy (0.67 mm's cochrome plate), and 2.885 mGy (1.685 mm thick PMMA plate). CONCLUSIONS: The shield property of cochrome is optimal. The poly methyl methacrylate behaves to some extend as a shield to the (125)I seed which can shield the radiation as the effects of plumbum when adopted together with the 0.557 mm's (or more) titanium plate.

[Changes in cerebral blood flow during mastication in patients receiving prosthesis insertion for repairing maxillary defect].

OBJECTIVE: To investigate the changes in cerebral blood flow in patients with maxillary defect treated with prosthesis insertion. METHODS: Thirty patients with maxillary defect receiving obturator prosthesis insertion were enrolled with another 30 subjects without dentition defect as the control. The cerebral blood flow rate was recorded before and at 5 and 10 min during mastication, and the results were analyzed statistically. RESULTS: There was no significant difference in Vs, Vd or Vm between the two groups at the time points for measurement. CONCLUSION: The blood supply by the middle cerebral artery is similar between the patients receiving obturator prosthesis insertion for maxillary defect and the subjects with full denture.

[Investigation and management of wound on head and neck from the disaster area in Wenchuan earthquake].

OBJECTIVE: To investigate and analyze the wounded's state of ear, nose, throat, neck and head injury in Wenchuan earthquake. METHODS: The 206 wounded cases, who was treated in No. 452 Hospital of People's Liberation Army, were investigated specially with emphasis on injury cause, severity and treatment. RESULTS: The injured 165 cases among the 206 were in hospital, while the cases who related to the injury of ear, nose and throat were 37 cases (22.4%). Among the inpatients, the trauma of otorhinolaryngology and head and neck included: ear injuries totally 13 cases (including hemotympanum 2 cases), extraneous matter 4 cases, haemorrhagic 4 cases, nasalis and the fracture of nasal bone and nasal sinuses 7 cases (including cerebrospinal rhinorrhea 1 case), zygomatic abscess 1 case, fracture of mandible 4 cases, lip injuries 2 cases and hoarse 2 cases. The inpatients were wounded mostly because of falling and stepping. All the inpatients recovered well after properly management by ENT doctors. CONCLUSIONS: Maxillofacial injury of the wounded those were medical evacuation in the earthquake area, was ignored more readily comparing to the injury of other spots, so specialist should examine early and treat properly the people as soon as possible.

[The finite element study on zygomatic injury by impact in child].

OBJECTIVE: The purpose of this study was to establish the constructive of craniofacial suture in the three-dimensional finite element model of craniofacial complex in child, to analyse the response procedure of the zygomatic impact, to explore the biomechanics characteristic of the children craniofacial trauma. METHODS: A 7-year-old female was adopted for study The complex cranial geometry was measured from a series of two-dimensional CT images. The multi-lay spiral CT scans were transformed with a self-developed preprocessor into a finite element mesh. The craniofacial sutures were constructed through the MSC Patran program. Identical impact and boundary conditions were used for the zygomatic impact simulations. RESULTS: It has been shown that the finite element model (FEM) exhibited fine morphological and mechanical comparability. The higher stress was showed in the zygomatic regions and atlas occipital articular in 3d FEM. The maximum von Mises stress was found at the zygomatic regions and atlas occipital articular. CONCLUSION: The concentrations of shear stress and tension stress in the suture and articular would increase the risk of injury in this area. But the conduction of the stress might be weakening in the suture of child skull.

[Establishment of the database of female skull by the aesthetics].

OBJECTIVE: The three-dimensional (3D) craniofacial measurements were studied through the quantitative computed tomography (CT). The dynamic database of quantitative measurement of three-dimensional craniofacial bone was established as mandible in physiological position. METHODS: 170 aesthetics female were examined by spiral volumetric CT (GE SR-7000). 3D craniofacial bone images were reformatted and 3D measurements were performed in SUN Workstation respectively. 33 points were defined in the 3-d craniofacial structure in screen, 14 distances and 11 angles were measured, and 12 ratios were calculated in each case. All data were transferred into the database based on the SPSS software. There is all information of one case (such as number, sex, age, distances, angers) in one row; each column is a measurement item. The mean, standard deviation, standard error, medium, coefficient of variation and 95% confidence interval of data can be calculated and the correlation, regression between several groups of measurement item can be proceeded by computer automatically in the dynamic database. RESULTS: 3D craniofacial bone imagings were displayed in arbitrary views without disturbing superposition by using cutting, rotating and 3D measurement procedures. The large data volume provides more information of special relationship of skull base, zygomatic bone, maxilla, mandible and vertebra. The coefficient of variation of skull base is less than them of maxilla and mandible. The standard deviation of ratios is further smaller than the standard deviation of distances and angles. With stepwise regression, the equation is (Go - Go) Y = 0.578X1 + 0.754X2 + 0.228X3 - 0.579X4 - 14.672; (Tz- Tz) : Y = 0.775X1 + 0.161X2 + 0.348X3 + 0.201X4 + 27.730. CONCLUSIONS: The database offers reference of the studying of growth rule of craniofacial bone of aesthetics female. It will help improve diagnostic accuracy, staging of reconstruction, precision of corrective surgery, and follow-up patients.

Reconstruction of caprine mandibular segmental defect by tissue engineered bone reinforced by titanium reticulum.

OBJECTIVE: To investigate the feasibility of using natural poritos as scaffolds in bone tissue engineering (TE) and repair of caprine mandibular segmental defect with titanium reticulum reinforced. METHODS: Natural poritos with a pore of 190-230 microm in size and porosity of about 50percent-65percent was molded into the shape of granules 5 mm x 5 mm x 5 mm in size. Expanded autologous caprine marrow mesenchymal stem cells were induced by recombinant human morphogenetic protein-2 (rhBMP2) to improve osteoblastic phenotype. Then marrow derived osteoblasts were seeded into poritos in density of 4 x 10(7)/ml and incubated in vitro for 48 hours prior to implantation. Then osteoblastic cells/poritos complexes were implanted into mandibular defect and the defect was reinforced by titanium reticulum. Implantation of poritos alone acted as the control. Bone regeneration was assessed 4, 8, 16 weeks after implantation using roentgenographic analysis and histological observation was done after 16 weeks. RESULTS: New bone could be observed histologically on the surface and in the pores of natural coral in all specimens in the cell-seeding group, whereas in the control group there was no evidence of osteogenesis process in the center of the construction. The results showed that new bone grafts were successfully restored 16 weeks after implantation. CONCLUSIONS: This study suggests the feasibility of using porous coral as scaffold material transplanted with marrow derived osteoblasts by TE method. By means of titanium reticulum reinforcement, mandibular defect could be successfully restored. It shows the potentiality of using this method for the reconstruction of bone defect in clinic.