The 10th Costal Cartilage Graft in Secondary Cleft Rhinoplasty-A Versatile Rib.

Autologous costal cartilage for rhinoplasty is an excellent graft material providing both volume and quality of cartilage required for nasal reconstruction. Commonly, the 5th, 6th, 7th, and 8th rib costal cartilages have been harvested but other ribs such as the 10th rib are often overlooked and yet offer an excellent graft option for columellar, alar rim, nasal tip, and dorsal augmentation grafts. The use of the 10th rib costal cartilage in patients with complex secondary cleft nasal deformity has scant reference in the literature. We demonstrate our simple and quick 10th rib cartilage harvesting technique and elicit its use in secondary rhinoplasty and cleft lip nasal deformities. The advantages of harvesting the 10th rib cartilage and our long-term results demonstrating ease of harvest, stability, and predicable outcomes are with several clinical cases. The senior author has used the 10th rib graft successfully in a variety of challenging secondary cleft rhinoplasty procedures with excellent and consistent outcomes. We advocate the use of the 10th rib graft in such procedures as it is easy to harvest, is a dynamic cartilage graft, and offers predictable results with low levels of complications.

Combined correction of the nasal tip and upper lip in bilateral cleft lip patients: A novel approach.

Secondary nasal deformity in bilateral cleft lip is one of the great surgical challenges. The problems are an under projected tip, an infra-tip lobule merging with the pro-labium and a short columella. Upper lip vermillion border deformity is a further significant problem. We demonstrate our novel approach to management by classifying patients into 3 groups depending on the status of important features such as the anatomy of the prolabial skin island, length of columella and upper lip width and fullness. We demonstrate that cleft patients with nasal deformity and poor upper lip aesthetics can be managed with a single operation.

Phenotypic plasticity and epithelial-to-mesenchymal transition in the behaviour and therapeutic response of oral squamous cell carcinoma.

It is increasingly recognised that phenotypic plasticity, apparently driven by epigenetic mechanisms, plays a key role in tumour behaviour and markedly influences the important processes of therapeutic survival and metastasis. An important source of plasticity in malignancy is epithelial-to-mesenchymal transition (EMT), a common epigenetically controlled event that results in transition of malignant cells between different phenotypic states that confer motility and enhance survival. In this review, we discuss the importance of phenotypic plasticity and its contribution to cellular heterogeneity in oral squamous cell carcinoma with emphasis on aspects of drug resistance and EMT.

Publish or perish? A survey of abstracts accepted for meetings of the British Association of Oral and Maxillofacial Surgeons, and subsequently published.

Publications are important for all surgeons, including those practising oral and maxillofacial surgery (OMFS). The results of relevant research are usually presented at the annual scientific meetings of the British Association of Oral and Maxillofacial Surgeons (BAOMS). The aim of this study was to find out how many abstracts that were accepted for presentation at the BAOMS go on to be published. Lists of abstracts accepted at BAOMS meetings 2002-2006 were obtained, and a thorough search was made for each article using the web-based search engine PubMed. Related publications were recorded. A total of 623 abstracts were accepted, of which only 147 (24%) resulted in peer-reviewed publication. Compared with clinical studies, scientific research was in the minority, but was more likely to appear in print and in journals with higher impact factors. Units with senior academic input had better records of publication. Currently only a small fraction of studies deemed worthy of presentation at the BAOMS become publications. This conversion from presentation to print is facilitated by strong academic support. Exposing trainees in OMFS training posts to basic research training might improve their ability to publish.