Variant of internal jugular vein reconstruction in bilateral radical neck dissection.

BACKGROUND: The internal jugular vein (IJV) plays a major role in collecting venous blood from the cranium, face, and neck. Preserving or reconstructing at least one IJV during bilateral radical neck dissection (RND) allows preventing severe complications. The aim of this report was to present a variant of IJV reconstruction in bilateral radical neck dissection. CASE SUMMARY: A 55-year-old male complained for a gingival mass for about 2 months, which was approximately 4 × 2 cm in size with a surface ulceration, located in the anterior mandibular area. There were bilateral cervical adenopathy. The computed tomography (CT) scan revealed mandibular bone destruction with surrounding soft tissue masse, multiple enlarged lymph nodes around bilateral submandibular space and bilateral carotid sheath, with obvious necrosis in the center. The preoperative diagnosis was mandibular gingiva squamous cell carcinoma (SCC), staged T4aN2bM0. Under general anesthesia, the patient underwent bilateral RND with sacrifice of right IJV and reconstruction of left IJV by anastomosis of IJV to the ipsilateral EJV using the common facial vein as a communicating way, followed by an expanded resection of mandibular gingiva SCC via marginal mandibulectomy, left anterolateral thigh (ALT) free flap reconstruction of the resulting defects, and tracheotomy. The patient's post-operative course was uneventfully. CONCLUSION: In our case report, the immediate IJV reconstruction by the W method was performed without compromising oncologic principles and was found feasible, safe and effective to prevent the occurrence of severe postoperative complications related to bilateral RND with sacrifice of both IJV.

Diagnosis and Treatment of an Unusual Maxillary Gingiva Malignant Melanoma Arising Around Dental Implant.

BACKGROUND: Oral mucosal malignant melanoma (OMMM) arises from malignant melanocytes, and the most affected age, sex, and site are 20 to 83 years, male, and the mucosa of hard palate and maxillary gingiva, respectively. Despite several cases of OMMM have been published in the literature, cases of malignant melanoma arising around the dental implant are rarely reported. CASE SUMMARY: A 59-year-old male was admitted to our Department with the complain of gingival black pigmentations following dental implant treatment for 3 years. Intraoral examination revealed a painless black lobulated mass around maxillary gingiva and alveolar fossa of dental implant (first molar). CBCT revealed bone destruction around the implant. Positron emission tomography/computed tomography confirmed the presence of tumoral lesion, which was diagnosed as right maxillary gingiva malignant melanoma (T4aN0M0). Partial maxillectomy+buccal fat pad transfer+free tissue patch repair were carried out. Pathologic analyses confirmed the diagnosis of malignant melanoma. The postoperative course was uneventfully, the patient is undergoing follow-up without any evidence of recurrence. CONCLUSION: Our report showed that an ill-fitting dental implant may cause OMMM. Excisional biopsy with sufficient surgical margins allows complete removal and final diagnosis of OMMM. Early diagnosis and treatment are recommended.

Endoscopic Neck Dissection and Intraoral Approach for Oral Cancer and Free Flap Reconstruction.

This study aimed to report our experience about endoscopic neck dissection through a post-auricular hairline incision, followed by intraoral resection of oral cancer and free flap reconstruction. Laryngoscope, 2024.

Review of Hard Palate Lipoma and Retrospective Clinicopathological Analysis of Patients With Oral Lipomas.

Lipomas occurring in the hard palate are extremely rare, and treating lipomas in this area presents challenges due to the thinness of soft tissue and the risk of postoperative bony surface exposure. We present a case of hard palate lipoma that was successfully removed using the partial thickness flap dissection technique. In addition, we reviewed the clinicopathological features of 20 reported cases of hard palate lipomas worldwide and retrospectively analyzed the clinical characteristics and pathological types of 68 oral lipomas in China. The use of a partial thickness flap demonstrates potential effectiveness in excising benign masses located in the hard palate. Regarding 68 patients with oral lipomas, the most commonly affected sites were the buccal region, tongue, and floor of the mouth. Histologically, simple lipomas and fibrolipomas were the predominant types observed.

Application of Oral Retractor for Lip Injury Protection in Oral and Maxillofacial Surgeries: A Randomized Controlled Trial.

PURPOSE: Iatrogenic lip injury may occur during oral and maxillofacial surgical procedures. This study aimed to evaluate the effect of oral retractors on iatrogenic lip injury prevention during intraoral procedures of oral and maxillofacial surgery. METHODS: We conducted a randomized controlled trial and included patients who underwent intraoral procedures of oral and maxillofacial surgery. Patients were randomly allocated to receive oral retractor (intervention group) or traditional procedure without lip protection (control group). The incidence of lip injury was the outcome variable. Other study variables included surgical time and satisfaction of patients and surgeons with treatment experience evaluated by visual analog scale (VAS). Student t test and χ 2 test were used to compare both groups' variables and measure the relationship between the predictor variable and the outcome variable. P <0.05 was considered significant for all analyses. RESULTS: A total of 114 patients were included, with 56 allocated to intervention group and 58 to control group. The results showed that the application of an oral retractor did not significantly increase surgical time ( P =0.318). A total of 12 patients had lip injury, with 1 in the intervention group and 11 in the control group ( P =0.003). For the assessment of satisfaction with treatment experience, the intervention group had significantly higher VAS scores for doctors and patients ( P <0.05). CONCLUSIONS: We found that the oral retractor was a good tool for iatrogenic lip injury prevention in oral and maxillofacial surgical procedures and could be considered in clinical treatment.

Reconstruction of Extensive Maxillary Defects Using Flow-Through Fibula Free Flap With Anterolateral Thigh Free Flap.

BACKGROUND: The maxillary defects left unreconstructed or inadequately reconstructed often result in significant functional and esthetic impairments. Adequate reconstruction of extensive maxillary defects requires a sufficient volume of hard and soft tissues. METHODS: A 48-year-old male presenting bilateral extensive maxillary defects underwent secondary reconstruction with a flow-through fibula free flap in combination with an anterolateral thigh free flap. RESULTS: The use of flow-through technique allowed minimizing the problem of limited recipient vessels and the length of free flap vascular pedicle usually encountered in secondary reconstruction. The bilateral maxillary defects were successfully reconstructed, and the postoperative outcomes were uneventful. The patient was satisfied with the treatment outcomes. He is being followed up and was referred to the implantology department for the placement of osseointegrated dental implants. CONCLUSIONS: The flow-through fibula free flap, in combination with the anterolateral thigh free flap, was found reliable and feasible for this case of secondary reconstruction of bilateral maxillary defects. This technique has provided satisfactory functional and esthetic outcomes and effectively improved the patient's self-esteem.

Prelamination of Anterolateral Thigh Osseocutaneous Flap With Fibula for the Reconstruction of Zygomatic Arch Defects After Facial Trauma.

Complex facial trauma usually results in significant physical, esthetical, functional, and psychological damage. Nowadays, tissue flap transfer is the most effective and common treatment for the reconstruction of facial defects. Among them, the prelaminated flap has a bigger role in reconstructing massive facial defects. In this report, the authors have described a case of a 48-year-old man who presented a complex defect of tissue and deformity in the oral and maxillofacial region because of traffic accident trauma. Given the complexity of this case, it was impossible to complete the reconstruction in a single operation. The authors used a vascularized fibula-free flap (VFFF) to reconstruct the right mandible during the first operation and implanted a segment of fibula into the subcutaneous tissue of the right anterolateral thigh, which was used during the second operation for the reconstruction of zygomatic arch. This individualized treatment plan achieved a final satisfactory surgical outcome.

Glycolysis-Related Gene Analyses Indicate That DEPDC1 Promotes the Malignant Progression of Oral Squamous Cell Carcinoma via the WNT/ß-Catenin Signaling Pathway.

Increasing evidence suggests that aerobic glycolysis is related to the progression of oral squamous cell carcinoma (OSCC). Hence, we focused on glycolysis-related gene sets to screen for potential therapeutic targets for OSCC. The expression profiles of OSCC samples and normal controls were obtained from The Cancer Genome Atlas (TCGA). Then, the differentially expressed gene sets were selected from the official GSEA website following extraction of the differentially expressed core genes (DECGs). Subsequently, we tried to build a risk model on the basis of DECGs to predict the prognosis of OSCC patients via Cox regression analysis. Furthermore, crucial glycolysis-related genes were selected to explore their biological roles in OSCC. Two active glycolysis-related pathways were acquired and 66 DECGs were identified. Univariate Cox regression analysis showed that six genes, including HMMR, STC2, DDIT4, DEPDC1, SLC16A3, and AURKA, might be potential prognostic factors. Subsequently, a risk formula consisting of DEPDC1, DDIT4, and SLC16A3 was established on basis of the six molecules. Furthermore, DEPDC1 was proven to be related to advanced stage cancer and lymph node metastasis. Moreover, functional experiments suggested that DEPDC1 promoted the aerobic glycolysis, migration, and invasion of OSCC via the WNT/ß-catenin pathway. The risk score according to glycolysis-related gene expression might be an independent prognostic factor in OSCC. In addition, DEPDC1 was identified as playing a carcinogenic role in OSCC progression, suggesting that DEPDC1 might be a novel biomarker and therapeutic target for OSCC.