Evaluation of Vermillion Symmetry and Scar Quality in Unilateral Cleft Lip Repair Using Modified Millard's Technique Versus Fisher's Technique.

BACKGROUND: Since the primary goal of cleft lip repair is to achieve a symmetrical, aesthetic lip, several surgical techniques have been utilized. Accordingly, in this study, a unilateral cleft lip was surgically repaired using two techniques: modified Millard's and Fisher's techniques. PURPOSE: This study was designed to compare the vermillion symmetry and scar quality in the surgical management of patients with unilateral incomplete cleft lip using the modified Millard's and Fisher's techniques. STUDY DESIGN, SETTING, AND SAMPLE: We conducted a prospective randomized controlled clinical study. The study involved 20 patients selected from the Department of Plastic Pediatric Surgery at the Specialized Pediatric Hospital, Faculty of Medicine, Cairo University. The patients included in the study were aged between 2 and 6 months old, had a primary nonsyndromic unilateral incomplete cleft lip, and had no other associated anomalies. PREDICTOR VARIABLE: The predictor variable was operative management of the cleft lip, and subjects were randomly assigned to either the modified Millard or Fisher techniques. MAIN OUTCOME VARIABLES: The primary outcome, vermillion symmetry, was evaluated by computerized photogrammetric lip analysis with Image J software. Additionally, scar quality, considered a secondary outcome, was assessed with the Vancouver Scar Scale and the Image J software. Every measurement was meticulously recorded in millimeters. COVARIATES: Age, sex, and cleft side were considered. ANALYSES: Descriptive and analytic statistics were computed. Statistical significance was set at P < .05. RESULTS: The study comprised 20 children (12 males and 8 females), with a mean age of 140.5 ± 23.7 days in the Fisher's group and 137.4 ± 25.6 days in the modified Millard's group (P = .8). No statistically significant differences (P = .6) were found in vermillion height and width between both groups at 1 week, 3 months, and 6 months. Similarly, there were no statistically significant differences (P = .4) between both groups in terms of scar length and width at the 3- and 6-month follow-up periods. CONCLUSION AND RELEVANCE: This study found no statistically significant differences in vermillion symmetry and scar quality between the two cleft lip repair techniques. Notably, one patient in the modified Millard group exhibited a notch on the vermillion border, which was not statistically significant.

Balancing Risks versus Benefits: Vitamin C Therapy versus Copper Oxide Nanoparticles Toxicity in Albino Rats' Submandibular Salivary Gland.

OBJECTIVES: This study aimed to examine the suppressive effect of the natural antioxidant vitamin C (VC) against submandibular gland toxicity induced by copper oxide nanoparticles (CuO-NPs). MATERIALS AND METHODS: Three groups of 30 mature male albino rats (4 weeks old) weighing between 150 and 200 g were selected. The rats were randomly assigned for 6 weeks to receive: intraperitoneal injection (IP) of vehicle (control group); IP of 2.5 mg/kg body weight (bw) of CuO-NPs (CuO-NPs group); and IP of 2.5 mg/kg bw of CuO-NPs, combined with a daily oral dose of 100 mg/kg bw of VC in drinking water via gavage (CuO-NPs/VC group). The rats were euthanized, and their submandibular glands were dissected for histological evaluation, including hematoxylin and eosin staining and immunohistochemistry for Ki-67 and caspase-3. STATISTICAL ANALYSIS: The area expression for Ki-67 and caspase-3 was statistically analyzed using GraphPad Prism. Following analysis of variance analysis, Tukey's post hoc was used for multiple comparisons. The significance level was set at p < 0.05. RESULTS: CuO-NPs caused significant cytotoxic effects on submandibular salivary gland cells in albino rats. This led to an increase in Ki-67 and caspase-3 levels compared with the control group. VC administration improved tissue histology and reduced Ki-67 and caspase-3 levels in the VC/CuO-NPs group compared with rats treated with CuO-NPs alone. CONCLUSION: The study revealed significant cytotoxic effects of CuO-NPs on the submandibular salivary gland of albino rats. VC effectively mitigated these toxic effects, suggesting its potential as a readily available antioxidant.

Virtual Surgical Guidance Improves Quality of Life Following Scapular Free-Flap Reconstruction of Maxillary Defects.

BACKGROUND: The best approach to maxillary reconstruction with negative impact on the patient's quality of life (QOL) remains the subject of debate. PURPOSE: This study was designed to evaluate the QOL outcomes following maxillary reconstruction using a scapular-free flap, with and without the computer-aided design and computer-aided manufacturing (CAD/CAM) technique. STUDY DESIGN, SETTING, SAMPLE: A prospective randomized controlled clinical trial was performed following the CONSORT checklist. To be included, patients suffering from maxillary defects without previous surgery or lymph node involvement were selected. Patients with poor oncological prognosis, deficient performance status, preoperative chemotherapy, or radiotherapy, besides vascular contraindications, were excluded. PREDICTOR VARIABLE: The predictor variable was the reconstruction technique, grouped into two equal categories. Patients were randomly assigned to reconstruction with a scapular-free flap, with the control group not utilizing a guide and the study group utilizing a CAD/CAM-customized guide. MAIN OUTCOME VARIABLE: The primary outcome variable was the various domains of QOL, measured using the University of Washington Quality of Life score, 12 months after reconstruction. COVARIATES: Age; sex; scapular flap side; and maxillary defect tumour type, histopathology, side, length, class, sagittal, and axial differential areas were considered. ANALYSES: Shapiro-Wilk and Kolmogorov-Smirnov tests were performed for normality. For comparisons between the two groups, Student's t-test and Mann-Whitney test were used. The category variables were compared using the χ2 test. P ≤ .05 was considered statistically significant. RESULTS: The sample was composed of twenty-two eligible patients, eleven in each group. The mean age of the control group was (50.09 ± 17.14) years, and 45.45% were male, while in the study group, the mean age was (48.36 ± 14.14) years, with 36.36% male. All the patients were evaluated, showing statistically significant differences between control and study groups in terms of pain, appearance, chewing, swallowing, speech, and shoulder (P ≤ .05), indicating that the scapular-free flap with a CAD/CAM osteotomy guide had improved the patient's QOL. CONCLUSION AND RELEVANCE: The findings of this study indicate that virtual surgical planning with a CAD/CAM customized osteotomy guide using a scapular-free flap can improve QOL in maxillary reconstruction in terms of pain, appearance, chewing and swallowing food, pronouncing words, and shoulder QOL outcomes.

MALAT1 as a potential salivary biomarker in oral squamous cell carcinoma through targeting miRNA-124.

OBJECTIVES: To determine the diagnostic accuracy of the long non-coding RNA "MALAT1" measured in the saliva of patients with oral squamous cell carcinoma (OSCC) and assess the salivary expression of microRNA-124, which MALAT1 targets. SUBJECTS AND METHODS: Forty subjects were collected in a consecutive pattern and allocated into two groups. Group A included 20 patients with OSCC, while Group B included 20 healthy subjects. Salivary expression of MALAT1 and microRNA (miRNA)-124 was evaluated in the two study groups using quantitative real-time polymerase chain reaction and correlated with histopathological examination of OSCC subjects. RESULTS: OSCC yielded a statistically significant higher expression of MALAT1 than healthy controls and a lower expression of miRNA-124 in OSCC than controls. There is a statistically significant inverse relationship between salivary MALAT1 and miRNA-124. Moreover, there is a statistically significant difference in the MALAT1 expression in saliva samples from metastatic cases compared with non-metastatic cases, as well as in patients with lymph node involvement compared with those without involvement. At a cut-off value of 2.24, salivary MALAT1 exhibited 95% sensitivity and 90% specificity in differentiating OSCC from healthy subjects. CONCLUSION: Salivary MALAT1 acts as a sponge for miRNA-124 and could be a potential salivary biomarker for OSCC.

Oral carcinoma cuniculatum: an unacquainted entity with diagnostic challenges-a case report.

BACKGROUND: Oral carcinoma cuniculatum (OCC) is an unacquainted well-differentiated subtype of oral squamous cell carcinoma, which displays unique clinic-pathological features. Up to date, OCC remains rare with about 75 reported cases, and is frequently missed or even misdiagnosed. CASE PRESENTATION: The aim of the present work was: to report a case of OCC in mandibular gingiva and to highlight its main clinic-pathological diagnostic features: with an exophytic cobble-stone surface and a characteristic endophytic burrowing architecture, as well as to differentiate between it and other closely similar lesions including verrucous carcinoma, papillary squamous cell carcinoma, and well-differentiated conventional oral squamous cell carcinoma. CONCLUSIONS: An accurate diagnosis of OCC entails awareness of the clinicians and pathologists about its entity, proper knowledge of the diagnostic clinical and histopathological evidence, and the ability to differentiate it from closely similar lesions.