Oral submucous fibrosis transforming into squamous cell carcinoma: a prospective study over 31 years in mainland China.

OBJECTIVE: Oral submucous fibrosis (OSF) is an oral mucous disease caused by betel quid chewing. It is controversial whether OSF can transform into oral squamous cell carcinoma (OSCC). MATERIALS AND METHODS: In this prospective study, a group of 567 patients with OSF were enrolled from 1986 to 2017 and followed-up until 2019. The cancerous information was collected and analyzed. RESULTS: OSF transformed into OSCC in 32 cases (32/567, 5.6%). The patient's age ranged from 20 to 69 years, and the average age was 52 years. The time taken for transformation ranged from 2 to 24 years, the average being 8.6 years. The cancerous transformation occurred in 18 patients (56%) from years 2 to 9, in 13 patients (41%) from years 10-19 and in 1 patient (3%) from 24 years. We analyzed the betel quid chewing habits and found all 32 patients with OSCC-chewed betel quid. Betel quid chewing was most prevalent in patients aged 40-69 years. Sixteen patients had chewed betel quid for 10-19 years (16/32, 50%) and 19 patients (60%) chewed 10-19 slices each day. The OSCC was located in the left or right buccal regions in 23 patients (23/32; 72%) and in the left or right lingual regions in 4 patients (4/32; 12%). Well, moderately and poorly differentiated squamous cell carcinoma was present in 23 patients (23/32; 72%), 4 patients (3/32; 9%), and 5 patients (5/32; 16%), respectively. CONCLUSION: Our findings supported that OSF is a real oral premalignant disorder. CLINICAL RELEVANCE: The long duration of the transformation from the OSF to OSCC suggests more frequent examinations and corresponding treatments are necessary for OSF patients.

Linc01234 promotes cell proliferation and metastasis in oral squamous cell carcinoma via miR-433/PAK4 axis.

BACKGROUND: Increasing studies have demonstrated that long non-coding RNAs (lncRNAs) play an important role in tumor progression. However, the potential biological functions and clinical importance of Linc01234 in oral squamous cell carcinoma (OSCC) remain unclear. METHODS: We evaluated the expression profile and prognostic value of Linc01234 in OSCC tissues by RT-qPCR. Then, functional in vitro experiments were performed to investigate the effects of Linc01234 on tumor growth, migration and invasion in OSCC. Mechanistically, RT-qPCR, bioinformatic analysis and dual luciferase reporter assays were performed to identify a competitive endogenous RNA (ceRNA) mechanism involving Linc01234, miR-433-3p and PAK4. RESULTS: We found that Linc01234 was clearly upregulated in OSCC tissues and cell lines, and its level was positively associated with T stage, lymph node metastasis, differentiation and poor prognosis of patients with OSCC. Our results shown that Linc01234 inhibited cell proliferation and metastatic abilities in CAL27 and SCC25 cells following its knockdown. Mechanistic analysis indicated that Linc01234 may act as a ceRNA (competing endogenous RNA) of miR-433-3p to relieve the repressive effect of miR-433-3p on its target PAK4. CONCLUSIONS: Our results indicated that Linc01234 promotes OSCC progression through the Linc01234/miR-433/PAK4 axis and might be a potential therapeutic target for OSCC.

Application of a chimeric ALT perforator flap with vastus lateralis muscle mass in the reconstruction of the defects after radical resection of a buccal carcinoma: A retrospective clinical study.

BACKGROUND AND OBJECTIVES: Aggressive resection of buccal cancer simultaneously leaves both oral and lateral facial defects. It is unknown whether a perforator-based chimeric anterolateral thigh (ALT) flap, with a muscular component, is suitable for the reconstruction of these complicated defects. METHODS: In this retrospective study, 48 patients with a buccal carcinoma (T2 N0-1 M0), who underwent extensive surgical resection, were enrolled. Twenty-seven cases underwent reconstruction using the classical ALT perforator flap (classical group), and 21 cases used the chimeric ALT perforator flap with vastus lateralis muscle mass (chimeric group). The incidence of wound infection, lower limb extremity function, facial appearance, survival curves, and quality of life were compared between groups. RESULTS: The incidence of wound infection or effusion was lower in the chimeric group than in the classical group. The aesthetic result achieved in the chimeric group was better than in the classical group. Meanwhile, there was no significant difference in the function of the donor site between groups. CONCLUSIONS: The chimeric ALT perforator flap, with a muscular component, can reconstruct both the oral and lateral face defects accurately. It sustains the profile of the lateral face and decreases the incidence of wound infection.

Application of chimerical ALT perforator flap with vastus lateralis muscle mass for the reconstruction of oral and submandibular defects after radical resection of tongue carcinoma: a retrospective cohort study.

BACKGROUND: Patients with tongue carcinoma who undergo combined tongue and neck radical resection often have simultaneous oral and submandibular defects. Due to its high flexibility, the anterolateral thigh (ALT) perforator flap is gradually being adopted by surgeons for oral reconstruction. However, the tissue volume of perforator flaps is insufficient for the reconstruction of both the oral and submandibular regions. In this retrospective cohort study, we compared the postoperative outcomes and complications between patients reconstructed with using the classical ALT perforator flap and patients reconstructed using the chimeric ALT perforator flap with vastus lateralis muscle mass. METHODS: From August 2017 to August 2019, 25 patients underwent reconstructive therapy using a classical ALT perforator flap (classical group), while 26 patients were reconstructed with the chimeric ALT perforator flap (chimeric group) after radical resection of tongue cancer in Xiangya Hospital, Central South University. The flap survival rate, incidence of submandibular infection, lateral appearance, lower extremity function, and quality of life were compared between the two groups. RESULTS: There were no differences in flap survival rate and postoperative lower extremity function between the two groups. The incidence of submandibular infection was 15.4 and 40% in the chimeric and classical group, respectively. The duration of recovery was 12.20 ± 2.69 and 15.67 ± 4.09 days in the chimeric and classical group, respectively. The submandibular region fullness was satisfactory in the chimeric group. The postoperative quality of life in the chimeric group was better than that in the classical group (P < 0.05). CONCLUSIONS: The chimerical ALT perforator flap with muscle mass reconstructs both the oral and submandibular defects accurately. It maintains the profile and fullness of the submandibular region and may reduce the incidence of submandibular infection.

Functional Mandibular Reconstruction With Double-Barrel Fibular Flap and Primary Osseointegrated Dental Implants Improve Facial Esthetic Outcome.

PURPOSE: Osseointegrated dental implants in fibular free flaps can be used to reconstruct segmental mandibular defects resulting from head and neck resections. The double-barrel fibular flap (DBFF) has been applied as a modified method to overcome insufficient fibular width. This article describes the use of the DBFF with simultaneous dental implant placement as a superior method for esthetic mandibular reconstruction. MATERIALS AND METHODS: From 2012 to 2015, 26 patients underwent mandibular reconstruction with a free fibular flap and immediate dental implant placement after segmental mandibulectomies. Twelve patients received the DBFF and the other 14 patients received the conventional single-barrel fibular flap (SBFF). Palatal mucosal grafting was performed when necessary. Functional and esthetic outcomes were evaluated after 31 to 45 months of follow-up. RESULTS: All microvascular fibula transplantations were successful. All patients completed prosthodontic rehabilitation. The mean follow-up of patients after reconstruction was 36.3 months (range, 31 to 45 months). The facial esthetic score was significantly higher in patients treated with the DBFF than with the SBFF after 24 and 30 months (P < .05). There was no significant difference in marginal bone resorption between the DBFF and SBFF groups (P > .05). CONCLUSIONS: This 1-stage surgical method is safe and reliable. Use of the DBFF markedly decreased the height discrepancy between the native and new mandible and achieved a better lower face esthetic outcome than the SBFF. Osseointegrated dental implantation was adequate to achieve satisfactory dental rehabilitation in the DBFF group.

[Efficacy for combined injection of salvizanolic acid B with triamcinolone acetonide on the treatment of the soft palate with oral submucous fibrosis].

OBJECTIVE: To evaluate therapeutic effect of combined injection of salvizanolic acid B with triamcinolone acetonide on the treatment of the soft palate with oral submucous fibrosis.
 Methods: Salvizanolic acid B combined with triamcinolone acetonide was consecutively applied once a week for 30 weeks for 33 patients with middle and later periods of oral submucous fibrosis. The response rate of color change in the soft palate and the increase of capillary vessels (determined by degree I-IV visual analog scale) were evaluated at the 12th, 24th, and 36th months after 30 weeks treatment.
 Results: Thirty-three patients were fulfilled the study without obvious adverse reactions and they were followed up for 24 months, while 31 patients were followed up for 36 months. The color change in the soft palatal mucus and the increase of capillary vessels at the 36th month follow-up after treatment were significantly better than those at the 12th month (P=0.004).
 Conclusion: Combined injection of salvizanolic acid B with triamcinolone acetonide in the treatment of the soft palate with oral submucous fibrosis is effective.

Application of Combined Osteotomy and Reconstruction Pre-Bent Plate Position (CORPPP) Technology to Assist in the Precise Reconstruction of Segmental Mandibular Defects.

PURPOSE: To introduce and evaluate the clinical effects of digital surgical guide plate technology in the combined osteotomy and reconstruction pre-bent plate position (CORPPP) technique during mandibular segmental resections. MATERIALS AND METHODS: Seven cases of mandibular segmental resection with simultaneous vascularized free fibula flap reconstruction by oral and maxillofacial surgery were selected (Xiangya Hospital, Changsha, China; June 2015 through December 2015). Cone-beam computed tomographic (CBCT) and spiral CT scans of mandibles and fibular donor sites, respectively, were collected. Surgical simulations were conducted after data collection. Pre-bent titanium plates were placed within the predicted mandibular models. The samples were scanned by CBCT to obtain the positional relations. Then, CORPPP surgical guide plates with location holes were designed and fabricated on pre-bent titanium plates. The CORPPP surgical guide plates were applied in osteotomy and the placement of pre-bent titanium plates during surgery. CBCT scans were obtained 2 weeks after surgery to examine the reconstructed composite models composed of mandibles and titanium plates. Then, the scans were compared with the preoperatively designed models. In addition, the deviation of the integral and characteristic structure loci was analyzed. RESULT: The 7 cases with placed pre-bent titanium plates exhibited good recovery in occlusal relations and the contour of the reconstructed mandibles. The absolute deviations in the integral analysis were 0.89 ± 0.96 mm (mandibles) and 0.33 ± 0.36 mm (titanium plates). The absolute deviations on the diseased side were 1.78 ± 0.35 mm (condylar head), 2.43 ± 0.29 mm (gonion), 2.22 ± 0.22 mm (gnathion), and 2.66 ± 0.36 mm (mesial inferior margin of the fibula). CONCLUSION: The results of this study suggest that mandibular segmental resections and the precise orientation of pre-bent titanium plates could be simultaneously assisted by CORPPP digital surgical guide plates. The use of these guide plates should be expanded.

[Isolation and gene screening for collagen phagocytic subpopulation of fibroblasts and non-collagen phagocytic subpopulation of fibroblasts].

OBJECTIVE: To isolate the collagen phagocytic subpopulation of fibroblast (CPSF) and non-collagen phagocytic subpopulation of fibroblast (nCPSF) and to identify their differentially expressed genes.
 METHODS: The CPSF and nCPSF was isolated by using collagen-fluorescein-isothiocynate-latex bead (COL-FITC-LB) phagocytosis technique and FCM sorting method. Microarray analysis was used to screen the differentially expressed genes, which were verified by real-time PCR. 
 RESULTS: CPSF and nCPSF was successfully isolated. Seventeen differentially expressed genes were identified. Compared with nCPSF, the expression of 12 or 5 genes was up-regulated or down-regulated in CPSF. Three of the 12 up-regulated genes were urokinase plasminogen activator receptor-associated protein (uPARAP), cytochrome b-245, beta polypeptide (CYBB) and Hook homolog 1 (HOOK1), which were confirmed by real-time PCR. uPARAP mRNA expression level in CPSF was 2788 times of that in nCPSF. CYBB mRNA expression in CPSF was only 0.85 times of that in nCPSF. HOOK1 mRNA expression in CPSF was 1.96 times of that in nCPSF (P<0.05). 
 CONCLUSION: A novel method is successfully established to isolate CPSF and nCPSF. uPARAP is the main differentially expressed gene in CPSF and nCPSF, which is obviously involved in the fibroblast collagen phagocytosis. It might be a potential biomarker for treatment of collagen diseases.

[Changes of miRNA after oral submucous fibrosis co-cultured with Salvia and low-dose prednisolone].

OBJECTIVE: To explore and analyze the the expression change of miRNA associated with oral submucous fibrosis (OSF) treated by the Salvia combined with law-dose prednisolone. METHODS: Ten pairs of tissues from patients with typical early or advanced stage clinical pathological features of OSF and their paired normal tissues (internal control), were selected respectively. The miRNA expression profiles between the OSF and its paired controls were compared by the Affymetrix analysis. The primary normal oral mucous cells were cultured in arecoline (50 µg/mL) for 3, 6, 12 d (0 d ser ved as cont rol), and the primary OSF-fibroblast cells were cultured with Salvia (90 mg/mL) combined with low-dose prednisolone for 12, 24, 36 h (0 h served as control). The differential expression of miRNA was detected. RESULTS: Arecoline induced the expression changes of miRNAs in normal mucosal cells. Salvia combined with low doses of prednisolone reversed the related miRNA expression. CONCLUSION: MiRNAs play an essential role in the occurrence and development of OSF. Salvia combined with low-dose prednisolone can reverse the expression of related miRNAs in OSF cells.

Cys-X-Cys ligand 9 might be an immunological factor in the pathogenesis of oral submucous fibrosis and its concomitant oral lichenoid lesion.

OBJECTIVES: Oral submucous fibrosis (OSF) is a chronic oral precancerous disease primarily caused by betel quid chewing. Some OSF patients are concomitant with oral lichenoid lesion (OLL), a white-streak lesion with a higher risk for cancerization, in OSF mucosa. Immunological reaction has been considered as one of their common pathogenic mechanisms. Cys-X-Cys ligand 9 (CXCL9) is an important factor to recruit effector neutrophils and lymphocytes in immunological reactions. However, the expression levels of CXCL9 in OSF and OLL remain unclear. MATERIALS AND METHODS: We investigated the expression levels of CXCL9 in 10 normal buccal mucosa (NBM) samples and 56 OSF concomitant with OLL patients, and evaluated the possible mechanism of CXCL9 on their pathogenesis. RESULTS: Our results showed NBM demonstrated negative CXCL9 expression. OSF stained positive CXCL9 mainly in the cytoplasm of inflammatory cells and endothelial cells throughout the superficial layer of connective tissue, while its concomitant OLL showed much stronger CXCL9 in all mononuclear cells of subepithelial inflammatory infiltration (p = 0.0006). There was an upregulated trend of CXCL9 expression from NBM to OSF to OLL. However, no significant association between CXCL9 expression and clinicopathologic parameters of patients was found. CONCLUSIONS: In conclusion, CXCL9 was found for the first time to contribute to the immunological pathogenesis for both OSF and its concomitant OLL, indicating a continuously enhanced intensity of immunoreactivity in their pathogenic process. CLINICAL RELEVANCE: CXCL9 might be a useful tool to monitor the phase and disease severity of OSF and OLL, and a potential target for further clinical therapy for both lesions.

Tripaddled anterolateral thigh flap for simultaneous reconstruction of bilateral buccal defects after buccal cancer ablation and severe oral submucous fibrosis release: a case report.

For buccal squamous cell carcinoma (SCC) patients accompanied with severe oral submucous fibrosis (OSF), it is a challenge to simultaneously reconstruct bilateral buccal defects created from cancer resection and contralateral OSF release to improve postoperative mouth opening. Herein, we present a case of reconstruction of bilateral buccal defects in a 46-year-old patient who had left buccal SCC accompanied with severe OSF. Extensive ablation involved the left full-thickness cheek as well as part of mandible and a release of right OSF tissue were performed. A tripaddled anterolateral thigh (ALT) flap with three independent sets of perforators was harvested for reconstruction. The flap survived in its entirety. No donor or recipient site complication occurred. The preoperative inter-incisor distance (IID) was 1 mm, while the postoperative IID was 23 mm. This is the first report on the use of one tripaddled ALT flap for reconstruction of bilateral buccal defects created from cancer ablation and severe contralateral OSF release.

[Soluble major histocompatibility complex class I-related chain A in sera of patients with oral squamous cell carcinoma].

OBJECTIVE: To examine the expression of soluble major histocompatibility complex class I-related chain A (sMICA) in the serum in patients with oral squamous cell carcinoma (OSCC) and to explore its clinicopathological significance. METHODS: Seventy-eight OSCC patients were selected as an experiment group, and 19 healthy persons as a control group. The sMICA in the serum in the experiment group and the control group was detected by enzyme-linked immunosorbent assay. RESULTS: The detection rate of sMICA in the serum in the experiment group was 98.7% (77/78), with the 95% confidence interval 74.30-93.95 pg/mL and the median 82.17 pg/mL, The detection rate in the control group was 94.7% (18/19), with the 95% confidence interval 29.48-50.30 pg/mL and the median 37.54 pg/mL. The sMICA in the serum in the experiment group was higher than that in the control group (P<0.01). There was statistic difference in the serum sMICA in the experiment group among the different clinicopathological parameters such as tumor size, disease stage and regional lymph node status (P<0.05), but no difference was found in gender, age, and tumor differentiation (P>0.05). CONCLUSION: The sMICA in the serum in the OSCC patients increases, and is related with the tumor size, disease stage and regional lymph node status. Determination of sMICA in the serum may provide useful information to evaluate the immune state of OSCC patients.

Silencing of LncRNA SNHG16 Downregulates Cyclin D1 (CCND1) to Abrogate Malignant Phenotypes in Oral Squamous Cell Carcinoma (OSCC) Through Upregulating miR-17-5p.

BACKGROUND: Targeting the long non-coding RNAs (LncRNAs)-microRNAs (miRNAs)-mRNA competing endogenous RNA (ceRNA) networks has been proved as an effective strategy to treat multiple cancers, including oral squamous cell carcinoma (OSCC). Based on this, the present study identified a novel LncRNA SNHG16/miR-17-5p/CCND1 signaling pathway that played an important role in regulating the pathogenesis of OSCC. METHODS: The expression levels of cancer-associated genes were examined by Real-Time qPCR and Western Blot at transcriptional and translated levels, respectively. CCK-8 assay was performed to determine cell proliferation, and cell apoptosis ratio was measured by the Annexin V-FITC/PI double staining assay. Transwell assay was performed to examine cell migration, and dual-luciferase reporter gene system assay was used to validate the ceRNA networks. RESULTS: LncRNA SNHG16 and CCND1 were upregulated, while miR-17-5p was downregulated in OSCC tissues and cell lines, compared to their normal counterparts. Also, miR-17-5p negatively correlated with both LncRNA SNHG16 and CCND1 mRNA, but LncRNA SNHG16 was positively relevant to CCND1 mRNA in OSCC tissues. By performing the gain- and loss-of-function experiments, we noticed that LncRNA SNHG16 overexpression aggravated the malignant phenotypes, such as cell proliferation, viability, migration and epithelial-mesenchymal transition (EMT) in OSCC cells, while LncRNA SNHG16 knock-down had opposite effects. Furthermore, our dual-luciferase reporter gene system evidenced that LncRNA SNHG16 sponged miR-17-5p to upregulate CCND1 in OSCC cells, and the inhibiting effects of LncRNA SNHG16 ablation on OSCC progression were abrogated by both downregulating miR-17-5p and overexpressing CCND1. Finally, the xenograft tumor-bearing mice models were established, and our data validated that LncRNA SNHG16 served as an oncogene to promote tumorigenicity of OSCC cells in vivo. CONCLUSION: Taken together, targeting the LncRNA SNHG16/miR-17-5p/CCND1 axis hindered the development of OSCC, and this study provided potential diagnostic and therapeutic biomarkers for OSCC in clinic.

Investigation of anthropometric measurements of anatomic structures of orbital soft tissue in 102 young han chinese adults.

PURPOSE: The aim is to measure and investigate the anatomic structures of orbital soft tissue and the relationships between the adjacent regions in 102 normal young Han Chinese adults using a computer-assisted photography system to provide reference data for periocular cosmetic and reconstructive surgery. METHODS: A random sample of 102 Han young Chinese adults (53 males and 49 females) aged from 18 to 25 years in Changsha, Hunan Province, was obtained. Standard digital images were taken and then processed using Image-Pro Plus 6.0 software. The linear and angular measurements, including intercanthal distance, outer canthal distance, palpebral fissure width (PFW), palpebral fissure height (PFH), orbit height (OH), upper lid height, lower lid height, nasal eyebrow height, central eyebrow height, temporal eyebrow height, reference line to lateral canthus'inclination of palpebral fissure, were measured. The proportional indices, including intercanthal distance/outer canthal distance, PFH/PFW, PFH/OH, OH/PFW, upper lid height/OH, lower lid height/OH, nasal eyebrow height/OH, central eyebrow height/OH, and temporal eyebrow height/OH, were investigated. RESULTS: Means and standard deviations of all the items had been obtained and differences between male and female subjects were assessed. CONCLUSIONS: The normal measurement values of anatomic structures of orbital soft tissue and the proportional indices for normal young Han Chinese adults provided reference data for periorbital cosmetic and reconstructive surgery.

Development of the research on the application of chlorotoxin in imaging diagnostics and targeted therapies for tumors.

Precisely locating tumors always proves to be difficult. To find a molecule that can specifically bind to tumor cells is the key. Recently, chlorotoxin (CTX) has been proved to be able to bind to many kinds of tumor cells. The CTX receptor on the cell surface has been demonstrated to be matrix metalloproteinase-2 (MMP-2). Many researchers have combined CTX with other molecules, including 131I, Cy5.5, iron oxide nanoparticles coated by polyethylene glycol (NP-PEG), and so on, and thus synthesized various types of probes that can be detected by gamma-camera, single photon emission computed tomography (SPECT) or magnetic resonance imaging (MRI). With these methods, the binding degree of CTX could be assessed. These studies demonstrated that CTX has a highly specific binding ability, high stability, and security. CTX could also inhibit or kill the tumor cells. A nonviral nanovector has been developed for gene therapy. As a result, it gradually develops into a new method of diagnosis and targeted therapy of tumors. This article reviews the current progress on CTX including the origin, chemical construction, the mechanism of binding with tumor cells, and the application to tumor imaging diagnosis and therapy.

Strategy for Correction of the Whistling Deformity in Secondary Cleft Lip Reconstruction.

BACKGROUND: Following primary repair of a cleft lip, patients present with many facial deformities. One of the commonly observed sequelae of cleft lip repair is a whistling deformity. This retrospective study was carried out to evaluate the outcomes following correction of whistling deformities in secondary cleft lip reconstruction. METHODS: We retrospectively reviewed the hospital records of patients with various whistling deformities who underwent repair from April 1989 to March 2018; 2 surgeons performed the repair using either the double movable mucomuscular complex flaps technique, modified Abbe flap technique, or Abbe flap technique. The postoperative anatomical structure and aesthetic effects of the surgery were evaluated. RESULTS: In total, 136 patients were included in this study. Among these patients, 60 (44.2%) had a grade I whistling deformity and 47 (34.5%) had a grade II deformity and repair was performed using the double movable mucomuscular complex flaps technique and modified Abbe flap transfer technique, respectively, whereas the Abbe flap transfer technique was used in 16 patients (11.8%) and 13 patients (9.5%) with a grade III and grade IV whistling deformity, respectively. All patients were found to have normal postoperative anatomical structures and aesthetic effects of the upper lip, with all patients experiencing mild to moderate postoperative edema of the upper lip, and 29 cases (21.3%) developed an inconspicuous scar. CONCLUSION: The repair technique should be chosen based on the type of whistling deformity.

[Influence of mandibulotomy approaches on oral function following radical resection of tongue carcinoma].

OBJECTIVE: This study aimed to compare the influences of postoperative oral function in patients with median or paramedian mandibulotomy during the radical resection of tongue carcinoma and to provide evidence for the choice of osteotomy location for mandibulotomy. METHODS: The clinical data of 126 patients who underwent combined radical neck dissection with mandibulectomy and glossectomy followed by simultaneous reconstruction were analyzed retrospectively. The patients were divided into two groups according to the position of mandibulotomy: median mandibulotomy group (median group, n=60) and paramedian mandibulotomy group (paramedian group, n=66). The fourth edition of the University of Washington Quality of Life Questionnaire (UW-QOL) was used to compare the differences in oral functions, such as swallowing, mastication, and speech, between the two groups during regular follow-up. SPSS 24.0 software package was used for statistical analysis, and P<0.05 was considered statistically significant. RESULTS: Six months after the operation, no significant differences in swallowing, mastication, and speech functions were found between the median and paramedian groups. However, the swallowing and speech functions in the paramedian group were better than those in the median group 1 year after the operation (P<0.05), whereas no statistical difference in mastication function was observed between the two groups. CONCLUSIONS: Evaluation of the postoperative oral function results showed that paramedian mandibulotomy was a better surgical approach than median mandibulotomy. Paramedian mandibulotomy is worth prioritizing in the radical resection of tongue carcinoma.

Anthropometric measurement and analysis of the external nasal soft tissue in 119 young Han Chinese adults.

A random sample of 119 young, healthy Han Chinese adults (56 men and 63 women) between the age of 18 and 25 years (mean, 22.7 y) in PR China was obtained for this study. By the guidance of standard methods, based on Farkas's anthropometric measurements in craniofacial region, 12 nasal soft tissue landmarks and 12 linear and 3 angular measurements were chosen. The linear measurements were taken directly, whereas the angular measurements were taken by photogrammetric method. Eight nasal proportion indices were calculated according to the linear measurements. The application of the independent-samples t-test showed sex dimorphism in most parameters of the nasal region. All the linear measurements were larger in men than in women, whereas all the angular measurements were smaller in men than in women. The significant differences in partial parameters between men and women have been proved. Ten of 12 linear measurements, 1 of 3 angular measurements, and 3 of 8 nasal proportion indices showed significant sexual dimorphism (P < 0.01). Compared with other racial/ethnic groups, the nasal anthropometric measurements and proportion indices of Han Chinese adults were different, to some extent. This study could provide credible and objective reference material for plastic and maxillofacial surgeons for the external nasal soft tissue evaluation and planning of the cosmetic nasal surgery. Besides, these results could be a useful guidance for preoperative and postoperative evaluations of secondary rhinoplasty in nasal deformity associated with cleft lip and palate.

[Biomechanical study on 3-dimensional finite element model of maxillary protraction and the palate expansion].

OBJECTIVE: To determine the rule of simulated protraction and palate expansion on shift of maxillary bone,and to supply the scientific data for treating maxilla in patients with cleft lip and palate. METHODS: Based on the establishment of 3-dimensional finite element model of maxilla with cleft lip and palate, we used ANSYS 10.0 software to simulate protraction and expand fissures of palate, and analyzed the changes of maxillary shift. RESULTS: After the simulated protraction and pa-late expansion,an upward, forward, and outward growth occurred on maxilla, and the normal lateral bow had no internal shrinkage as well as the abnormal one. CONCLUSION: Combined palate expansion with maxillary protraction treatment in patients with cleft lip and palate tend to improve the development of maxillary bone.

[Biomechanical study on 3-dimensional finite element model of simulated maxillary protraction after maxillary fissure repair].

OBJECTIVE: To determine the effect of simulated protraction after maxillary fissure repair on stress and shift of maxillary bone and to provide the scientific evidence for treatment of maxilla in patients with cleft lip and palate. METHODS: Based on the establishment of 3-dimensional finite element model of maxilla with cleft lip and palate, we used ANSYS 10.0 software to simulate protraction, repair fissures of maxillary bone, and then analyzed the change of maxillary stress and shift. RESULTS: The maxillary fissures could be enlarged by protraction without reparation of maxillary. Obvious motion was observed on the uninjured side, with 500 g/per lateral protraction and 30 degree protraction angle. The major principal stress and von Mises stress of craniofacial bone distributed evenly under protraction after fissure repair. CONCLUSION: The maxillary fissures have an enlarged trend by protraction without repair.The protraction treatment benefits the development of maxillary bone after repairing maxillary fissure.