Sequential treatment for a patient with hemifacial microsomia: 10 year-long term follow up.

Hemifacial microsomia (HFM) is the most common craniofacial anomaly after cleft lip and cleft palate; this deformity primarily involves the facial skeleton and ear, with either underdevelopment or absence of both components. In patients with HFM, the management of the asymmetries requires a series of treatment phases that focus on their interception and correction, such as distraction osteogenesis or functional appliance treatment during growth and presurgical orthodontic treatment followed by mandibular and maxillary surgery. Satisfactory results were obtained in a 9-year-old girl with HFM who was treated with distraction osteogenesis. At the age of 19, genioplasty and mandible body augmentation with a porous polyethylene implant (PPE, Medpor®, Porex) was sequentially performed for the functional and esthetic reconstruction of the face. We report a case of HFM with a review of the literature.

Skeletal stability and condylar position related to fixation method following mandibular setback with bilateral sagittal split ramus osteotomy.

PURPOSE: To investigate postoperative intersegmental displacement and relapse following bilateral sagittal split ramus osteotomy (BSSRO) by comparing three different fixation methods: group A (sliding plate), group B (miniplate) and group C (bicortical screws). MATERIALS AND METHODS: The present retrospective study included 55 patients with mandibular prognathism who were treated with BSSRO. To evaluate skeletal changes, cone-beam computed tomography was taken before surgery (T0), three days after surgery (T1), and 6 months after surgery (T2). Differences among the three groups were assessed using a one-way analysis of variance, where P < 0.05 was accepted as statistically significant. RESULTS: There were no significant differences among the three groups in demographic data and the amount of mandibular setback. In skeletal changes and condylar axis changes, there were no statistically significant differences among the three groups. However, there were statistically significant postoperative skeletal changes in group C (bicortical screws) at all landmarks. The mean horizontal relapse rate was 1.9% in group A (sliding plate); 4.8% in group B (miniplate); and 15.4% in group C (bicortical screws). CONCLUSION: The sliding plate system has good adaptability to the proximal segment after mandibular setback with BSSRO, and behaves according to semi-rigid fixation principles.

The impact factors on 5-year survival rate in patients operated with oral cancer.

OBJECTIVES: The purpose of this study is to analyze clinical impact factors on the survival rate, and to acquire basic clinical data for the diagnosis of oral cancer, for a determination of the treatment plan with long-term survival in oral cancer patients. MATERIALS AND METHODS: Through a retrospective review of the medical records, the factors for long-term survival rate were analyzed. Thirty-seven patients, among patient database with oral cancer treated in the Department of Oral and Maxillofacial Surgery at Pusan National University Hospital within a period from March 1998 to March 2008, were selected within the study criteria and were followed-up for more than 5 years. The analyzed factors were gender, age, drinking, smoking, primary tumor site, type of cancer, TNM stage, recurrence of affected region, and metastasis of cervical lymph node. The 5-year survival rate on the impact factors was calculated statistically using the Kaplan-Meier method. RESULTS: By classification of clinical TNM at the 1st visit, there were 11 (29.7%) cases for stage I, 11 (29.7%) cases for stage II, 3 (8.1%) cases for stage III, and 12 (32.5%) cases for stage IV. The 5-year survival rate of total oral cancer patients after the operation were 75.7%, pathological TNM stage related 5-year survival rate were as follows: stage I 90.0%, stage II 81.8%, stage III 100% and stage IV 45.5%; in which the survival rate difference by each stage was significantly observed. The recurrence of cervical lymph node was the significant impact factor for the survival rate, because only 30.0% the survival rate in recurrent cases existed. During the follow-up, there were 15 (40.5%) patients with confirmed recurrence, and the 5-year survival rate of these patients was decreased as 46.7%. CONCLUSION: The classification of clinical and pathological TNM stage, local recurrence after surgery, and metastasis of cervical lymph node after surgery were analyzed as the 3 most significant factors.