Effect of Prophylactic Placement of Percutaneous Endoscopic Gastrostomy on the Surgical Prognosis in Patients With Oral Cancer: A Pilot Study.

This study assessed the application of prophylactic percutaneous endoscopic gastrostomy (pPEG) in patients with newly diagnosed oral cancer (OC) who underwent surgery and were ready for subsequential chemoradiation. In total, 113 patients who underwent OC surgical treatment were divided into pPEG (n = 26), nasogastric tube (n = 54), and oral feeding (n = 33) groups. Their baseline characteristics, surgery-related outcomes, and nutritional data were analyzed using the Wilcoxon rank-sum test and χ2 test. No statistical significance was shown among the 3 groups using different flaps for reconstructing OC-related defects (P > 0.05). Patients of the pPEG group had the lowest incidence of surgical site infection (SSI; 23.1%, P = 0.006), but the longest hospital stay (24.1 ± 7.9 d, P < 0.001). Prophylactic percutaneous endoscopic gastrostomy may decrease the frequency of SSI but increase the length of hospitalization in SSI OC. However, multicentric prospective clinical controlled trials with large sample sizes are needed to further validate our findings.

Investigation of Morphologic Changes in Temporomandibular Joint With Anterior Disk Displacement Based on 3-Dimensional Reconstructive Imaging.

The objective of this study was to measure the association between the disk position and condylar alteration in patients diagnosed with anterior disk displacement (ADD) of temporomandibular joint (TMJ). A retrospective cross-sectional study was designed, dividing into 4 groups: normal articular disk position (NADP) of unilateral ADD patients (n=10), ADD with reduction (ADDwR, n=16), ADD without reduction (ADDwoR, n=24), and healthy volunteers (HV, n=30) based on magnetic resonance imaging and cone-beam computed tomography. After morphologic parameters were calculated from 3-dimensional reconstructive images, differences in parameters with respect to ADD status were tested with analysis of variance and Fisher least significant difference multiple comparisons were performed. Condylar volume of ADDwR, ADDwoR, NADP, and HVs were 1768.29±404.19, 1467.13±438.20, 1814.48±753.60, and 1914.66±476.48 mm, respectively, showing a significant downward trend from healthy disk to a displaced one ( P <0.05). Same trend also found in condylar superficial area, with the condylar superficial area of the ADDwR, ADDwoR, NADP, and HVs were 842.56±138.78 mm, 748.52±157.42 mm, 842.87±263.00 mm, and 892.73±164.19 mm, respectively. From NADP to ADDwR to ADDwoR, superior joint space (SJS) was declined, [SJS (NADP) (2.10±0.91 mm) > SJS (ADDwR) (1.85±0.61 mm) > SJS (ADDwoR) (1.50±0.50 mm), P =0.034]; medial joint space was significantly associated with the different disk displacement types ( P(HV-ADDwR) =0.001; P(HV-ADDwoR) =0.021; P(NADP-ADDwR) =0.022; P(ADDwR-ADDwoR) =0.001). Our findings suggest that condylar volume and superficial area, and superior and medial joint space, albeit with a small sample size, are significantly associated with different disk displacement types, detection of which might therefore be worth exploring for assessing ADD.

A retrospective analysis for the management of oromaxillofacial invasive mucormycosis and systematic literature review.

PURPOSE: Mucormycosis is a type of fatal infectious disease, rarely involved in the oromaxillofacial region. This study aimed to describe a series of 7 cases with oromaxillofacial mucormycosis and to discuss the epidemiology, clinical features, and treatment algorithm thereof. METHODOLOGY: Seven patients in the author's affiliation have been treated. They were assessed and presented as per their diagnostic criteria, surgical approach, and mortality rates. Reported cases of mucormycosis originally happened in craniomaxillofacial region were synthesized through a systematic review so as to better discuss its pathogenesis, epidemiology, and management. RESULTS: Six patients had a primary metabolic disorder, and one immunocompromised patient had a history of aplastic anemia. The criteria for a positive diagnosis of invasive mucormycosis were based on clinical presentation of signs and symptoms, and a biopsy for microbiological culture and histopathologic analysis. Each patient used antifungal drugs and five of them also underwent surgical resection at the same time. Four patients died due to the unregulated spread of mucormycosis, and one patient died owing to her main disease. CONCLUSIONS: Although uncommon in clinical practice setting, mucormycosis should be of great concern in oral and maxillofacial surgery, due to the life-threatening possibility of this disease. The knowledge of early diagnosis and prompt treatment is of utmost importance for saving lives.

Hydatid Cyst of the Oromaxillofacial Region - A Rare Location: A Case Report and Review of the Literature.

Oromaxillofacial hydatid cysts are rare, even in countries where echinococcosis is endemic. This study aimed to describe an isolated oromaxillofacial hydatid cyst and to discuss the epidemiology, clinical features, and treatment thereof. The authors report the case of a 12 year-old boy who presented with a 2-week history of an enlarging hydatid cyst in the parapharyngeal space extending to the neck, with no pulmonary or hepatic involvement. We present our clinical findings, diagnostic techniques, and treatment and review the relevant literature. Forty-one cases, with a male:female ratio of 1.21:1, have been reported, mostly in patients aged 20 to 40 years (both sexes). Oromaxillofacial hydatid cysts are most commonly located in the parotid gland (19.51%, n = 8), submandibular region including the submandibular gland (17.07%, n = 7), and infratemporal fossa (14.63%, n = 6). Only 2 (4.88%) cases of hydatid cysts in the parapharyngeal space have been reported before. Although isolated parapharyngeal space hydatid cysts are rare, oromaxillofacial surgeons should consider relevant diagnostic and therapeutic procedures to ensure complete resection.

Application of deep learning radiomics in oral squamous cell carcinoma-Extracting more information from medical images using advanced feature analysis.

OBJECTIVE: To conduct a systematic review with meta-analyses to assess the recent scientific literature addressing the application of deep learning radiomics in oral squamous cell carcinoma (OSCC). MATERIALS AND METHODS: Electronic and manual literature retrieval was performed using PubMed, Web of Science, EMbase, Ovid-MEDLINE, and IEEE databases from 2012 to 2023. The ROBINS-I tool was used for quality evaluation; random-effects model was used; and results were reported according to the PRISMA statement. RESULTS: A total of 26 studies involving 64,731 medical images were included in quantitative synthesis. The meta-analysis showed that, the pooled sensitivity and specificity were 0.88 (95 %CI: 0.87∼0.88) and 0.80 (95 %CI: 0.80∼0.81), respectively. Deeks' asymmetry test revealed there existed slight publication bias (P = 0.03). CONCLUSIONS: The advances in the application of radiomics combined with learning algorithm in OSCC were reviewed, including diagnosis and differential diagnosis of OSCC, efficacy assessment and prognosis prediction. The demerits of deep learning radiomics at the current stage and its future development direction aimed at medical imaging diagnosis were also summarized and analyzed at the end of the article.

Propranolol induces hemangioma endothelial cell apoptosis via a p53­BAX mediated pathway.

The use of propranolol for the treatment of infantile hemangioma (IH) has been widely investigated in recent years. However, the underlying therapeutic mechanism of propranolol for the treatment of IH remains poorly understood. The aim of the present study was to investigate the expression of proteins regulated by cellular tumor antigen p53 (p53) in associated apoptosis pathways in IH endothelial cells (HemECs) treated with propranolol. Furthermore, the present study aimed to investigate the exact apoptotic pathway underlying the therapeutic effect of propranolol against IH. In the present study, HemECs were subcultured and investigated using an inverted phase contrast microscope, immunocytochemical staining and a scanning electron microscope (SEM). Experimental groups and blank control groups were prepared. All groups were subjected to drug treatment. A high p53 expression model of HemECs was successfully established via transfection, and a low p53 expression model of HemECs was established using pifithrin­α. The apoptosis rate of each group was determined using Annexin V­fluorescein isothiocyanate/propidium iodide double staining and flow cytometry. The expression levels of downstream proteins regulated by p53 [tumour necrosis factor receptor superfamily member 6 (FAS), p53­induced death domain­containing protein (PIDD), death receptor 5 (DR5), BH3­interacting domain death agonist (BID), apoptosis regulator BAX (BAX), p53 unregulated modulator of apoptosis (PUMA), phosphatidylinositol­glycan biosynthesis class S protein (PIGS), and insulin­like growth factor­binding protein 3 (IGF­BP3)] were revealed in the experimental and control groups via western blotting. Microscopic observation revealed the growth of an adherent monolayer of cells, which were closely packed and exhibited contact inhibition. Immunocytochemical staining demonstrated increased expression of clotting factor VIII. SEM analysis revealed presence of Weibel­Palade bodies. The results of the analyses verified that the cultured cells were HemECs. The staining of the samples resulted in a significantly increased rate of apoptosis in experimental groups compared with the blank control group. This result suggested that there is an association between p53 expression and the rate of apoptosis of propranolol­treated HemECs. The results of the western blot analysis demonstrated an upregulation of BAX expression and a downregulation of IGF­BP3 expression in the HemECs treated with propranolol. There were no significant differences in the expression levels of FAS, DR5, PIDD, BID, PUMA and PIGS between experimental and control groups. This result suggests that p53 has an important role in HemEC apoptosis. The results of the present study additionally suggest that the propranolol­induced HemEC apoptosis pathway is a mitochondrial apoptosis pathway and is regulated by p53­BAX signaling.