Despite the evolution in cancer management and the introduction of multidisciplinary treatment modalities, 5-year overall survival rate of oral cancer remained to be 45-50%. Retrospectively, one patient's prognosis, relapse pattern and survival were determined by clinicopathological parameters. Nevertheless, radical resection with adequate safe margins is crucial for local control in treatment strategy for oral cancer. However, orthogonally muscle orientation of tongue with enriched neurovascular bundles and lymphatic network make it disadvantaged for progressive deep tumor invasion and regional metastasis. Tumor spread along the muscle fibers following the path of least resistance, this thereby reflected the shortcomings of conventional 1-2cm circumferential wide excision. Compartment resection is removal of entire primary lesion along with its entire potential spreading path with an advantage in removing the potential spreading path. Contrary, lymphatic drainage of tongue cancer is outstanding, there is overtly existence of lymphatic vessels and lingual lymph node which occult lymph node metastasis might easily being overshadowed. Routine neck dissection is disadvantaged for unable to reach. Nevertheless, compartmental surgery can overcome it by bringing lingual lymphatic system into surgical ifeld. Compartment resection is more appreciable than conventional 1-2cm wide resection in fuliflling oncological radicality criteria. In summary, we need to explore the characteristic pattern of tumor invasion and metastasis for other subtypes of oral cancer, thereby establishing a location orientated compartment resection, subsequently enhance the radicality of surgical management and strive to improve the survival rate.

Oral cancer is the most common form of malignant tumor in the head and neck. However, traditional systematized and individualized treatments cannot provide a full range of treatment strategies for patients. As such, multidisciplinary team (MDT) diagno-sis plays an important role in improving the survival and prognosis of patients. Compared with a traditional single disciplinary model, the MDT diagnosis model provides a high-quality comprehensive individualized treatment. The MDT diagnosis and treatment model al-so contributes to medical education and clinical research. Although this model has been established overseas, it is in the initial develop-mental stage in China;thus, appropriate guidelines have yet to be designed. Therefore, MDT diagnosis and treatment model focusing on oral should be promoted and standardized.

Bone Transplantation ; Dental Implants ; Humans ; Mandibular Reconstruction ; Surgical Flaps

Objective To investigate the score changes of graduates majoring in clinical medicine after using the method of “role of identification”. Methods Sixty students who were undertaking internship in Endocrinology Department of Shanghai Traditional Chinese Medicine Hospital received three-week clinical teaching and examination. Then they got into one-week “role of identification”, and were appointed as clinical teachers to teach what they have learned during the last 3 weeks to the next batch of interns and make another examination. Scores of the two examinations were compared. Results Scores of the examination after received the method in“role of identification”improved significantly (P<0.01). Conclusion The method of“role of identification”can enhance clinical medicine graduates’ mastery of professional knowledge.

Objective To report our experience in the embolization of the high-flow vascular lesion in the head and neck by direct percutaneous puncture. Methods Eleven cases of high-flow vascular lesion in the head and neck (8 cases of central hemangioma of the jaws and 3 cases of juvenile nasopharyngeal angiofibroma) were included in this study group. The patients of central hemangioma of the jaws were embolized with coils by a 14-gauge needle, and the fibered coils were placed directly into the center of the intraosseous AVM. The patients of juvenile nasopharyngeal angiofibroma were embolized with NBCA by a No.7 needle. The procedure was under the guidance of DSA machine (Philips V3000). Results The acute arterial bleeding in patients with central hemangioma of the jaws from the extraction of the tooth was controllable, and the pericoronal oozing of bleed disappeared in the 9-24 months follow-up. The juvenile nasopharyngeal angiofibromas were resected without blood transfusion after the embolization. Conclusion The embolization of the high-flow vascular lesion in the head and neck by direct percutaneous puncture was effective and safe, however the longer follow-up was expected.

Oral and maxillofacial microsurgery has its own characteristics, including high precision, complicated operation, and long learning curve. It is important for young oral and maxillofacial surgeons to master the basic operation skills through standardized and systematic training.Department of Oral & Maxillofacial-Head & Neck Oncology of Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine gives systemic teaching course for senior resident doctors or young attending surgeons. The teaching teams make an intensive course organization and focus on the practical training. They integrat theoretical teaching, basic skill training, gross anatomy training as well as operation observation into a systematic "four-stage ladder approach" , which make a better teaching effect in promoting the oral and maxillofacial surgeons to master the practical and correct microsurgery technique.

Oral and maxillofacial microsurgery has its own characteristics, including high precision, complicated operation, and long learning curve. It is important for young oral and maxillofacial surgeons to master the basic operation skills through standardized and systematic training.Department of Oral & Maxillofacial-Head & Neck Oncology of Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine gives systemic teaching course for senior resident doctors or young attending surgeons. The teaching teams make an intensive course organization and focus on the practical training. They integrat theoretical teaching, basic skill training, gross anatomy training as well as operation observation into a systematic "four-stage ladder approach" , which make a better teaching effect in promoting the oral and maxillofacial surgeons to master the practical and correct microsurgery technique.

Oral and maxillofacial microsurgery has its own characteristics, including high precision, complicated operation, and long learning curve. It is important for young oral and maxillofacial surgeons to master the basic operation skills through standardized and systematic training.Department of Oral & Maxillofacial-Head & Neck Oncology of Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine gives systemic teaching course for senior resident doctors or young attending surgeons. The teaching teams make an intensive course organization and focus on the practical training. They integrat theoretical teaching, basic skill training, gross anatomy training as well as operation observation into a systematic "four-stage ladder approach" , which make a better teaching effect in promoting the oral and maxillofacial surgeons to master the practical and correct microsurgery technique.

Oral and maxillofacial microsurgery has its own characteristics, including high precision, complicated operation, and long learning curve. It is important for young oral and maxillofacial surgeons to master the basic operation skills through standardized and systematic training.Department of Oral & Maxillofacial-Head & Neck Oncology of Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine gives systemic teaching course for senior resident doctors or young attending surgeons. The teaching teams make an intensive course organization and focus on the practical training. They integrat theoretical teaching, basic skill training, gross anatomy training as well as operation observation into a systematic "four-stage ladder approach" , which make a better teaching effect in promoting the oral and maxillofacial surgeons to master the practical and correct microsurgery technique.

Objective:To assess the effectiveness of free vascularized bone flap transfer for treatment of advanced osteoradionecrosis of the mandible (ORNM). Methods:We reviewed 53 patients who were treated for ORNM by radical resection and reconstruction with free vascularized bone flaps in our institute between January 2003 and January 2015. Results:Among the 53 vascularized bone flap patients, 48 (90.57%) had fibula osteocutaneous and 5 (9.43%) had deep circumflex iliac artery (DCIA). Postoperative complications occurred in 5 (10.42%) of the 48 fibula osteocutaneous patients (4 cases of vein thrombosis and 1 case of arterial crisis). In three of these patients, flap was salvaged back to normal in a timely manner by vascular exploratory surgery. However, pectoralis major myocutaneous flap was conducted as a second procedure for the other two patients. Meanwhile, complications occurred in 2 (40%) of the 5 DCIA transfer patients (1 case of vein thrombosis and 1 case of arterial crisis). None of these two flaps was salvaged back. Necrosis transfer bone was finally removed. No obvious donor site complications were noted. The mean follow-up time was 28 months. Our results showed that 88.57%of the patients with ORNM were stable, 85.71%of the patients can open their mouth at 2-3 figures, 85.72%of the patients can eat soft or semi-liquid food, and 80%patients can speak clearly and can be understood by others around them. No significant difference was found in mouth opening and face type of the patients with or without the intact condyle. However, the temporomandibular joint area discomfort of the patients with intact condyle was obviously less than that of patients with removed condyle. Conclusion:Radical resection, followed by vascularized bone flaps, especially fibula osteocutaneous, is still the best way to treat ORNM, as long as the indications are chosen appropriately, intraoperative work is conducted properly, and postoperative complications are controlled.