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 review our patients who underwent reconstruction of the defect after combined cranio-maxillo-facial resection in recent years.Methods From January,2005 to January,2011,88 patients underwent reconstruction of the defect after combined cranio-maxillo-facial resection.Different reconstructive techniques were used according to the defect classifications in dura,skull base bone,and facial tissues.For dural defects,no repair (37 cases),primary closure (25 cases),and dural repair (26 cases) were performed,respectively.Dural repair materials included thigh fascia lata (2 cases),temporalis fascia (2 cases),pericranium (1 case) and artificial dural patch (21 cases).Bone reconstruction of the skull base were performed in 61 patients with titanium mesh (57 cases),free iliac bone graft (1 case),free cranial bone graft (2 cases) and Medpor (1 case),respectively.Limited facial soft and hard tissue defects in 44 patients were reconstructed with temporalis system of flaps (36 cases),sternocleidomastoid myocutaneous flap (6 cases),and pterygoid muscle flap (2 cases),respectively.Extensive facial soft and hard tissue defects in 44 patients were reconstructed with free latissimus dorsi myocutaneous flap (26 cases),free pectoralis major myocutaneous flap (12 cases),free anterolateral thigh perforator flap (5 cases cases) and free anteromedial thigh perforator flap (1 case),respectively.Results The overall success rate of 88 flaps was 100％.Cerebrospinal fluid leak was found in 4 patients,wound infection was found in 2 patients,intracranial infection was found in 2 patients,respectively.Six patients with cerebrospinal fluid leak or wound infection were cured by conservative treatment.Two patients with intracranial infection were dead although they underwent salvage surgery.Overall rate of complications was 9.1％,dead rate was 2.3％.Conclusion Successful reconstruction of the defect after combined cranio-maxillo-facial resection can be achieved by watertight dural repair,bone reconstruction of the skull base and well-vascularized tissue covered.Regional flap and free tissue transfer are both preferred reconstructive technique depending on the anatomic site and the extent of the defect.