Objective:To explore an improved osteotomy of mandible ascending ramus for the surgical approach to large tumors in parapharyngeal space.Methods:According to the operation of parotid gland, masseter muscle was cut near the border of mandibular angle till subperiosteum dissection to mandibular notch, vertical osteotomy outside mandibular foramen to 1.0 cm under mandibular notch, vertical to posterior border of ascending ramus, tumor was exposed and removed, bone plate was repositioned and fixed with titanium. Results:Tumors were completely removed in this way in 3 patients without complications. Conclusion:This surgical approach is suitable for the surgical removal of parapharyngeal interstitial giantism tumor.

Objective: To compare the pedicled supraclavicular artery island flap (SCAIF) and the pectoralis major myocutaneous flap (PMMF) for oral reconstruction after cancer resection. Methods: This is a retrospective study from May 2007 to May 2017. Sixty-one patients from the Jiangxi University of Traditional Chinese Medicine and the First Affiliated Hospital of Nanchang University, were included. All the patients underwent oral squamous cell carcinoma resection and pedicled flap reconstruction. Sixteen patients were performed SCAIFs (group A), and 45 were performed PMMFs (group B). The flap survival rate, flap size, flap preparation time, the presence of scar hyperplasia, pigmentation and dysfunction (temporary or permanent) were compared between these two groups. Results: The survival rate of flaps in group A was 93.75% (15/16), and the survival rate of flaps in group B was 95.56% (43/45). There was no statistically significant difference in the survival rate of flaps, the average skin flap size or flap produce time between these 2 groups. There were no scar hyperplasia, pigmentation and dysfunction was observed in group A. However, scar hyperplasia (n=11), pigmentation (n=10) and dysfunction (n=12) occurred in group B. The difference was statistically significant (P<0.05). Conclusions This study suggests that SCAIF is more reliable, and brings more satisfied outcome, when compared with the PMMF.