Objective:To summarize the experience of reconstruction of mandibular defects with vascularized fibular osteocutaneous flap.Methods:Segmental mandibular resection and immediate reconstruction with vascularized fibular osteocutaneous flap were performed in 8 patients with tumor.The fibula flaps were cut into 2-4 segments and bent to the contour of the mandibles,and they were fixed precisely by the titanium plate.The skin flaps were used for reconstruction of soft tissue defects or as observation windows of the blood circulation.Results:In all 8 patients,transplanted vascularized fibular osteocutaneous flaps survived well,and restoration of mandibular contour and function was satisfactory. Conclusion:The fibular osteocutaneous flap can be cut into segments and shaped according to location and contour of mandibular defect.Vascularized fibular osteocutaneous flap may be an ideal selection for the reconstruction of mandibular defect.

Objective: To evaluaate the effect of pingyangmycin(PYM ) in the treatment of cavernous hemangioma, strawberry hemangioma and mixed hemangioma in the oro-maxillo-facial region. Methods:The medical records of 520 patients with hemangioma in oro-maxillo-facial region between January 1994 and January 2000 were reviewed. Pingyangmycin(

Objectives:The effects of pingyangmycin(PYM) in the treatment of cavernous hemangioma, strawberry hemangioma and mixed hemangioma in the oromaxillofacial and intraoral regions is evaluated.　Methods:450 cases of hemangioma in the oromaxillofacial regions from January 1993 to January 1999 were reviewed. PYM was injected into the cavity or in the circumference of the hemangioma, and the injection may be repeated every 7～10 days for 3～5 times.　Results:450 patients were followed-up for 6 months～6 years. 86.89% were cured and nearlly cured,and 12% were improved. The total efficiency rate was 98.86%. The cure and elementary cure rates of cavernous hemangioma, strawberry hemangioma and mixed hemangioma were 91.04%, 86.08% and 78.01%, respectively, but the elementary cure rate of the wine color stainscapillary hemangioma was 14.29% only.　Conclusions:This method may be a safe, simple and effective therapy for cavernous hemangioma, strawberry hemangioma and mixed hemangioma in the oromaxillofacial regions.

Objectives:To evaluate the efficiency of packing jaw defects with a composite of coral and bone marrow.　Methods:Twelve patients (9 with jaw cyst and 3 with ameloblastoma) underwent enucleation of jaw lesion and packing with a composite of coral and bone marrow.Repair of the bone defects was evaluated at 1 week,1,6 and 12 months postoperatively by clinical examination and X-ray films.　Results:Wound healing after the operations on 10 patients was uneventful,and definite ossification around the implanted material could be detected at 1 month postoperatively.A lot of bone formation and partial resorption of coral were observed at 6 months postoperatively.Complete resorption of coral and complete bone repair were obtained at 12 months postoperatively.Wound breakdown was observed on two other patients,and the composite had to be removed completely.　Conclusions:A composite of coral and bone marrow may enhances bone healing in jaw defects after cyst or ameloblastoma removal.

Objectives: To study the histopathological grading and the clinical-staging system on the surgical prognosis in patients with mucoepidermoid carcinoma(MEC) of the salivary glands. 　Methods: Analysis were made to the primary sites, clinical findings and the correlation between the histopathological-grading/clinical-staging system and the surgical prognosis in 43 patients with pathological evidence of MEC. 　Results: Recurrence or regional lymph node metastasis were diagnosed in 6 of the 36 MEC patients, among which 4 were well differentiated and 2 were poorly differentiated, 1 was in stage Ⅰ to Ⅱ, and 5 were in the stage of Ⅲ or Ⅳ, there were 23 survivors. Thirteen of the 36 patients died, 4 of whom from MEC and 9 from reasons not related to MEC. All the died were in stage Ⅲ or Ⅳ. 　Conclusions: Recurrence or metastasis of MEC correlates with clinical-staging, but not related to the histopathological grading, this suggested that ablative surgery of the primary tumor and dissection of the regional lymphatic system are required in cases of Ⅲ and Ⅳstage MEC. Postoperative irradiation is proposed in the event of inadequate resection.

Objective Parotidectomy and superficial parotidectomy are traditional surgical treatment to the malignant parotid gland tumour although they have many defects.The aim of this study was to analyze the feasibility of individualized treatment to patient according to tumor`s size and TNM stage. Methods Thirty three patients with low grade malignant parotid gland tumours from Dec 2005 to Dec 2010 were recruited in the present study.All the patients received the territorial surgical resection firstly.Then, 9 cases re-ceived the expanded territorial surgical resection (1 case had recurrent probability, accepted adjuvant radiotherapy).Sixteen cases un-derwent parotidectomy with complete tumor resection ( 2 case had envelope invasion, accepted adjuvant radiotherapy) .Eight cases ac-cepted adjuvant radiotherapy(4 cases on T1 and T2 stage preserved facial nerve although the nerves adhering to tumors, and other 4 ca-ses on T4a stage accepted facial nerve excision ) . Results Follow up ranged from 3.5 to 8.5 years and no recurrences were docu-mented.9 patients who accepted territorial surgical resection showed fine facial symmetry.8 cases of them without adjuvant radiotherapy had good salivary secretion.Nine cases of other 24 patients showed temporary facial nerve injury and recovered within 1 to 4 months. Four cases with facial nerve excision showed permanental facial paralysis. Conclusion To protect the function of parotid gland to the greatest extent, the small low grade malignant parotid gland tumors without facial nerve invasion could have territorial surgical resection. Combined territorial surgical resection with postoperative adjuvant radiation therapy is useful to avoid the tumors recurrence and en-croachment of facial nerve to protect the facial nerve function.

Objective:To explore the effect of damage control surgery on polytraumatism with severe oral maxillo-facial trauma.Methods: We retrospectively analyzed 32 cases of polytraumatism with severe oral maxillo-facial trauma treated by damage control surgery.Results: The principles of damage control surgery were successfully applied to the treatment.Of the 32 cases,31 survived,with their polytraumatism sequentially managed,and only 1 died.Conclusion: Damage control surgery helps to raise the success rate in the treatment of polytraumatism with severe oral maxillo-facial trauma.

By combining coral with recombinant human bone morphogenetic protein-2 (rhBMP-2), rhBMP-2/coral composite was obtained in this study. Following implantation of the composite into the muscle pouches of mice, cartilage growth was induced in the pores or on the surface of the implants at one week, woven bone at three week and lamellar bone with bone marrow at six week, and coral was absorbed partially. The induced formation of endochondral bone was time-related and rhBMP-2 dose-related. The results of this study indicate that the composite possesses a superior ability of osteogenesis, and coral acts as one of the most suitable rhBMP-2 slowrelease carriers currently available. The composite will be a new type of bone substitute to be used in orthopaedics and maxillofacial surgery.