Humans ; Mouth ; surgery ; Pharynx ; surgery ; Robotic Surgical Procedures ; Skull Base Neoplasms ; surgery

OBJECTIVETo investigate the risk factor for metastasis in Level IV of ipsilateral neck in tongue cancer patients.

METHODSA total of 248 tongue caner paitents (255 necks) that underwent radical neck dissection was enrolled in the study. Chi-square test and Logistic regression analysis were used to determine the factors associated with metastasis in Level IV. The variable included age, sex, growth type, T stage, histopathological grade, Level III involvement, number of positive lymph nodes in Levels I-III.

RESULTSOut of 147 cases (152 necks) with positive lymph node, 21 necks (8.2%, 21/255) had Level III involvement, and 2 necks (0.8%, 2/255) developed skip metastasis. Chi-square test showed that age (P = 0.020), Level III involvement (P = 0.000), number of positive Level (≥ 2 Levels) in Levels I-III (P = 0.006), and number of positive lymph node (≥ 3 nodes) in Levels I-III (P = 0.000) were identified as independent risk factor. Logistic regression analysis revealed that only Level III involvement (P = 0.003) was the risk factor for metastasis in Level IV.

CONCLUSIONSIn tongue cancer patients, Level III involvement was a high risk factor for metastasis in Level IV.

Age Factors ; Carcinoma, Squamous Cell ; Chi-Square Distribution ; Female ; Humans ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; Male ; Neck ; Neck Dissection ; Regression Analysis ; Risk Factors ; Sex Factors ; Tongue Neoplasms ; pathology

OBJECTIVETo evaluate the application of computer-aided design and navigation technology in skull base and infratemporal fossa tumor surgery and to analyze its advantages and disadvantages.

METHODSTwenty-nine cases with tumor of skull base and infratemporal fossa were treated with computer-aided design and navigation surgery. The Parameters of age, gender, primary or recurrent tumor, tumor nature and surgical approach were recorded.

RESULTSEn bloc resection was performed in 20 cases and subtotal resection in 9 cases. The margin status was negative margin in 8 cases, near-tumor margin in 17 cases and positive resection margin in 4 cases. Postoperative complication rate was 14% (4/29). During the follow-up period, 2 benign cases recurred.In the malignant group, there were 7 cases of recurrence, 2 cases of metastasis and 3 deaths. The 5-year overall survival and progression-free survival rate were 69% and 40% respectively.

CONCLUSIONSNavigation technology can enhance the confidence of the surgeons and operation safety in handling malignant tumors in skull base and infratemporal fossa.

Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Computer-Aided Design ; Cranial Fossa, Middle ; diagnostic imaging ; pathology ; surgery ; Female ; Follow-Up Studies ; Humans ; Imaging, Three-Dimensional ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Postoperative Complications ; Skull Base ; diagnostic imaging ; pathology ; surgery ; Skull Base Neoplasms ; diagnostic imaging ; pathology ; surgery ; Tomography, X-Ray Computed ; Treatment Outcome ; Young Adult

OBJECTIVETo retrospectively analyze the data of the patients with Bisphosphonate-related osteonecrosis of the jaw over the past five years in our hospital.

METHODSTwenty-four patients with bisphosphonate-related osteonecrosis of the jaw treated in our hospital from 2009 to 2013 were included. The medication, bisphosphonate types, clinical signs and symptom, treatment methods and results were also analyzed.

RESULTSOf the 24 cases, 20 cases suffered from malignant tumors and received intravenous infusion of bisphosphonates and 4 cases took oral bisphosphonates. Three of the 4 cases with osteoporosis had history of glucocorticoid (rheumatoid arthritis). All patients had oral clinical symptoms for an average of 11.6 months, and 19 patients had the history of tooth extraction. There were 11 cases with mandible involved, 10 cases with maxilla involved, and 3 cases with both mandible and maxilla involved. After conservative treatment (3 cases) or operation (21 cases), 10 cases had wound healing, 6 cases were stable with bone exposure, and 4 cases with died bone needed reoperation. During the follow-up period, there was one patient died of primary disease (renal carcinoma).

CONCLUSIONSBoth intravenous and oral application routes of bisphosphonates can induce osteonecrosis of the jaw. Bisphosphonate-related osteonecrosis of the jaw can be caused by alveolar trauma. The treatment modality is to relieve the clinical symptoms of bisphosphonate-related osteonecrosis of the jaw.

Bisphosphonate-Associated Osteonecrosis of the Jaw ; complications ; pathology ; therapy ; Bone Density Conservation Agents ; Diphosphonates ; Glucocorticoids ; Humans ; Mandible ; Maxilla ; Osteoporosis ; Retrospective Studies ; Tooth Extraction ; Wound Healing

OBJECTIVETo establish a three- dimensional virtual deformable mandible model used for individual reconstruction design of large mandibular defect.

METHODSA virtual deformable mandible model has been established by a 3D animation software. The model could be used for preoperative reconstruction design of large mandibular defects cases. According to the temporomandibular joint fossa position, maxillary dental arch, the normal relationship of cranio-maxillofacial profile, and the morphology of the residual segments of mandible, the virtual mandible model could be scaled and adjusted and a virtual mandible with individual features was obtained. Three normal skulls have been used to validate the adjustment ability of the virtual deformable mandible model. The preoperative reconstruction design process of 1 typical large mandibular defect case was demonstrated.

RESULTSThe deformation matching ability of the virtual deformable mandible model was very good. The registration between the design model and the original mandible was over 90%. The design effect of the large mandiblar defect case was satisfied.

CONCLUSIONSVirtual deformable mandible model is a new feasible method to aid preoperative reconstruction design of large mandibular defects.

Computer-Aided Design ; Humans ; Image Processing, Computer-Assisted ; Imaging, Three-Dimensional ; Mandible ; anatomy & histology ; surgery ; Models, Anatomic ; Reconstructive Surgical Procedures ; Software ; Temporomandibular Joint ; User-Computer Interface