A 30-year-old female patient with a benign tumor in the superficial lobe of the left parotid gland underwent tumor resection via a 5 cm intra-hairline incision, using the da Vinci Xi surgical robot combined with the NIM-Response 3.0 facial nerve monitoring system. During the operation, facial nerve branches were located and protected through facial nerve monitoring, and the robotic arms were used for precise tumor dissection. Postoperatively, the facial nerve function, incision healing, and tumor recurrence were observed. duration of the procedure was 120 minutes, and the tumor（2.0 cm×1.5 cm） was completely resected. Postoperative pathological examination indicated a pleomorphic adenoma. During the 3-month postoperative follow-up, the patient's facial nerve function remained normal, no salivary fistula occurred, the incision was hidden within the hairline, no tumor recurrence was found in the ultrasound reexamination, and the patient was highly satisfied with the appearance. The surgical approach of robot-assisted resection of benign parotid gland tumor via a hairline incision under facial nerve monitoring has significant advantages in facial nerve protection and cosmetic effect, and is suitable for patients with benign parotid gland tumors meeting specific conditions.
Humans ; Female ; Adult ; Parotid Neoplasms/surgery* ; Facial Nerve ; Robotic Surgical Procedures/methods* ; Adenoma, Pleomorphic/surgery* ; Parotid Gland/surgery* ; Monitoring, Intraoperative

Humans ; Facial Nerve/surgery* ; Endolymphatic Sac/surgery* ; Cranial Sinuses ; Postoperative Complications ; Neoplasms

Objective: To explore the classification and reconstruction strategy of defects in lateral face region after operation of malignant tumors. Methods: Eighteen cases with the reconstruction of complicated defects after resection of tumors in the region of lateral face from January 2015 to January 2018 in Hunan Cancer Hospital were retrospectively reviewed. There were 14 males and 4 females, aged from 32 to 68 years. According to the presence or absence of bony scaffold, complicated defects were divided into two main categories: soft tissue perforating defects and soft tissue defects combined with bony scaffold defects. All soft tissue perforating defects in 5 cases were repaired with free anterolateral femoral flaps. Among 13 cases with soft tissue plus bony scaffold defects, 3 were repaired with free fibular flaps, 6 with free fibular flaps combined with free anterolateral femoral flaps, and 4 with chimeric deep circumflex iliac artery perforator flaps combined with anterolateral femoral flaps. Results: All flaps survived well. Two patients complicated with fistula in floor of mouth, but the wound healed after dressing change. Transoral feeding was resumed within 2 weeks after surgery in all patients. One year follow-up evaluation showed that 14 cases had symmetrical face and 10 cases had mouth opening more than 3 transverse fingers. After 36-50 months of follow-up, 6 patients died, with an overall 3-year survival rate of 66.7%. Conclusion: The classification of defects with or without bony stent loss is conducive to the overall repair design, the recovery of facial contour stent, the effective fill of dead space and the maintain of residual occlusal relationship. Good reconstruction results require a multi flap combination of osteocutaneous and soft tissue flaps.
Facial Neoplasms ; Female ; Free Tissue Flaps ; Humans ; Male ; Perforator Flap ; Reconstructive Surgical Procedures ; Retrospective Studies ; Skin Transplantation ; Soft Tissue Injuries/surgery* ; Thigh/surgery*

BACKGROUND: The impairment of the appearance is a major problem for patients with carcinomas of the oral cavity. These patients want to recover their preoperative facial appearance. Some do not realize that this is not always possible and hence develop a desire for further cosmetic and reconstructive surgery (CRS) which often causes psychological problems. METHOD: The desire of patients for CRS (N = 410; 26%) has been acquired in this DÖSAK rehab study including multiple reasons such as medical, functional, aesthetic and psychosocial aspects. They relate to the parameters of diagnosis, treatment and postoperative rehabilitation. Patients without the wish for CRS (N = 1155; 74%) served as control group. For the surgeons, knowledge of the patient’s views is relevant in the wish for CRS. Nevertheless, it has hardly been investigated for patients postoperatively to complete resection of oral cancer. In this retrospective cross-sectional study, questionnaires with 147 variables were completed during control appointments. Thirty-eight departments of Oral and Maxillofacial Surgery took part, and 1652 German patients at least 6 months after complete cancer resection answered the questions. Additionally, a physician’s questionnaire (N = 1489) was available. Statistical analysis was performed with SPSS vers. 22. RESULTS: The patient’s assessment of their appearance and scarring are the most important criteria resulting in wishes for CRS. Furthermore, functional limitations such as eating/swallowing, pain of the facial muscles, numb regions in the operating field, dealing with the social environment, return to work, tumour size and location, removal and reconstruction are closely related. CONCLUSION: The wish for CRS depends on diverse functional psychosocial and psychological parameters. Hence, it has to be issued during conversation to improve rehabilitation. A decision on the medical treatment can be of greater satisfaction if the surgeon knows the patients’ needs and is able to compare them with the medical capabilities. The informed consent between doctor and patient in regard to these findings is necessary.
Appointments and Schedules ; Cicatrix ; Cross-Sectional Studies ; Depression ; Diagnosis ; Facial Muscles ; Humans ; Informed Consent ; Methods ; Mouth Neoplasms ; Mouth* ; Quality of Life ; Rehabilitation ; Retrospective Studies ; Return to Work ; Social Environment ; Surgeons ; Surgery, Oral ; Surgery, Plastic

Adenolymphoma ; surgery ; Adenoma, Pleomorphic ; surgery ; Compression Bandages ; Drainage ; Facial Nerve Diseases ; epidemiology ; Female ; Fibrin Tissue Adhesive ; therapeutic use ; Health Care Costs ; Hospitalization ; economics ; statistics & numerical data ; Humans ; Length of Stay ; Male ; Middle Aged ; Parotid Gland ; surgery ; Parotid Neoplasms ; surgery ; Postoperative Complications ; epidemiology ; Singapore ; epidemiology ; Tissue Adhesives ; therapeutic use

OBJECTIVETo explore the anatomic basis and clinical application of the horn shaped perforator flap pedicled with the angular artery for the reconstruction of midface defect.

METHODS(1) 10 fresh cadavers were perfused with a modified guiding oxide gelatin mixture for three-dimensional visualization reconstruction using a 16-slice spiral computed tomography scanner and specialized software (Materiaise' s interactive medical image control system, MIMICS). The origin and distribution of the angular artery perforator were observed. (2) Between July 2012 and July 2014, twenty-one patients underwent operations for the reconstruction of midface defect. Ten patients had squamous cell carcinoma, nine patients had basal cell carcinoma and two patients had nevus. The flaps' size ranged from 1.5 cm x 3.5 cm to 2.5 cm x 5.0 cm.

RESULTSThe facial artery branches the lateral nasal artery 1 cm from the outside corner of the mouth, subsequently strenches to inner canthus continuing as the angular artery. The angular artery anastomoses extensively with the dorsal nasal artery and the infraorbital artery. All the flaps survived. The patients were satisfied with the final aesthetic and functional results.

CONCLUSIONSThe flap can be designed flexibly and simply with reliable blood supply. The donor sites could be closed directly without skin graft, it is a simple and fast method for the reconstruction of midface defect.

Anastomosis, Surgical ; methods ; Arteries ; anatomy & histology ; Cadaver ; Carcinoma, Basal Cell ; surgery ; Carcinoma, Squamous Cell ; surgery ; Face ; blood supply ; Facial Neoplasms ; surgery ; Humans ; Nevus ; surgery ; Nose ; blood supply ; Perforator Flap ; blood supply ; transplantation ; Skin Neoplasms ; surgery ; Skin Transplantation ; Software ; Tomography, Spiral Computed

OBJECTIVE: To study our experiences on deep lobe tumor parotidectomy with preservation of the superficial lobe of the parotid gland. METHOD: Eleven cases of benign tumor in the deep lobe of the parotid gland were analyzed restrospectively. Tumour recurrence, Frey's syndrome, paralysis of facial nerve, salivary fistula, dry mouth and feeling around the auricular lobule were evaluated. RESULT: Numbness around the auricular lobule appeared in 2 cases and salivary fistula appeared in 1 case, transient facial paralysis in 1 case. There were no patients appeared Frey's syndrome, dry mouth, permanent facial paralysis and recurrence in the 1-3 years followed up time. CONCLUSION Deep lobe tumor parotidectomy with preservation of the superficial lobe improves the cosmetics and the feeling around the auricular lobule, reduces the incidence rate of Frey's syndrome, facial paralysis and dry mouth.
Ear Auricle ; Face ; Facial Paralysis ; Humans ; Neoplasm Recurrence, Local ; Organ Sparing Treatments ; Parotid Gland ; surgery ; Parotid Neoplasms ; surgery ; Postoperative Complications ; pathology ; Retrospective Studies ; Sweating, Gustatory ; Xerostomia

OBJECTIVE: 10 summarize tne clinical features of the facial nerve tumors involving the internal auditory canal and promote the management of facial nerve tumor. METHOD: We retrospectively reviewed the clinical manifestations, the experiences of diagnosis and treatment of the facial nerve tumor involving the internal auditory canal. All these 5 cases were enrolled during January 2013 to Apr 2015. RESULT: Among the 5 cases, 3 cases were facial neurilemmoma and the others were facial neurofibroma. The main symptoms of facial nerve tumors involving the internal auditory canal most commonly were facial paralysis companied with hearing loss. All the patients accepted the surgical treatment with various approaches, 3 cases of translabyrinthine approach, 1 case of middle fossa approach, and 1 case of combination of translabyrinthine and transotic approach. Total tumor resection were achieved in all 5 cases. Facial-hypoglossal nerve anastomosis was performed in one case, another case was undergone great auricular nerve graft. CONCLUSION Surgical intervention for patients with facial neuroma involving internal auditory canal should be considered when facial weakness has deteriorated to grade 4. The management should be based on the patient's hearing, facial nerve function, tumor size and invasive extension to select the appropriate surgical procedures.
Anastomosis, Surgical ; Cranial Nerve Neoplasms ; diagnosis ; surgery ; Facial Nerve ; pathology ; surgery ; Facial Nerve Diseases ; diagnosis ; surgery ; Facial Paralysis ; complications ; Hearing Loss ; complications ; Humans ; Hypoglossal Nerve ; surgery ; Neurilemmoma ; diagnosis ; Neurofibroma ; diagnosis ; Retrospective Studies

OBJECTIVE: To Summary the experience of surgical treatment for many times in 1 case of maxillofacial huge dermatofibrosarcoma protuberans. METHOD: The patient was diagnosed with dermatofibrosarcoma protuberans according to the pathological examination. From 2004 to 2011, the patient underwent extensive surgical resection, Mohs micrographic surgery(MMS) and free flap grafting method as surgical treatment for many times, and was closely followed-up after operation. RESULT: The tumor was completely removed in each operation, with wound skin graft survived. But relapse occured repeatedly, recurrence interval was from 7 months up to five years and eight months,recurrence interval gradually extended, all of the recurrence occurred at Mohs microsurgery cut edge. CONCLUSION Eexpanded resection is the preferred treatment for the early stage maxillofacial huge dermatofibrosarcoma protuberans. For advanced stage tumor, expanded resection should be combined with Mohs microsurgery. Free flap grafting was suggested in primary repair insteading of myocutaneous flap. At the same time, postoperative assistant radiotherapy, strengthen follow-up and early intervention were suggested.
Dermatofibrosarcoma ; surgery ; Facial Neoplasms ; surgery ; Free Tissue Flaps ; Humans ; Mohs Surgery ; Myocutaneous Flap ; Neoplasm Recurrence, Local ; surgery ; Reoperation ; Skin Neoplasms ; Skin Transplantation

OBJECTIVETo evaluate the effect of orthognathic surgery in the treatment of condylar osteochondroma.

METHODSA total of 12 cases of condylar osteochondroma were treated with Le Fort I osteotomy, intraoral vertical ramus osteotomy, sagittal split ramus osteotomy and genioplasty.

RESULTSNo recurrence of condylar osteochondroma was observed in all 12 cases two years after the treatments. Facial asymmetry was obviously corrected.

CONCLUSIONThe orthognathic surgery methods are advantageous in improving facial figure without scar development in the treatment of condylar osteochondroma.

Bone Neoplasms ; Face ; abnormalities ; Facial Asymmetry ; congenital ; Humans ; Hyperplasia ; Male ; Orthognathic Surgery ; Osteochondroma ; Osteotomy ; Osteotomy, Le Fort ; Osteotomy, Sagittal Split Ramus