The forearm ulnar free cutaneous or myoculaneous flap is a newly designed flap which is safe and convenient in using and can be applied for many purposes. It has more advantages than the radial free flap. The new flap is suitable for the repair of the oral and maxillofacial defects, and has been used in 12 cases by the authors with successful results. After 6-14 months followup study, it was found that both the external appearance and functions of the repaired sites of the 12 cases were satisfactory. No functional or sensational disturbance of the donor arm was found.

Surgical treatment of tongue cancer often results in half or more than half tongue defects, which not only makes swallow, speech and mastication very difficult, but also causes mental suffering. In order to restore the contour and function of the tongue, we repaired and reconstructed 21 cases tongue defects by using radial or ulnar skin flaps and myocutaneous flaps in forearm since 1981. All the skin flaps survived. Post-operative shape and function of the tongue were satisfactory. The technique of tongue reconstruction was decribed and the functional repairing of tongue and how to raise the success rate of the operation were discussed.

Tracheotomy is an important auxiliary operation used in the perioperative period of the oral and maxillofacial (OMF) surgery. It plays an essential role in the success of the OMF operation and even in the recovery of the patients. According to the review of 126 cases of OMF operations with the perioperative tracheotomy during the past 27 years- by the authors and their team, the cases are classified into 3 types prophylactic, anesthetic and emergency tracheotomy. Indications for operation, complications in the postoperative period and their treatments are discussed. In conclusion and experience tracheotomy taker at the accurate time and well done is the key to achieve the success.

Objective To observe the changes in cytokeratin expression pattern of the regenerated epithelia of dermal tissue flaps transferred for intraoral mucosal reconstruction. Methods Mucosal defects were made on the right buccal mucosa of 12 healthy adult dogs, and then were reconstructed immediately by pedicled platysma myodermal flaps (PMDF). Changes in the expression patterns of CK10 and CK19 of the epithelia on the flaps were observed by immunohistochemical staining. Results Low level of CK19 expression was found in the basal layer and the layers superior to the basal layer of the regenerated epithelia at 4 week after transferring the dermal tissue flaps. The expression pattern of keratin in PMDF was identical to that of the normal skin 12 weeks later. Conclusion The regenerated epithelia remain the original structure without mucosal changes.

Vestibular schwannoma is a rare tumor, which is easily misdiagnosed. The authors presented a case of vestibular schwannoma in a 36-year-old woman. The clinical manifestations were recurrent vertigo, hearing loss of the left ear, and tinnitus. The pure tone audiometry threshold of the left ear was 45dBHL with air conduction, and 33 dBHL with bone conduction. A CT scan of the temporal bone region didn't show any abnormal finding. A MRI scan of the head showed nodule abnormal signal in the internal of left vestibular and the narrow of perilymphaticum gap in T2W1 + T2Flair. The initial diagnosis was Meniere's disease. And the post-operation pathologic diagnosis was vestibular schwannoma.
Adult ; Audiometry, Pure-Tone ; Diagnostic Errors ; Female ; Hearing Loss ; Humans ; Magnetic Resonance Imaging ; Meniere Disease ; diagnosis ; Neuroma, Acoustic ; diagnosis ; Temporal Bone ; Tinnitus ; Tomography, X-Ray Computed ; Vertigo ; Vestibule, Labyrinth

Objective　To determine the expression and the change of vascular endothelial growth factor(VEGF) and it's acceptor Flt-1 during maxillofacial blast injury at early stage,and to evaluate the effect of VEGF on traumatic wound healing.Methods　The rabbit model of maxillofacial blast injury was made by KTY-04 blasting cap. The expression of VEGF and Flt-1 in wound tissue was determined by ABC immunohistochemistry after injury 6h,1d,2d,3d,5d,and 7d. Also,the results were compared with preinjury groups.Results　In the wound tissue of maxillofacial blast injury, the expression of VEGF was rising steadily at the first week after injury. Comparing with normal tissue,it showed different from the first day after injury, and showed very different from the third day(P<0.01).It reached the peak at the seventh day after injury.The expression of Flt-1 showed no difference within 3 days after injury comparing with normal tissue.After injury 5d-7d,the protein expressed strengthly.Conclusion　The stage of the VEGF expression at maxillofacial blast injury is similar to the angiogenic stage during wound healing, and the Flt-1 expression is also occurring at that period.It illustrates that VEGF take part in angiogenic cascades of traumatic wound healing and product auxo-action to the regeneration of blood vessel.

Surgery to repair cheek defect has been performed for a long time but no method can be considered as the best and be universally applicable since the shape and size of cheek defect are variable and no reasonable classification is established for cheek defect.Two hundred and twenty-three cases of cheek defect were collected in a 26-year period from 1964 to 1990.According to the size and degree of the cheek defects,a classification into 5 categories and corresponding 5 repair methods were established.The total success rate war 92.83%.The clinical features of the defects,the indications of operation,and the choice of repair methods for different types of defects were discussed.It is concluded that our classification of cheek defects into 5 categories is helpful to differentiate the operative indications,to choose the suitable method of repair and to evaluate the.therapeutic efficacy.

In order to assess whether there is any possibility of early reconstructive surgery to repair oromaxillofacial soft tissue defect resulting from gun-shot wound.8 dogs were wounded in the left cheek with model Mm bullet of 5.56 mm in diameter fired from a M]6 rifle made in USA with a firing distance of 6 meters.As a result,there was a hole in the left cheek of the dogs.Debridement was performed,immediately and it was repeated 72 hours after wounding.Meanwhile,saphenous artery skin flap was excised and used to repair the skin defect of the left cheek with microvascular anastomosis.The defect of the mucous membrane was repaired by drawing the adjacent mucous membrane together or by a sliding mucous membrand flap.The dogs were observed for 2 to 6 months postoperatively.The survival rate of the free skin flap was 75%.Our findings suggest that it is practicable to perform early reconstructive surgery for the repair of the oromaxillofacial soft tissue defect resulting from gunshot wound with vascular anastomotic free skin flap.

Objective To observe the changes of astrocytes and expressions of bcl 2 and bax in neuron apoptosis in facial nerve nucleus after facial nerve transection in rats Methods A total of 72 rats were equally divided into normal control, and facial neurotmesis groups. Six rats were killed 3,7,15,21,30 and 60 d after transection respectively and same amount of rats were killed in same time interval in the control group. Brain samples were taken from the aboue mentioned rats and the facial neuron apoptosis was detected with TUNEL, and expressions of bcl 2 and bax and changes of GFAP in the astrocytes of facial nerve nucleus were studied with immunohistochemical methods and image analyses separately Results The apoptotic peak of facial neurons and remarkable expression of bcl 2 and bax appeared in 15 d after the facial neurotmesis, while the expression ratio of bcl 2/bax were the lowest Meantime, the reaction of the astrocytes(GFAP)was remarkable, too All the changes were statisfically significantly compared with the control groups ( P

Objective To explore the feasibility of the construction and formation of cartilage with immortalized chondrocytes by tissue engineering technology in vitro . Methods Human telomerase reverse transcriptase(hTERT) gene was introduced into rabbit mandibular condylar chondrocytes by eukaryotic vector. After screening with G418, the positive clones were amplified for culture. Normal or immortalized chondrocyte loaded cytoskeleton ? tricalcium phosphate (? TCP) complexes were incubated in vitro for 1～2 d and then implanted into subcutaneous tissue of nude mouse. The complexes of immortalized chondrocyte ? TCP and chondrocyte ? TCP or ? TCP alone were established as the experimental group and control groups respectively. The specimens were harvested within 3 and 6 months after surgical procedure for histological and immunohistochemical observation. Results In experimental groups and control group 1, the complexes packed with cartilage like tissue were found, but there was only a little fiber like tissue formed in control group 2. Immunohistochemistry revealed strong positive staining with safranine O, toluidine blue and collagen type II and obvious formation of cartilage. There was significant difference between the experimental group and the control groups( P