When secondary reconstruction is required in the head and neck region where a primary operation was performed before, it is important to select a flap which is not only suitable for the purpose, but also can be transferred more safely. In the present case, a female patient, 33 years old, complained of depression deformity around the left mandibular region. She had undergone segmental mandibulectomy coupled with radical neck dissection because of adenoid cystic carcinoma of the left submandibular gland 12 years ago. The deformity was thought to be mainly due to the deficiency of subdermal soft tissue. The insertion of a denuded and folded pedicled latissimus dorsi myocutaneous flap into the submandibular space satisfactorily restored the depressed mandibular contour. The pedicled latissimus dorsi myocutaneous flap can acquire a bulkiness by being folded, whose atrophy is tolerable for a long period, and is safe for secondary reconstruction.

A case of nodular fasciitis which arose from the buccal submucosal region is reported. One week after an incisional biopsy, the lesion enlarged alarmingly and protruded from the submucosa. Although a sarcoma was suspected because of rapid growth, the diagnosis of the biopsy was nodular fasciitis showing a haphazard arrangement of plump fibroblasts without atypical mitoses. After complete resection, no signs of recurrence were seen.

Hybrid revascularization by MIDCAB and stent was performed in a 70-year-old man for reperfusion in the treatment of graft stenosis after CABG. The right SVG, which supplied coronary blood flow, was immediately under the median incision site, and was approached safely by the present method. After intervention, bleeding in the left thoracic cavity occurred, but this was treated conservatively. During intervention after cardiac surgery, transient heparinization of blood was performed for prevention of coagulation. Since strong anticoagulative treatment was continued thereafter, the patient was easily bled. Therefore, it appeared preferable to take time after cardiac operation or insert an indwelling drainage tube into the pleural cavity to monitor hemorrhage. The present method appears useful for patients undergoing re-operation or of high risk.

We studied 1809 oral cancer patients who visited and were treated in 2002 at the 148 institutions certified as training facilities by the Japanese Society of Oral and Maxillofacial Surgeons, which is composed of 39 dental university hospitals, 44 medical university hospitals, 64 general hospitals, and 1 unknown institution. The patients consisted of 1071 (59.2 %) males and 738 (40.8 %) females (male:female ratio, 1.45:1), who had a mean age of 65.2 years old. The tongue (40.2 %) was the most common site affected, followed by the gingiva (32.7 %), buccal mucosa (10.1 %), and oral floor (9.0 %). There were 6 cases of intraoral multiple cancer. In histopathological examinations, squamous cell carcinoma (88.7 %) was the most common type found, followed by adenoid cystic carcinoma (2.1 %), and mucoepidermoid carcinoma (1.7 %). In addition, non-epithelial tumors comprised 1.8 % , among which malignant melanoma was the most common type. Cases classified as T2N0 were the most common (32.1 %), followed by T1N0 (21.4 %), T4N0 (8.0 %), and T2N1 (7.6 %). Distant metastasis occurred in 17 patients (1.0 %). The sizes of the non-epithelial malignant tumors ranged from 1.0 to 7.0 cm, with a mean size of 3.7 cm.
Asian Continental Ancestry Group ; Carcinoma, Adenoid Cystic ; Carcinoma, Mucoepidermoid ; Carcinoma, Squamous Cell ; Epidemiologic Studies ; Female ; Floors and Floorcoverings ; Gingiva ; Hospitals, General ; Hospitals, University ; Humans ; Male ; Melanoma ; Mouth Mucosa ; Mouth Neoplasms ; Neoplasm Metastasis ; Surgery, Oral ; Tongue

We studied 1809 oral cancer patients who visited and were treated in 2002 at the 148 institutions certified as training facilities by the Japanese Society of Oral and Maxillofacial Surgeons, which is composed of 39 dental university hospitals, 44 medical university hospitals, 64 general hospitals, and 1 unknown institution. The patients consisted of 1071 (59.2 %) males and 738 (40.8 %) females (male:female ratio, 1.45:1), who had a mean age of 65.2 years old. The tongue (40.2 %) was the most common site affected, followed by the gingiva (32.7 %), buccal mucosa (10.1 %), and oral floor (9.0 %). There were 6 cases of intraoral multiple cancer. In histopathological examinations, squamous cell carcinoma (88.7 %) was the most common type found, followed by adenoid cystic carcinoma (2.1 %), and mucoepidermoid carcinoma (1.7 %). In addition, non-epithelial tumors comprised 1.8 % , among which malignant melanoma was the most common type. Cases classified as T2N0 were the most common (32.1 %), followed by T1N0 (21.4 %), T4N0 (8.0 %), and T2N1 (7.6 %). Distant metastasis occurred in 17 patients (1.0 %). The sizes of the non-epithelial malignant tumors ranged from 1.0 to 7.0 cm, with a mean size of 3.7 cm.
Asian Continental Ancestry Group ; Carcinoma, Adenoid Cystic ; Carcinoma, Mucoepidermoid ; Carcinoma, Squamous Cell ; Epidemiologic Studies ; Female ; Floors and Floorcoverings ; Gingiva ; Hospitals, General ; Hospitals, University ; Humans ; Male ; Melanoma ; Mouth Mucosa ; Mouth Neoplasms ; Neoplasm Metastasis ; Surgery, Oral ; Tongue