OBJECTIVETo examine the benefits of anterolateral thigh myocutaneous flaps in reconstruction of oral and maxillofacial defects.

METHODSPatients were recruited from February 2002 to June 2013 in the Department of Oral and Maxillofacial Surgery of Central South University. All patients (1,185 patients, 1,212 transferred flaps) underwent reconstructive surgery employing anterolateral thigh myocutaneous flaps. Basic information for all patients including defect side, flap size and type, recipient vessel processing method, donor complications, and postoperative quality of life were recorded and statistically analyzed.

RESULTSAmong the 1 212 transferred flaps, 1 176 survived and 36 showed necrosis, for a survival rate of about 97.0%. No cases presented with local serious complications, and 90% of patients achieved good functional recovery and aesthetically acceptable results after reconstruction of oral and maxillofacial defects at various locations using anterolateral thigh myocutaneous flaps. The time for anastomosis of one vein was significantly less than that for two veins (P=-0.000 3), which indicated one vein anastomosis could significantly reduce the operating time. The incidence of venous crisis, the survival rate after treatment, and the rate of venous crisis resulting in flap necrosis were comparable between the groups (P>0.05).

CONCLUSIONAnterolateral thigh myocutaneous flaps can be easily obtained and provide a good amount of muscle for filling dead space and fascia lata. These flaps can meet the various requirements of oral and maxillofacial defects. Therefore, the anterolateral thigh myocutaneous free flaps are more suitable for oral and maxillofacial defects than other flaps.

Free Tissue Flaps ; Humans ; Maxillofacial Abnormalities ; surgery ; Myocutaneous Flap ; Necrosis ; Quality of Life ; Reconstructive Surgical Procedures ; methods ; statistics & numerical data ; Surgery, Oral ; Thigh ; Wound Healing

The link between nonresolving inflammation and cancer is well documented. On the one hand, epidemiologic evidence supports that approximately 25% of all human cancer worldwide is caused by nonresolving inflammation. On the other hand, inflammatory cells are found in the microenvironment of most, if not all, tumors. In the tumor micro-environment, inflammatory cells and molecules influence almost every aspect of cancer. MicroRNAs (miRNAs) participate in the initiation and progression of nonresolving inflammation-related cancer by regulating the key genes and related signaling pathways. Further investigation into the molecular mechanisms by which miRNAs carry out their functions will be of great value in the prevention, early diagnosis, and treatment of tumors.
Chronic Disease ; Humans ; Inflammation ; complications ; genetics ; immunology ; Inflammation Mediators ; immunology ; MicroRNAs ; genetics ; Neoplasms ; etiology ; genetics ; Tumor Microenvironment

Objective To summarize the anatomic characteristic of sigle pedicled double island free anterolateral thigh flaps and to evaluate its application and classification.Methods Between January 2010 and March 2013,76 patients underwent free femoral anterolateral double island flap reconstruction of the defects in oral and maxillofacial region.Summarized the anatomic features of perforators,such as the number and origin of the perforators.Results According to the anatomic features and regularity of perforators,76 cases of femoral anterolateral double island flaps were divided into 3 types:trunk type (type Ⅰ),15 cases (20％),in which the perforators of two flaps originated in descending branch and transverse branch of lateral femoral circumflex artery respectively; branch type (type Ⅱ),55 cases (72％),in which both the perforators originated in lateral femoral circumflex artery descending branch or lateral femoral circumflex artery transverse branch; bifurcation type (type Ⅲ),6 cases (8％),in which two perforators originated in the two bifurcation of one perforator.Among the 76 cases,75 survived and 1 showed partial necrosis.Conclusions According to the anatomic features and regularity of perforators,femoral anterolateral double island flaps can be divided into 3 types:trunk type (Ⅰ type),branch type (Ⅱ type),bifurcation type (Ⅲ type).

Long non-coding RNAs (lncRNAs) are a group of endogenous RNA molecules which exceed 200 nt in length, lack complete specific open reading frame, and completely lack or possessvery limited protein-coding capacity. Recent studies have revealed that lncRNAs participate in critical processes such as genomic imprinting, cell differentiation, and immune reaction, etc. lncRNAs regulate gene expression at the epigenetic, transcriptional and post-transcriptional levels by modulating chromatin remodeling and histone modifications, interfering the transcription, regulating patterns of alternative splicing, generating small RNAs, and modulating protein activation and localization. Through their numerous functions, lncRNAs play critical roles in the growth, development, senescence, death, and other important physiological and pathological processes. Further investigation into the regulation of gene expression mediated by lncRNAs will be of great value in the thorough understanding of pathogenies and provide new molecular markers and drug targets of diseases.
Alternative Splicing ; Chromatin Assembly and Disassembly ; Gene Expression ; Open Reading Frames ; Proteins ; RNA, Long Noncoding

Objective??To?examine?the?benefits?of?anterolateral?thigh?myocutaneous?flaps?in?reconstruction?of?oral?and?maxillofacial?defects. Methods??Patients?were?recruited?from?February?2002?to?June?2013?in?the?Department?of?Oral?and?Maxillofacial?Surgery?of?Central?South?University.?All?patients?(1?185?patients,?1?212?transferred?flaps)?underwent?reconstruc-tive?surgery?employing?anterolateral?thigh?myocutaneous?flaps.?Basic?information?for?all?patients?including?defect?side,?flap?size?and?type,?recipient?vessel?processing?method,?donor?complications,?and?postoperative?quality?of?life?were?recorded?and?statistically?analyzed.?Results??Among?the?1?212?transferred?flaps,?1?176?survived?and?36?showed?necrosis,?for?a?survival?rate?of?about?97.0%.?No?cases?presented?with?local?serious?complications,?and?90%?of?patients?achieved?good?functional?recovery?and?aesthetically?acceptable?results?after?reconstruction?of?oral?and?maxillofacial?defects?at?various?locations?using?anterolateral?thigh?myocutaneous?flaps.?The?time?for?anastomosis?of?one?vein?was?significantly?less?than?that?for?two?veins?(P=0.000 3), which?indicated?one?vein?anastomosis?could?significantly?reduce?the?operating?time.?The?incidence?of?venous?crisis,?the?sur-vival?rate?after?treatment,?and?the?rate?of?venous?crisis?resulting?in?flap?necrosis?were?comparable?between?the?groups?(P>0.05).?Conclusion??Anterolateral?thigh?myocutaneous?flaps?can?be?easily?obtained?and?provide?a?good?amount?of?muscle?for?filling?dead?space?and?fascia?lata.?These?flaps?can?meet?the?various?requirements?of?oral?and?maxillofacial?defects.?Therefore,?the?anterolateral?thigh?myocutaneous?free?flaps?are?more?suitable?for?oral?and?maxillofacial?defects?than?other?flaps.

Objective To identify the factors that were predictive of outcome and to determine the effect of age on perioperative complications.Methods Reviewed the records of 1 100 consecutive patients who underwent anterolateral thigh flap free flap transfers for oral and maxillofacial cancer surgery defects between February 2002 and March 2013.All patients were divided into two groups:A group (＜60 years old) and B group (≥60 years old).Postoperative complications were analyzed from all patients.Results There were 781 cases in A group and 319 in B group.The overall success rate was 97.2％(1 100/l 132)[97.3％ (781/803) in A group,97.0％ (319/329) in B group,P＞0.05].The overall complication rate was 27.5％ (302/1 100)[25.9％ (202/781) in A group,31.3％ (100/319) in B group,P=0.064].Multivariate Cox regression analyses revealed that American Society of Anesthesiologists (ASA) status (P＜0.001),operation time (P=0.021) and comorbidity (P=0.002) were the independent factor for the complication of patients.However,age (P＞0.05) was not an independent factor for the complication of patients.Conclusions Oral and maxillofacial reconstruction using anterolateral thigh flap free flaps in elderly patients can achieve similar outcomes as in younger patients.Controlling operative time is very important in reducing postoperative complications and improving the results of surgery.