Objective: To evaluate the effect of trifoliate flap design of radial forearm flap in reconstruction of defects after mouth floor cancer resection. Methods: From June 2016 to December 2019, 12 patients with defect after resection of mouth floor cancer were treated with trifoliate flap design of radial forearm flap. All of these patients were T2 stage, included 9 well-differentiated squamous cell carcinoma (SCC) and 3 moderate differentiated SCC. The defect size ranged from 8.0 cm×6.0 cm to 5.0 cm×4.5 cm after resection of tumor and neck dissection. All defects were repaired with trifoliate flap design of radial forearm flap. The flap size ranged from 8.0 cm×2.0 cm to 4.0 cm×1.5 cm, the donor site was sutured directly on Z plasty. Results: All flaps completely survived well. Both the wound and the donor site were stage Ⅰ healing. With the average follow-up of 38.6 months, the swallowing and speech function were satisfactory. Conclusions: Trifoliate flap design of radial forearm flap can effectively repair the postoperative defect of mouth floor cancer, and the donor site can be directly sutured on Z plasty. This technique can avoid forearm scar caused by skin grafting and the formation of the second donor site.
Forearm/surgery* ; Humans ; Mouth Floor ; Neoplasms ; Reconstructive Surgical Procedures/methods* ; Skin Transplantation ; Surgical Flaps ; Treatment Outcome

BACKGROUND AND OBJECTIVES: Generally, the benign mixed tumors of the submandibular gland are successfully removed via transcervical approach. Recently, however, an alternative to the standard transcervical approach, such as an intraoral approach, has been reported. The surgical results of intraoral excisions for submandibular mixed tumors are discussed here. SUBJECTS AND METHOD: A retrospective review was carried out for 24 patients with submandibular mixed tumors who were past 3 years of follow-up. Surgical morbidities and benefits were studied using these data. RESULTS: All patients successfully received an excision of the submandibular gland with tumor via an intraoral approach. Early postoperative complications of temporary lingual sensory paresis were developed in 75% of patients, followed by 54% of patients with temporary limitation of tongue movement. In contrast, there were no permanent paresis. Late complications were developed in two cases of mild deviation of tongue due to scar contracture on the floor of mouth, whereas two cases of tumor recurrence and one case of post-gustatory sweating syndrome were observed after surgery. CONCLUSION: This approach might be safe, if used with proper expertise, for the treatment of submandibular mixed tumors. The main advantages of this approach are that no external scars nor permanent injury are incurred to the related nerves. However, disadvantages are temporary lingual paresis and temporary limitation of tongue movement. Unfortunately, there were two cases showing recurrence after surgery and thus required more follow-up.
Cicatrix ; Contracture ; Follow-Up Studies ; Humans ; Methods ; Mouth Floor ; Paresis ; Postoperative Complications ; Recurrence ; Retrospective Studies ; Submandibular Gland ; Sweat ; Sweating ; Tongue

OBJECTIVES: This study evaluated the predictive factors for survival of patients with oral squamous cell carcinoma (OSCC) and investigated the overall and disease-specific survival (DSS) outcomes. MATERIALS AND METHODS: A total of 67 consecutive patients who underwent surgery for OSCC from January 2006 to November 2014 were included in this study. Patients were classified according to age, sex, pTNM stages, primary sites, smoking and alcohol drinking habits, depth of invasion, perineural and lymphovascular invasion, cell differentiation and postoperative radiotherapy. Kaplan-Meier methods were used to estimate the survival categorized by patient groups. Cox regression methods were used to investigate the main independent predictors of survival. RESULTS: Nineteen patients died of OSCC during follow-up periods. Another five patients died of other diseases including lung adenocarcinoma (n=1), cerebral infarction (n=1), general weakness (n=2), and pneumonia (n=1). The tongue (n=16) was the most common site for primary origin, followed by buccal mucosa (n=15), mandibular gingiva (n=15), maxillary gingiva (n=9), floor of mouth (n=9), retromolar trigone (n=2), and palate (n=1). Eleven patients had pTNM stage I disease, followed by stage II (n=22) and stage IV (n=34). No patients had pTNM stage III disease in this study. The overall survival of all patients was 64.2% and the DSS was 71.6%. DSS of patients with stage I and II disease was 100%. Stepwise Cox regression showed the two predictors for DSS were pTNM stage (P<0.0001, odds ratio=19.633) and presence of metastatic lymph nodes (P=0.0004, odds ratio=0.1039). CONCLUSION: OSCC has been associated with poor prognosis; however, there were improved survival outcomes compared with past studies. Advanced-stage disease and presence of metastatic lymph nodes were associated with poorer survival compared with early-stage OSCC and absence of neck node metastasis. Stage I and II OSCC were associated with excellent survival results in this study.
Adenocarcinoma ; Alcohol Drinking ; Carcinoma, Squamous Cell ; Cell Differentiation ; Cerebral Infarction ; Epithelial Cells ; Follow-Up Studies ; Gingiva ; Humans ; Lung ; Lymph Nodes ; Lymphatic Metastasis ; Mouth Floor ; Mouth Mucosa ; Neck ; Neoplasm Metastasis ; Neoplasm Staging ; Palate ; Pneumonia ; Prognosis ; Radiotherapy ; Smoke ; Smoking ; Tongue

Lipoma is one of the most common benign tumors in the human body. However, they are uncommon in the oral cavity. Oral lipomas can occur on the cheeks, tongue, lips, gums and rarely on the floor of the mouth. Clinical symptoms are usually asymptomatic yellow masses. Sometimes the tumor grows and can have difficulty speaking and mastication. The treatment of lipoma is surgical excision, and recurrence is rare. We present a case of oral lipoma in an unusal location on the floor of mouth which is rare in the literature.
Cheek ; Gingiva ; Human Body ; Lip ; Lipoma ; Mastication ; Mouth Floor ; Mouth ; Recurrence ; Tongue

Clavicle fracture, a very rare delayed complication following radical neck dissection of oral carcinoma, is normally ignored by oral and maxillofacial surgeons. We report and analyze a male patient with clavicle fracture after primary extended excision and bilateral radical neck dissection. This case was misdiagnosed as cervical metastasis.
Clavicle ; Fractures, Bone ; Humans ; Male ; Mouth Floor ; Mouth Neoplasms ; complications ; Neck Dissection

BACKGROUND: Although previous studies have focused on determining prognostic and causative variables associated with fistula-related complications after head and neck reconstructive surgery, only a few studies have addressed preventive measures. Noting that pooled saliva complicates wound healing and precipitates fistula-related complications, we devised a continuous suction system to remove saliva during early postoperative recovery. METHODS: A continuous suction system was implemented in 20 patients after head and neck reconstructive surgery between January 2012 and October 2017. This group was compared to a control group of 16 patients at the same institution. The system was placed orally when the lesion was on the anterior side of the retromolar trigone area, and when glossectomy or resection of the mouth floor was performed. When the orohypopharynx and/or larynx were eradicated, the irrigation system was placed in the pharyngeal area. RESULTS: The mean follow-up period was 9.2±2.4 months. The Hemovac system was applied for an average of 7.5 days. On average, 6.5 days were needed for the net drain output to fall below 10 mL. Complications were analyzed according to their causes and rates. A fistula occurred in two cases in the suction group. Compared to the control group, a significant difference was noted in the surgical site infection rate (P < 0.031). CONCLUSIONS: Clinical observations showed reduced saliva pooling and a reduction in the infection rate. This resulted in improved wound healing through the application of a continuous suction system.
Fistula ; Follow-Up Studies ; Glossectomy ; Head* ; Humans ; Larynx ; Mouth Floor ; Neck* ; Saliva ; Suction* ; Surgical Wound Infection ; Wound Healing

BACKGROUND AND OBJECTIVES: Ranulas, pseudo cysts found on the floor of mouth, develop from the retention or extravasation of saliva from the sublingual gland. The main treatment of ranula is surgical excision but the extent of surgery is controversial. The aim of this study was to evaluate the significance of sublingual gland excision in the surgical treatment of ranula. SUBJECTS AND METHOD: We retrospectively reviewed 112 patients with ranula who had undergone surgical excision from January 2004 to April 2016. Those who underwent any previous treatment such as sclerotherapy, marsupialization, or excision of cyst were excluded in the study. Surgical outcomes including complications and recurrence were compared between the group that went through simple cyst excision and the group that went through cyst and sublingual gland excision. RESULTS: Of 112 patients, 94 were simple ranula and 18 were plunging ranula. Thirty-seven (33%) were male and 75 (67%) were female. Of the 94 simple ranula patients, 23 underwent excision of cyst only; the remaining 71 patients and all other patients with plunging ranula underwent excision of cyst and sublingual gland together. The recurrence rate was significantly lower for the cyst and sublingual gland excision group than for the simple cyst excision group (2.2% vs. 17.4%, p=0.004). The complication rate did not differ between the two groups (4.3% vs. 1.1%, p=0.298). CONCLUSION: The excision of sublingual glands as well as cysts is an important option to reduce recurrence in the surgical treatment of ranula.
Female ; Humans ; Male ; Methods ; Mouth Floor ; Ranula* ; Recurrence ; Retrospective Studies ; Saliva ; Sclerotherapy ; Sublingual Gland*

Adenoid cystic carcinoma (ACC) of the sublingual gland is an extremely rare neoplasm. The clinicopathological characteristics of ACC are slow-growing swelling with or without ulceration, perineural spread, local recurrence, and distant metastasis. This report describes a 58-year-old male who had a slowly growing swelling without ulceration on the right side of the mouth floor that had been present for 1 month. In a radiological examination, the mass showed multilocular cystic features and no bony or tongue muscle invasion. No enlarged cervical lymph nodes were detected. Excisional biopsy and histological analysis showed that the lesion was ACC. In addition to reporting a rare case of ACC, this report also discusses the differential diagnosis and treatment of ACC with a review of the relevant literature.
Adenoids* ; Biopsy ; Carcinoma, Adenoid Cystic* ; Diagnosis, Differential ; Humans ; Lymph Nodes ; Male ; Middle Aged ; Mouth Floor ; Neoplasm Metastasis ; Recurrence ; Salivary Glands ; Sublingual Gland* ; Tongue ; Ulcer

Schwannomas are benign peripheral nerve sheath tumors. It is found rarely in the oral cavity but most commonly in the tongue followed by the palate, floor of mouth, buccal mucosa, and mandible. Because schwannoma of the base of tongue is exceedingly rare, it is often not immediately included in the differential diagnosis, causing delay in identification and treatment. We report here, with a review of the literature, a case of schwannoma of the base of tongue, which was misdiagnosed as a lingual thyroid. A 28-year-old man presented with a base of tongue mass, which was first detected a month ago. The preoperative diagnosis was lingual thyroid on the basis of the physical findings and computerized tomographic findings. The permanent pathologic report of the mass was schwannoma. Postoperatively, the patient showed no problem with tongue function and wound healing.
Adult ; Diagnosis ; Diagnosis, Differential ; Humans ; Lingual Thyroid ; Mandible ; Mouth ; Mouth Floor ; Mouth Mucosa ; Nerve Sheath Neoplasms ; Neurilemmoma* ; Palate ; Tongue* ; Wound Healing

OBJECTIVEThis study aimed to analyze the bone anatomy of edentulous sites in the posterior maxillary by cone beam computed tomography (CBCT).

METHODSA total of 100 CBCT radiographs from patients with missing maxillary posterior teeth were obtained, resulting in a sample size of 217 edentulous sites. The width and height of edentulous were assessed by three-dimensional reconstruction. In addition, the angle A and morphology of the maxillary sinus walls were evaluated.

RESULTSThe mean bone height was 9.53 mm, and the percentage of sites than 10 mm was 62.67% (136/217). The mean bone width was 9.30 mm, and the percentage of sites more than 6 mm was 91.71% (199/217). The bone height decreased from premolar to molar areas, but the opposite trend was observed in bone width. Regarding the morphology of the sinus floor, 64.52% exhibited an oblique configuration. In angle A, the group of less than 30° was 10.14%, 30°-60° was 42.40%, and greater than 60° was 47.47%.

CONCLUSIONA high percentage of edentulous sites in the posterior maxillary requires sinus floor elevation to allow the placement of dental implants. Thus, the use of CBCT scans is recommended to evaluate the anatomical structure of the maxillary sinus for reasonable implant planning.