Adenoid cystic carcinoma is a malignant tumor of the head and neck, this article reports a case of a large adenoid cystic carcinoma of the skull base, with the lesion involving the sphenoid sinus, sphenoid bone wings, pterygopalatine fossa, nfratemporal fossa, hard palate, and other structures. The treatment plan consisted of surgical excision, primary reconstrction of the surgical defect,and postoperative radiotherapy, resulting in a favorable prognosis for the patient.
Humans ; Carcinoma, Adenoid Cystic/surgery* ; Maxillary Sinus/surgery* ; Maxillary Sinus Neoplasms/surgery* ; Palate, Hard/surgery* ; Skull Base Neoplasms/surgery* ; Surgical Flaps

BACKGROUND: The reconstruction of eyelid defects is extremely complex because both functional and aesthetic aspects should be considered. Numerous techniques for reconstruction are available for repairing eyelid defects, depending on the size, location, and extent of the defect. OBJECTIVE: This study was aimed at assessing the effectiveness and cosmetic consequences of various reconstruction techniques for eyelid defects after Mohs micrographic surgery. METHODS: Twenty patients who received a diagnosis of skin cancer of the eyelids from November 2005 to August 2009 were analyzed. Among them, 15 patients were treated with a local flap to reconstruct the defective eyelids, and the remaining patients were treated with primary closure. The medical records and photographs were reviewed by two independent physicians, and postoperative results were evaluated. RESULTS: Eyelid defects were reconstructed with various surgical techniques, such as primary closure, transposition flap, subcutaneous island pedicle flap, advancement flap, rotation flap, Tenzel flap, and hard palate mucous membrane graft. The cosmetic results were satisfactory, and 16 of 20 (80%) patients showed good to excellent results. However, one patient developed a sclera show and another patient showed tumor recurrence. CONCLUSION: Many reconstruction techniques can be used for eyelid defects. An optimal choice would be one that is based on the extent, depth, and location of the defect; skin condition and wishes of the patient; and the surgeon's experience. Furthermore, it is important to have an understanding of the anatomy of the eyelid, the basic principles of the reconstruction techniques, and the merits and drawbacks of each technique.
Diagnosis ; Eyelids* ; Humans ; Medical Records ; Mohs Surgery* ; Mucous Membrane ; Palate, Hard ; Recurrence ; Sclera ; Skin ; Skin Neoplasms* ; Transplants

OBJECTIVE: To explore the curative effect of velopharyngoplasty (VPP) combined with hard palate shorting and soft palate forward in the treatment of type II moderately severe obstructive sleep apnea hypopnea syndrome (OSAHS). METHOD: Thirty-two patients with OSAHS with and the obstructed surface located in soft palate were subjected to VPP combined with hard palate shorting and soft palate forward. The ESS scores, result of PSG included AHI and the lowest oxyhemoglobin saturation before and after operation were compared. RESULT: The effective rate of VPP was 78.12% this group. The grade of ESS, PSG and the lowest oxyhemoglobin saturation was statistically significant before and after the operation (P < 0.05). In the other 7 cases whose AHI decrease less than 50%, the grade of ESS, AHI and the lowest oxyhemoglobin saturation was also statistically significant. CONCLUSION VPP combined with hard palate shorting and soft palate forward can improve the surgical effective rate obviously for OSAHS patients.
Adult ; Female ; Humans ; Male ; Middle Aged ; Palate, Hard ; surgery ; Palate, Soft ; surgery ; Pharynx ; surgery ; Sleep Apnea, Obstructive ; surgery ; Syndrome

Miniscrews offer a reliable alternative for anchorage during orthodontic treatment, particularly for non-cooperative patients or periodontal patients with alveolar bone loss. The study aims at assessing the correlation of various clinical indicators with the success or failure of miniscrews used for anchorage during orthodontic treatment. Thirty-four consecutive patients with a cumulative total of 82 miniscrews implanted participated in the study. Generalized Estimating Equations were used to assess the correlation of various factors with success rates. The miniscrew was considered the unit of analysis clustered within site and within patient. The overall success rate of miniscrews was 90.2%. For every additional miniscrew used in a patient's oral cavity, the success rate was reduced by 67%. Retromandibular triangle and palatal placement and in movable mucosa resulted in lower success rate. The miniscrew length and diameter were found to correlate with success rates. Orthodontic force applied on miniscrews for uprighting purposes showed a lower success rate than that used for retraction. This study revealed that miniscrews present high success rates. The number of miniscrews used per patient, the miniscrew site placement, the soft tissue type of placement, the miniscrew length and diameter as well as the orthodontic force applied on the miniscrew showed significant correlation with success rates.
Adolescent ; Adult ; Alveolar Process ; surgery ; Bone Screws ; Dental Stress Analysis ; Female ; Gingiva ; surgery ; Humans ; Linear Models ; Logistic Models ; Male ; Mandible ; surgery ; Middle Aged ; Mouth Mucosa ; surgery ; Orthodontic Anchorage Procedures ; instrumentation ; Orthodontic Appliance Design ; Palate, Hard ; surgery ; Retrospective Studies ; Statistics, Nonparametric ; Treatment Outcome ; Young Adult

Low-grade myofibroblastic sarcoma (LGMS) is a rare, malignant tumor with myofibroblastic differentiation. Despite it being classified as a distinct entity by the World Health Organization, a few cases were reported in the oral and maxillofacial region. Here, a LGMS developed on the palate of a 73-year-old man who presented with a 1-cm tumor on the posterior border of the palate. Based on the histological and immunohistochemical features, a diagnosis of LGMS was established. The tumor was resected, and no recurrence was observed over 2 years. Although the tongue is the most preferred site for LGMS, it may occur in any region of the oral cavity.
Aged ; Humans ; Male ; Myofibroblasts ; pathology ; Osteosarcoma ; pathology ; surgery ; Palatal Neoplasms ; pathology ; surgery ; Palate, Hard ; pathology

Postoperative maxillary cyst is a rare complication of surgical intervention associated with maxillary sinuses. The present paper describes a 25-year-old man presenting with a lump sensation in the left cheek area after Le Fort I osteotomy and mandibular sagittal split osteotomy. The orthopantomograph revealed a bony defect in the left maxillary alveolus. On the computerized tomography, a 1x2x3cm sized, lower density mass, between the left paramedian side of the maxillary alveolar process and hard palate was observed. The cyst was drained and enucleated. More frequent post-operative maxillary cysts may occur with an increase of Le Fort I osteotomies.
Adult ; Alveolar Process ; Cheek ; Humans ; Maxillary Diseases ; Maxillary Sinus ; Nonodontogenic Cysts ; Orthognathic Surgery ; Osteotomy ; Palate, Hard ; Paranasal Sinus Diseases ; Sensation ; Surgery, Oral

OBJECTIVETo investigate the mechanism of new bone formation in the distraction osteogenesis (DO) for correction of cleft palate (CP) in rhesus.

METHODSCP was created by operation in 23 rhesus. The CP was corrected with DO in 21 animals as experimental group. The distraction rate was 0.8 mm per day, two times a day. The bone fragments were fixed after cleft closure, every 3 animals were sacrificed to get specimen after 1, 2, 4, 6, 8, 12, 24 weeks of fixation. 6 days before sacrifice, tetracycline was administrated for labeling (30 mg/kg).

RESULTSThe hard and soft tissue def of fixation. At the same time, the bone volume and calcification between the distraction gap increased. The cleft in the control group could not b ect was successfully closed with DO by intramembrane osteogenesis. The new formed bone was remodeling and became maturation during the period e corrected spontaneously.

CONCLUSIONSThe DO can successfully correct both the soft and hard tissue defect in CP by intramembrane osteogenesis. The fixation is important for remodeling and maturation of the new formed bone.

Animals ; Biomarkers ; Cleft Palate ; pathology ; surgery ; Macaca ; Osteogenesis, Distraction ; Palate, Hard ; pathology ; Palate, Soft ; pathology

OBJECTIVE: To investigate the neoplasia of fossa orbitalis, hard palate and the anterior skull base defect by making use of mucoperiosteal flap of nasal septum. METHOD: A retrospective study was reviewed in 12 patients with tumors in nasal cavity and nasal sinuses. According to tumor character and range, by partial or total maxillectomy and ethmoidectomy, fossa orbitalis, hard palate and the anterior skull base defects were repaired synchronously on the heels of resection of the tumors which damaged fossa orbitalis, hard palate and the anterior skull base. RESULT: Among the 12 patients there were 5 patients with the destructions on ethmoidal horizontal plate, 2 patients with the destructions on hanging wall of ethmoid, 1 patient with the destruction on hanging wall of fossa orbitalis, 1 patient with the destruction on medial wall of fossa orbitalis and on floor of orbit respectively, 2 patients with the destructions on hard palate and all the destructions were repaired following detection synchronously. There were no complications of surgical death, cerebrospinal fluid leaks, encephalomeningocele. CONCLUSION During the operation of tumor in nasal cavity and/or nasal sinuses when defect of fossa orbitalis, hard palate and anterior skull base were found and the defects need repair, we can take advantages of mucoperiosteal flap of nasal septum to perform the transplantation of mucoperiosteal flap in order to avoid forming local defect.
Adult ; Female ; Humans ; Male ; Middle Aged ; Nasal Septum ; surgery ; Orbit ; surgery ; Palate, Hard ; surgery ; Periosteum ; transplantation ; Reconstructive Surgical Procedures ; methods ; Retrospective Studies ; Skull Base ; surgery ; Surgical Flaps

OBJECTIVETo explore the ultrastructure of the palate-maxillary sutures under tensile forces by transmission electron microscope (TEM).

METHODSThe Suture expanders were made in NiTi-Shape memory alloy (NiTi-SMA). The maximum force was 3.5 N. Fourteen 8-month old mongrel dogs were used in the study. They were divided into three groups, (1) experimental group, (2) control group, (3) sham group. In the experiment and control groups, an 8 mm wide cleft was made by surgery. The suture expanders were fixed onto the palatine bones of the experimental group. The dogs of the experimental group were executed after 3, 7, 14, 28, 56 days of suture expansion. The change of suture tissue was examined by TEM.

RESULTSThe cleft of the experiment group were closed at the ninth day of expansion. At the beginning, tissue rupture, exudation, death of fibroblasts, disruption of collagen and tear vessels were seen at the early stage of suture expansion. Then highly active functional manifestations were seen in both osteocytic and fibrocytic populations. At last, normal structure restored.

CONCLUSIONSCell types and functional condition could be distinguished clearly by TEM. It suggests that the suture expansion should be the process of tissue repair and regeneration. The suture cells response, especially, the osteogenic response were the major factor of increasing suture width.

Alloys ; Animals ; Bone Regeneration ; Cranial Sutures ; surgery ; Dogs ; Maxilla ; surgery ; ultrastructure ; Microscopy, Electron, Transmission ; Nickel ; Osteogenesis ; Osteogenesis, Distraction ; Palate, Hard ; surgery ; ultrastructure ; Tensile Strength ; Titanium

OBJECTIVEInvestigate the response of the patients with obstructive sleep apnea hypopnea syndrome (OSAHS) patients to combination of transpalatal advancement pharyngoplasty and uvulopalatopharyngoplasty.

METHODSThirty two patients with OSAHS, age ranged from 27 to 54, mean value (x +/- s) 39.1 +/- 7.8, male, body mass index (BMI) ranged from 22.9 to 36. 7 kg/m2, mean value (29.0 +/- 3.6) kg/m2, preoperative apnea and hypopnea index (AHI) was 11.7/h to 113.7/h, mean value (61.8 +/- 21.9)/h, the lowest blood oxygen saturation was 0.10 to 0.85, mean value 0.64 +/- 0. 13. With preoperative endoscopic technique, bony nasopharynx cavity narrowing were present, 14 patients had concomitant tonge-base obstruction. Cephalometric result, SNA ranged from 72.9 degrees to 87.0 degrees, mean value (80.7 +/- 4.1) degrees; SNB 69.50 to 85.0 degrees, mean value (76.8 +/- 4.5) degrees; PAS 0.5 cm to 2.1 cm, mean value (1.2 +/- 0.5) cm; MP-H: ranged from 1.2 cm to 3.5 cm, mean value (2.2 +/- 0.7) cm; PNS ranged from 2.4 cm to 3.5 cm, mean value (2.8 +/- 0.4) cm. All the patients had H-UPPP and concomitant transpalatal advancement pharyngoplasty. Fourteen patients with tonge-base obstruction had chin advancement. Results Six months after the operations, the patients were evaluated the response to the operations using Epworth sleep scale, OSAHS filtration questionnaire scale and polysomnography (PSG). There were 27 patients with the decrease percent of AHI reaching or more than 25% and 22 patients with the decrease percent of AHI reaching or more than 50% including 8 patients with AHI less than 5. The other 5 patients were ineffective. After operation, the Epworth sleep scale decreased from (9.2 +/- 4.5) to (4.7 +/- 2. 8) and OSAHS filtration questionnaire scale decreased form (56.0 +/- 15.3) to (17.5 +/- 11.5). Both of the differences were obvious (P < 0.01).

CONCLUSIONSCombination of transpalatal advancement pharyngoplasty and H-UPPP can improve the efficacity and in some patients with pure retropalatal airway narrowing, the cure rate can be improved.

Adult ; Humans ; Male ; Middle Aged ; Otorhinolaryngologic Surgical Procedures ; Palate, Hard ; surgery ; Palate, Soft ; surgery ; Sleep Apnea, Obstructive ; surgery ; Treatment Outcome ; Uvula ; surgery