China Journal of Oral and Maxillofacial Surgery

Effect of silencing circular RNA hsa_circ_0006677 on migration and invasion of oral squamous cell carcinoma

LI Xiang, SU Wen, ZHANG Han-yu, ZHANG Bi-ru, YANG Hong-yu

2019, 17 (4): 289-294. doi: 10.19438/j.cjoms.2019.04.001

Abstract ( 320 )

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PURPOSE: To investigate the role of aberrantly expressed hsa_circ_0006677 in oral squamous cell carcinoma (OSCC) and its effect on OSCC migration and invasion. Methods: Quantitative PCR (qRT-PCR) was used to validate hsa_circ_0006677 in 40 pairs of matched OSCC tissue samples. The correlation between hsa_circ_0006677 expression and clinical information and receiver operating characteristic (ROC) curve was analysed. qRT-PCR assay was used to detect the expression of hsa_circ_0006677 in OSCC cell lines (SCC-9, SCC-15, SCC-25, CAL-27) and human oral keratinocytes (HOK). Scratch test and Transwell assay were used to evaluate the effect of silencing hsa_circ_0006677 on invasion and migration of OSCC cells SCC-15. The data were statistically analysed with Graphpad 5.0 software. Results: Hsa_circ_0006677 was significantly down-regulated in OSCC tissues compared with matched normal tissues (P<0.001), and the relative expression of hsa_circ_0006677 was correlated with cervical lymph node metastasis (P= 0.0405). The area under ROC curve (AUC) was 0.8221. The cutoff value was 10.74, the sensitivity and specificity were 0.8095 and 0.7619, respectively. The expression of hsa_circ_0006677 in SCC-15 and CAL-27 was significantly decreased. After transfecting si-hsa_circ_0006677 into SCC-15 cells, the ability of invasion and metastasis was significantly improved. Conclusions: The circular RNA hsa_circ_0006677 is significantly down-regulated in OSCC. Silencing hsa_circ_0006677 can significantly promote metastasis and invasion of SCC-15 cells.

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Establishment of human vascular endothelial hypoxia/reoxygeneration injury cell model

NIU Qi-fang, LI De-long, YANG Yang, QIN Li-zheng, FENG Zhi-en, LI Jin-zhong, HAN Zheng-xue

2019, 17 (4): 295-299. doi: 10.19438/j.cjoms.2019.04.002

Abstract ( 863 )

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PURPOSE: To establish a cell model of human vascular endothelial hypoxia/reoxygenation injury, as an in vitro model of tissue flap ischemia-reperfusion injury (IRI). Methods: Primary human umbilical vein endothelial cells (HUVECs) were cultured to the 5th generation, then divided into 4 groups randomly according to the time of exposing in hypoxia condition as 3h/2h group, 6h/2h group, 9h/2h group and control group. The cells of hypoxia groups were placed in low-glucose and serum-free DMEM and submitted to hypoxia condition for 3, 6 and 9 h respectively,then cultured in normoxia condition with original complete medium for 2 h as reoxygenation. After reoxygenation, morphological features, structures and numbers were observed, the rate of surviving cells was determined by Trypan blue assay, and the cell viability was measured by CCK-8 assay, the rate of apoptotic cells was detected by flow cytometry with Annexin V-PI assay. The data were analyzed with SPSS 19.0 software package. Results: Compared with the control group,the morphology of HUVECs were obviously damaged in HRI groups,with increasing time of hypoxia,the damage of cells gradually aggravated. In Trypan blue and CCK - 8 assays, the rate of surviving cells and the cell viability decreased in HRI groups, with the increase of hypoxia time, the rate of surviving cells and the cell viability decreased significantly (P<0.05). Annexin V-PI assay showed that the early and late apoptotic rate of cells in HRI groups were significantly higher compared with the control group; and with the increase of hypoxia time,the early and late apoptotic rate increased gradually(P<0.05). Conclusions: The reliable cell model of human vascular endothelial hypoxia/reoxygenation injury was established successfully with cultured HUVECs, which provides a basis for in vitro studies of tissue flap ischemia-reperfusion injury.

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Establishment of an oral squamous cell carcinoma model by using chemical carcinogen 4-NQO

FU You, XU Ke, LI Jiang, SUN Shu-yang, ZHANG Zhi-yuan

2019, 17 (4): 300-303. doi: 10.19438/j.cjoms.2019.04.003

Abstract ( 798 )

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PURPOSE: To establish a murine model with oral squamous cell carcinoma（OSCC）induced by chemical carcinogen 4-NQO. Methods: 4-NQO was added to drinking water for C57BL/6 mice, and the changes of oral mucosa were observed. The mice were sacrificed at various time points (12, 16, 20, 24 weeks), and the tissue samples were collected for identifying the characteristics and primary cell culture. Results: Mice in the experimental group had obvious exogenous tumors in the oral mucosa after 16 weeks, their diameters were about 0.2 mm. H-E staining of the tumors showed exogenous or invasive growth, with obvious keratinization and mitosis. The cells were polygonal and adherent to the wall firmly. CK and ki-67 staining was positive, indicating that the cells were squamous cell carcinoma cells. Conclusions: The induction process of this model is similar to that of human OSCC development, and it is an ideal animal model to study the mechanism of OSCC.

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Effects of Icarisid Ⅱ on proliferation and osteogenic differentiation of alveolar bone-derived stem cells in Beagle dogs

ZHANG Yi-wen, LUO Yuan, GUO Hua-yan, MIAO Guo-jun, ZHANG Ying-di, HUANG Yuan-liang

2019, 17 (4): 304-310. doi: 10.19438/j.cjoms.2019.04.004

Abstract ( 344 )

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PURPOSE: To investigate the effect of Icarisid Ⅱon proliferation and osteogenic differentiation of alveolar bone-derived stem cells(AMSCs) in Beagle dogs. Methods: Alveolar bone-derived stem cells were isolated and cultured from the jaw bone of Beagle dogs in vitro. After dAMSCs were stimulated by ICSII at 10^-5, 10^-6, 10^-7, 10^-8 and 10^-9 mol/L, the proliferation and alkaline phosphatase (ACP) activity of dAMSCs were detected by CCK-8 and ALP kit at 1, 3, 5 and 7 days. ALP staining, Alizarin red staining, Western blot and RT-PCR were performed at different time points to evaluate the osteogenic capacity of cells. SPSS22.0 software package was used for statistical analysis. Results: Primary dAMSCs adhered to the wall, showing spindle shape and multidirectional differentiation ability. ICSII can promote the proliferation of dAMSCs at different concentrations. The results showed that ALP activity was also increased, and the formation of calcium nodules was observed at the experimental concentration. The expression levels of each osteogenic gene increased, which were significantly higher than that of the complete medium group. With the extension of time, runx-2 protein expression decreased in the experimental group, OCN protein expression gradually increased, and the gap between the experimental group and the control group widened. OSX protein expression was higher than that of the control group, but there was no significant difference. Conclusions: ICSII can promote the proliferation and osteogenic differentiation of dAMSCs.

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Expression and clinical significance of CCL2 and CCR2 in salivary adenoid cystic carcinoma

XU Bo-ya, YANG Zi-hui, WANG Jun, LEI De-lin, YANG Xin-jie

2019, 17 (4): 311-315. doi: 10.19438/j.cjoms.2019.04.005

Abstract ( 468 )

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PURPOSE: To investigate the expression of CCL2 and CCR2 in salivary adenoid cystic carcinoma (SACC) and to find out its correlation with clinicopathological characteristics. Methods: Immunohistochemical staining was used to detect the expression of CCL2 and CCR2 in 60 primary SACC cases and 12 normal salivary gland tissues and analyze the correlation with clinicopathological characteristics. The results and clinicopathological data were statistically analyzed by SPSS 17.0 software package with χ² test, Wilcoxon rank sum test, and Spearman's rank correlation coefficient test. Results: High expression of CCL2(91.7%) and CCR2 (88.3%) was found in SACC cases compared with normal ones. The expression of CCL2 and CCR2 was significantly associated with histopathological stages, perineural invasion and distant metastasis (P<0.05), but there was no significant correlation with age, sex, and clinical stages (P>0.05). Conclusions: The expression of CCL2 and CCR2 is closely associated with clinicopathological characteristics of SACC. Detection of the expression of CCL2 and CCR2 may have great value in the diagnosis and clinicopathlogical study.

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The effects of preemptive analgesia with nalbuphine on postoperative pain in elder patients undergoing surgery of oral and maxillofacial neoplasms

ZHU Hao-zhen, SUN Yu

2019, 17 (4): 316-318. doi: 10.19438/j.cjoms.2019.04.006

Abstract ( 414 )

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PURPOSE: The purpose of this study was to evaluate the effects of preemptive single dose nalbuphine on postoperative pain in elder patients undergoing surgery of oral and maxillofacial neoplasms. Methods: The study enrolled 100 tumour patients aged 61 to 84 undergoing oral and maxillofacial surgery. The patients were randomly divided into 2 groups: nalbuphine group (group N, n=51), receiving 20 mg nalbuphine before surgery; while patients in the control group (group C, n=49) received 2 mL normal saline. Patients in both groups underwent same general anesthesia protocol. Postoperative analgesia was assessed by using visual analogue scale (VAS) 1, 2, 6, 12 and 24 h after surgery. The incidence of adverse reactions and additional analgesia consumption were recorded. The data were statistically analyzed with SPSS 22.0 software package. Results: VAS scores in nalbuphine group were significantly lower than the control group 6, 12, 24 h after surgery (P<0.05). 24-hour additional analgesia consumption was significantly smaller in the nalbuphine group than in the control group (P<0.05). The ratio of adverse reaction was significantly lower in nalbuphine group than in the control group (P<0.05). Conclusions: Preemptive analgesia with nalbuphine reduced postoperative VAS scores, adverse event and additional analgesia consumption in elder patients undergoing surgery of oral and maxillofacial neoplasms.

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Effect of PNAM orthodontics combined with Noordhoff operation on cleft lip and palate in children

SHI Guang, ZHANG Xiao, SUN Ying

2019, 17 (4): 319-322. doi: 10.19438/j.cjoms.2019.04.007

Abstract ( 368 )

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PURPOSE: To observe the effects of PNAM orthodontics combined with Noordhoff operation on cleft lip and palate in children. Methods: From March 2016 to August 2017, 120 patients with cleft lip and palate were divided into two groups according to the random number table. Each group had 60 cases. Patients in the experimental group were treated with PNAM orthodontics combined with Noordhoff operation, and patients in the control group were treated with PNAM orthodontic treatment. SPSS 20.0 software package was used for comparison between the two groups. Results: The cure rate of the experimental group (95.00%) was significantly higher than that of the control group (83.33%); pronunciation accuracy of the two groups was significantly improved (P<0.05), and the pronunciation accuracy score of the experimental group was significantly higher than that of the control group (P<0.05); the transverse distance of BK, BK connection, sagittal line and MC-sagittal line of the two groups were significantly decreased. The transverse distance of BK, BK connection, sagittal line and MC-sagittal line in the experimental group were significantly lower than those in the control group (P<0.05). The J-(F-G) of the two groups was significantly increased, and the J-(F-G) of the experimental group was significantly higher than that of the control group (P<0.05). There was no significant difference in the incidence of infection between the two groups ( χ²=1.031, P=0.309); Parents' satisfaction rate of the experimental group (93.33%) was significantly higher than that of the control group (71.67%). Conclusions: PNAM orthodontics combined with Noordhoff operation in the treatment of cleft lip and palate children can effectively improve the situation of cleft maxilla and enhance the accuracy of children's voice. It has good safety and high satisfaction of parents, and It is worthy of wide application in clinic.

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Study on the leadership of head nurses in the practice of evidence-based practice of artificial airway management

LI Qing-ge, YU Lei-lei, HU Jia-le, JIANG Li-li, YUAN Wei-jun, RUAN Hong

2019, 17 (4): 323-326. doi: 10.19438/j.cjoms.2019.04.008

Abstract ( 314 )

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PURPOSE: To study the leadership of head nurses in evidence-based practice of artificial airway management in ICU of tertiary hospitals in Shanghai through self-evaluation and other evaluation, and to compare the difference between them. Methods: From 8 October to 30 November 2018, at 8 tertiary hospitals in Shanghai, 42 ICU head nurses were selected to fill in the Implementation Leadership Scale (Self-rating version) and the ICU nurses to complete the Implementation Leadership Scale (Other-rating version), to measure the head nurse's leadership in evidence-based practice. The data were processed with SPSS 20.0 software package. Results: In the practice of evidence-based leadership, the score of supportive leadership behavior was the highest in both self-assessment and other-assessment, the score of knowledgeable leadership behavior was the lowest in the self-assessment, and the score of proactive leadership behavior was the lowest in other-evaluation. The score of knowledgeable leadership behavior rated by nurses was significantly higher than that by head nurse (P<0.05), and the score of supportive leadership behavior rated by nurses was significantly lower than that by head nurse (P<0.05). Conclusions: In the implementation of evidence-based practice of artificial airway management, the knowledgeable leadership behavior of head nurses is particularly important. The acquisition of manual airway management guidelines is the basis for head nurses to make and implement plans, so as to better support nurses' evidence-based practical learning and application.

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Clinical application of small needle knife therapy combined with exercise therapy in the treatment of displacement of temporomandibular joint disc without reduction

HUATE·Hadeer, ZHOU Wei, PALAHATI·Aimaiti, HU Juan, WANG Shan, MAIMAITITUXUN·Tuerdi

2019, 17 (4): 327-331. doi: 10.19438/j.cjoms.2019.04.009

Abstract ( 681 )

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PURPOSE: To evaluate the clinical efficacy of small needle knife therapy combined with exercise therapy in the treatment of anterior disk displacement without reduction of temporomandibular joint (TMJ). Methods: Thirty-two patients with anterior disk displacement without reduction of TMJ were randomly divided into the experimental group (n=16) and the control group (n=16). Patients in both groups received health guidance, manual reduction, exercise training. Patients in the experimental group were given small needle knife treatment at the same time. Visual analogue score (VAS), maximum mouth opening (MMO), Fricton TMJ index of the two groups were compared and analyzed before treatment, 3 months and 6 months after treatment. MRI examination was performed to observe the reduction of TMJ of the two groups. The measurement data were analyzed with SPSS 19.0 software package. Results: The average MMO of the control group was 25.95 mm before treatment, increased to 38.71 mm after treatment, and the average MMO was 38.94 mm and 38.94 mm at 3 and 6 months of follow-up, respectively. The MMO of the experimental group was 26.3 mm before treatment, increased to 41.06 mm after treatment, 41.04 mm and 41.19 mm at 3 and 6 months of follow -up, respectively. VAS scores in the control group were 3.93 before treatment, 1.60 after treatment, 3 and 6 months after treatment decreased to 1.18 and 0.62, respectively; while in the control group were 4.063 before treatment, 0.80 after treatment, 3 months and 6 months after treatment decreased to 0.375 and 0.25, respectively. Fricton TMJ index significantly improved 3 months and 6 months after treatment, and the treatment effect was significantly different before, after treatment and between the two groups (P<0.05). MRI examination suggested both groups were diagnosed as anterior disc displacement without reduction before treatment. In the control group, 3 months after treatment, 6 of the 16 patients were diagnosed as reducible anterior disc displacement; 6 months after treatment, 3 patients relapsed into anterior disc displacement without reduction.In the experimental group, 3 months after treatment, 5 of the 16 patients were diagnosed as reducible anterior disc displacement; 6 months after treatment, 2 patients relapsed into anterior disc displacement without reduction.The disc-condylar relationship of TMJ in both groups was significantly improved compared with that before treatment (P>0.05). There was no significant difference in therapeutic effect between the two groups after treatment (P>0.05). Conclusions: Small needle knife combined with exercise therapy is more effective than simple exercise therapy in the treatment of irreversible anterior disc displacement of TMJ.

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Breastfeeding rate and related influencing factors in 400 patients with cleft lip and palate

ZHANG Xiao-yu, CHEN Zheng-xi, SHI Jia-jun, LI Zhu-jun, TANG Xia, WENG Meng-jia, HUANG Si-jing, ZHENG Meng-ting, CHEN Zhen-qi

2019, 17 (4): 332-336. doi: 10.19438/j.cjoms.2019.04.010

Abstract ( 425 )

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PURPOSE: To analyze the breastfeeding rate and related influencing factors of patients with cleft lip and palate by means of questionnaire, and to provide theoretical foundation for breastfeeding promotion among patients with cleft lip and palate. Methods: Four hundred patients with cleft lip and palate were randomly chosen from the patients who were treated in Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine during 1994-2017. A questionnaire focusing on breastfeeding rate and related influencing factors of patients with cleft lip and palate was applied. Statistical analysis was performed using SPSS 20.0 software package. Results: Of 400 patients with cleft lip and palate, 184 received breastfeeding which accounted for 46%. Breastfeeding rate of the female patients was 1.868 times than the male (95%CI: 1.241-2.812). Breastfeeding rate of patients whose parents received professional medical counseling of breastfeeding was 1.560 times than those patients whose parents did not receive counseling of breastfeeding (95% CI:1.018-2.391). Breastfeeding rate of cleft lip group was 4.904 times than cleft lip and palate group (95%CI: 3.028-7.943). There was significant difference between direct breastfeeding, soft plastic bottle and hard bottle in different types of cleft lip and palate (P<0.0001). Direct breastfeeding rate of patients with unilateral cleft lip was significantly higher than other types. Soft plastic bottle rate in patients with unilateral lip and palate was significantly higher than other types. There was no significant difference between breastfeeding rate of patients born in different seasons(P=0.1374). Conclusions: Breastfeeding rate in patients with cleft lip and palate is lower than the non-cleft population worldwide. The influencing factors include gender, professional medical counseling and the existence of cleft palate.

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Analysis of long-term prognosis for 172 cases undergoing mandibular reconstruction with free fibular flap

WANG Jian, HE You-ya, CHEN Yi-ming, YANG Xi, JI Tong

2019, 17 (4): 337-341. doi: 10.19438/j.cjoms.2019.04.011

Abstract ( 355 )

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PURPOSE: To analyze the clinical features and risk factors of late complications for patients who received mandibular reconstruction with free fibular flap. Methods: A retrospective study of patients undergoing mandibular reconstruction with free fibular flap from 2011 to 2013 in our hospital was reviewed. Demographic, clinical, imaging, pathological and follow-up data were collected and analyzed with SPSS 17.0 software package. Results: Data of 172 patients were collected, 142 were followed up. Among 142 patients, 19 had late complications, which occurred at a median time of 8 months. Preoperative or postoperative radiotherapy (P=0.02), different type of Ti plates(P=0.019), and the disease characteristics(P=0.02) were significant factors on univariate analysis. Multivariate analysis showed that postoperative radiation(P=0.009) and smoking history (P=0.037) were independent significant factors for late complications. Secondary reconstruction(P=0.069) and preoperative radiotherapy(P=0.086) were potential significant risk factor. Conclusions: Postoperative radiation and smoking history are associated with late complications. Mini-Ti plate should be used cautiously. Patients with risk factors need to be observed for at least 6 to16 months before further management.

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Electro-microdynamic system versus impact air handpiece in impacted mandibular third molar surgery

ZHANG Rui, XUE Chang-ao, ZHANG Feng-ge, ZHANG Jian-hua

2019, 17 (4): 342-345. doi: 10.19438/j.cjoms.2019.04.012

Abstract ( 423 )

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PURPOSE: To investigate the value of electro-microdynamic system compared with impact air handpiece during impacted mandibular third molar removal. METDODS: The 212 mandibular bilateral third molars of 106 patients were extracted in 2 times through a randomized, split-mouth clinical trial. Electro-microdynamic system and impact air handpiece were used respectively. The extraction time,intraoperative and postoperative complications of two groups of patients were recorded and compared statistically with SPSS 21.0 software package. Results: The extraction time, swelling and postoperative pain on the 1st day were significantly lower in patients with electro-microdynamic system than in patients with impact air handpiece (P<0.05). Conclusions: Using electro-microdynamic system can reduce postoperative pain and swelling, which is worthy of clinical application.

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Management of difficult airway in children with hemifacial microsomia during anesthesia induction period

FANG Shu-dong, ZHI Yan-kang, SUN Yu, XU Hui, JIANG Hong

2019, 17 (4): 346-348. doi: 10.19438/j.cjoms.2019.05.013

Abstract ( 385 )

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PURPOSE: To investigate prospectively the morbidity of difficult airway and management in children with hemifacial microsomia. Methods: One hundred and seventy-two patients with hemifacial microsomia scheduled for distraction osteogenesis operation were evaluated for airway condition before induction of anesthesia, the difficult airway grade was determined by evaluating the degree of mouth opening, thyromental distance, the inability to slide the lower jaw in front of the upper jaw, neck activity, Mallampati classification, and Cormack classification. Rapid induction, slow induction with sedation or ketamine-based anesthesia was performed according to the assessment of patients with difficult airways. Results: The morbidity of difficult airway was 31.4% in 172 hemifacial microsomia patients. The ratio of limited mouth opening was 12.2%, and short thyromental distance was 17.4%. The inability to slide the lower jaw was behind the upper jaw in 8.7% of the patients, decreased neck mobility was accounted for 2.3%, 19.8% of the patients had Mallampati classification of Ⅲ or Ⅳ,and the ratio of Cormack grade Ⅲ or Ⅳ patients was 12.2%. All patients were intubated successfully during induction of anesthesia. Conclusions: Managing the airway of children with hemifacial microsomia can potentially be difficult. The need for perioperative careful evaluation is emphasized.

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Kiss flap design of radial forearm flap for primary closure of donor-site without skin-grafting

CHEN Chuan-jun, WANG Yi, WANG Lai-ping, ZHOU Yu, ZHU Wei-zheng, PENG Hui, XIANG Xian-wang, ZHANG Li-yu

2019, 17 (4): 349-351. doi: 10.19438/j.cjoms.2019.04.014

Abstract ( 593 )

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PURPOSE: The design and harvest of radial forearm (RF) flap was modified with kiss flap technique in order to achieve the aim that skin-graft in donor site was not necessarily performed. Methods: The shape of RF flap was designed as two components of kiss flaps like flying wings. The long axis of the two components formed a V shape, and the surrounding retained tissues formed a V-Y geometry after the flap was harvested.The length and width of the components can be adjusted according to the size of the defects.Side-to-side stitching of the two components formed the final surface area to match recipient site and reconstruct the defect and the donor site was directly closed based on V-Y plasty. Results: Reassembling of the two components of RF kiss flap reached the same area of traditional radial forearm flap and the components survived well based on the cutaneous perforator vessels. The donor-site was directly closed without skin-grafting. Conclusions: Kiss design of RF is an ideal technique as donor-site can be directly closed with less donor-site morbidities,less scar formation and no skin-grafting.

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Classification and treatment for recurrent anterior dislocation of temporomandibular joint on 45 cases

SONG Hao-tian, YANG Chi

2019, 17 (4): 352-355. doi: 10.19438/j.cjoms.2019.04.015

Abstract ( 577 )

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PURPOSE: To introduce a classification of recurrent anterior dislocation of temporomandibular joint(TMJ) based on MRI by analyzing relative position of TMJ disc and condylar; and summarize the experience of different therapeutic methods. Methods: MRI data of 45 patients who suffered from recurrent anterior dislocation of TMJ treated in our hospital during May 2003 to May 2016 were collected. On the basis of MRI findings, four categories were proposed, namely type Ⅰ: proper disc position, type Ⅱ: anterior disc displacement,type Ⅲ: osteoarthritis and type Ⅳ with mental disorders. Different treatments were conducted for different types of lesions. Results: TypeⅠ included 28 cases(62.2%), type Ⅱ included 12 cases(26.7%), type Ⅲ included 2 cases(4.4%) and type Ⅳ included 3 cases(6.7%). Type I was treated for either articular tubercle augmentation or arthroscopic sclerotherapy. Type Ⅱ was treated with TMJ disc reduction and fixation (anchoring), and arthroscopic disc reduction and fixation, assisted with TMJ tubercle enhancement. Type Ⅲ was treated according to clinical symptoms of patients. Type Ⅳ was treated using chiseling of the eminence. During the follow-up period, mouth opening limitation, pain, and dislocation recurrence were not present. Conclusions: The classification of TMJ dislocation based on the features of MRI imaging is instructive for surgeons to make appropriate treatment plan.

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Clinical study of oral squamous cell carcinoma with clinically negative cervical lymph node in 111 consecutive case

HAN Shang-zhi, LV Xin, CHEN Xi-bo, LI Le, HAO Li-li, ZHANG Xing-le

2019, 17 (4): 356-358. doi: 10.19438/j.cjoms.2019.04.016

Abstract ( 682 )

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PURPOSE: To investigate some clinical and pathological factors influencing metastasis in oral squamous cell carcinoma(OSCC) patients with clinically negative cervical lymph nodes(cN0). METHORDS: The clinical and pathologic data of 111 OSCC patients with clinically negative cervical lymph nodes between 2007.5-2017.5 were investigated retrospectively. The data were analyzed using SPSS 17.0 software package. Results: The total occult metastasis rate was 27.03%(30/111) in 111 cN0 patients with OSCC. Patient's gender, age, primary site had no significant impact on metastasis (P>0.05), while histopathologic grade of the diseases was closely related to cervical lymph node metastasis. Conclusions: The greater of tumor volume, the lower the degree of differentiation, the smaller the age, the higher occult lymph node metastasis rate. It is suggested that cN0 OSCC patients should be treated with selective neck dissection.

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CT and MRI features of diffuse tenosynovial giant cell tumor in temporomandibular joint

CHEN Pei-qian, TAO Xiao-feng, ZHANG Chun-ye, ZHU Ling

2019, 17 (4): 359-363. doi: 10.19438/j.cjoms.2019.04.017

Abstract ( 777 )

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PURPOSE: To analyze the clinical and imaging features of diffuse tenosynovial giant cell tumor (D-TSGCT) in temporomandibular joint (TMJ) space, in order to improve the diagnostic accuracy of the disease. Methods: Clinical features, CT and MRI findings of 23 cases confirmed by operation and pathology from November 2015 to May 2018 were analyzed retrospectively. Results: The main clinical symptoms in 23 cases were mass in preauricular region with pain. Maxillofacial CT showed mass in TMJ area,the average CT value was (72±20.49)HU,the average enhanced CT value was (125.3±22.68)HU. Nine cases (39.1%) had irregular or circular lower density lesions in the mass, but no enhancement was found after enhancement. Calcification was found in 14 cases (60.1%), widened articular space was found in 16 cases (69.6%), condylar bone destruction occurred in 14 cases (60.1%),bone destruction of articular fossa occurred in 17 cases (73.9%), tympanic destruction occurred in 6 cases(26.1%). Six cases (66.7%) showed iso-and hypo-intense signal on T1WI,hyper-and hypo-intense on T2WI; two cases(22.2%) showed hypo-intense signal on T1WI and hypo-intense on T2WI; one case（11.1%） showed iso-intense signal on T1WI and hypo-intense on T2WI. Cystic lesions were found in 5 cases (55.6%). Conclusions: The main clinical symptoms of D-TSGCT in TMJ space is mass in preauricular region with pain. Imaging features are high density of masses with calcifications, enhancement obviously after contrast injection and destruction of condyle, articular fossa and tympanic walls. T2WI shows characteristic low signal, cystic lesions may occur. Combined use of enhanced CT and MRI can significantly improve the diagnostic accuracy of D-TSGCT in TMJ.

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Clinical application of the pedicled buccal fat pad flap in immediate reconstruction of oral tissue defects during oral surgery

ZHU Hua-jun, XIAO Wan-shu, TANG Jing, GE Zi-li

2019, 17 (4): 364-367. doi: 10.19438/j.cjoms.2019.04.018

Abstract ( 365 )

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PURPOSE: The aim of this study was to investigate the effect and indication of the application of pedicled buccal fat pad flap for oral tissue defects during oral surgery. Methods: Eight-six cases (58 males, 28 females; mean age: 50 years) suffering from oral tumor were included in this study. The defect after tumor resection was immediately repaired by pedicled buccal fat pad transplantation. The effect and postoperative complications were observed. Results: All cases underwent uneventful healing with a surviving graft. The buccal fat pad healed in about 9 to 10 weeks and its uncovered surface became epithelialized with similar feature to the normal mucosa. At a follow-up of 3 months to 3 years, a good outcome was obtained with minimal malfunction and facial deformity. Complications were only 3.5%. Conclusions: The pedicled buccal fat pad is ideal material for repair. It has fewer complications and is a viable option for immediate reconstruction of oral tissue defects during oral surgery.

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An improved method of repairing nose columella combined defects

YANG Jun-shan, YANG Jing, LI Man

2019, 17 (4): 368-370. doi: 10.19438/j.cjoms.2019.04.019

Abstract ( 324 )

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PURPOSE: To introduce an improved method of repairing nose columella combined defects. Methods: According to the size, shape and depth of the nasal columella defect at the tip of nose, a combined forehead-nose-nasolabial groove skin flap pedicled on the branches of the medial canthus was designed to repair the defect. Results: Eight cases were operated successfully. All flaps survived without obvious complications and all nasal shape outline was fine. Conclusions: The improved skin flap can be used to repair the defect of nasal tip and columella at one time. The effect is satisfactory, and the method is worthy of wide application.

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PIK3CA-related overgrowth spectrum(PROS): Diagnostic and testing eligibility criteria, differential diagnosis, and evaluation

SONG Yong-hai, CHE Zong-gang, CHEN Zheng-gang

2019, 17 (4): 371-376. doi: 10.19438/j.cjoms.2019.04.020

Abstract ( 712 )

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PIK3CA, which encodes phosphatidylinositol 3 kinase (PI3K) subunit p110a, has been identified as an oncogene. Somatic mutations in the PIK3CA gene cause heterogeneous segmental overgrowth of body tissues, displays as various phenotypes include hemihyperplasia multiple lipomatosis (HHML), megalencephaly-capillary malformation (MCAP), CLOVES syndrome et al. Clinical findings of these syndromes were distinct, but partially overlapping ,and its designations were non-uniformed. The distinct clinical focus of the investigators has led to ascertainment bias in the published literature, complicating a comprehensive assessment of genotype-phenotype correlation analysis. On September 11 and 12, 2013,a two-day workshop convened on the NIH campus in Bethesda, Maryland, discussed emerging clinical and molecular information on the phenotypes caused by PIK3CA somatic mutations. The umbrella term of "PIK3CA-related overgrowth spectrum (PROS)" was agreed upon. Key clinical diagnostic features and criteria for testing were proposed, and testing approaches were summarized. Preliminary recommendations for a uniform approach to assessment of overgrowth and molecular diagnostic testing were determined. Future areas to address including surgical management of overgrowth tissue and vascular anomalies, the optimal approach to thrombosis risk, and the testing of potential pharmacologic therapies. This paper introduced the outcomes of this workshop to provide clarity in research endeavors and to give clinicians useful designations for management, prognostication, and the design of clinical trials of targeted therapies.

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