1/33. Coexisting congenital sublingual dermoid and bronchogenic cyst.A congenital dermoid together with a bronchogenic cyst at the base of the tongue is extremely rare. We describe a 5-year-old boy who presented with an enlarged anterior segment of mandible, slight swelling of the left submandibular region, and a large swelling of the floor of the mouth that was displacing the tongue posteriorly. Both cysts were successfully excised and the boy made an uncomplicated recovery. Occlusion and mastication returned to normal and his speech improved remarkably.- - - - - - - - - - ranking = 1keywords = mandible (Clic here for more details about this article) |
2/33. A large maxillofacial prosthesis for total mandibular defect: a case report.We successfully fabricated a large maxillofacial prosthesis for replacement of a total mandibular defect resulting from surgical failure to reconstruct the mandible. Although a number of reports have described procedures for fabricating midfacial prostheses, there is little information on prostheses to compensate for total loss of the mandible. A 54-year-old woman was referred to the dentistry and Oral Surgery Division of the National Cancer Center Hospital with total loss of the mandible and the surrounding facial soft tissue. The facial prosthesis we used to treat this patient is unique in that it is adequately retained without the use of extraoral implants and conventional adhesives. This prosthesis is retained by the bilateral auricles and the remaining upper front teeth. We present details of the design of this large silicone maxillofacial prosthesis, with which we successfully rehabilitated the patient.- - - - - - - - - - ranking = 3keywords = mandible (Clic here for more details about this article) |
3/33. Distraction of scarred soft tissue before secondary bone grafting. A case report.Mandibular distraction was performed to restore oral function in a 52-year-old man with tongue cancer, in whom a mandibular fracture developed after marginal resection of the mandible. The fracture caused the mandibular dental arch to be shorter than the maxillary arch. An external fixation device was attached to the collapsed mandible. The mandibular soft tissue was expanded by 32 mm. After gradual distraction, a vascularized iliac bone graft was transferred to the lengthened space. Subsequently, vestibuloplasty was performed and implants were inserted. A normal appearance, acceptable occlusion and satisfactory oral function were achieved.- - - - - - - - - - ranking = 2keywords = mandible (Clic here for more details about this article) |
4/33. Total tongue reconstruction with free functional gracilis muscle transplantation: a technical note and review of the literature.The tongue is one of the most difficult structures of the body to reconstruct if more than 85% to 90% of it has been resected. A functional neotongue requires both soft-tissue bulk and restoration of muscle function. The innervated gracilis muscle flap folded on itself was used to reconstruct a total glossectomy defect. The genioglossus muscle, which makes the greatest contribution to swallowing, and the mylohyoid muscle, which elevates the larynx to prevent aspiration, were simulated with the design and placement of the gracilis muscle. The muscle was placed and secured longitudinally from the remnant of the tongue base and pharynx to the mandible, and then folded on itself and attached to the hyoid bone. The obturator nerve to the gracilis was coapted with the hypoglossal nerve. The patient was able to resume oral feeding without aspiration. Electromyographic results demonstrated reinnervation of the flap with active elevation of the mouth base. The patient died 1 year postoperatively because of recurrence of her disease. This type of design and placement of gracilis muscle transplantation is recommended.- - - - - - - - - - ranking = 1keywords = mandible (Clic here for more details about this article) |
5/33. New multilobe "accordion" flaps for three-dimensional reconstruction of wide, full-thickness defects in the oral floor.When reconstructing a wide, full-thickness intraoral defect, the following principles are necessary for active food transport and improved swallowing and speech. First, the flap should touch the palate and obliterate the oral cavity. Second, jaw or flap excursion should not be hindered by tethering of the flap in the neck. And third, all surfaces of the tongue and oral floor, and the dead space of the floor should be reconstructed. To accomplish these goals, two new designs, similar to an accordion, using an anterolateral thigh flap and a deep inferior epigastric perforator flap have been developed. The outlines of multilobe flaps create an accordion-type structure of the tongue and oral floor complex. The advantages of the new designs using anterior thigh or deep inferior epigastric perforator flaps are follows: First, three-dimensional intraoral reconstitution allows maximal movement postoperatively of the reconstructed tongue. Second, the donor sites are so far from the tongue that simultaneous flap elevation is possible for tumor resectioning. Third, even in obese patients, totally or partially thin flaps are available. And fourth, in most patients the donor defects can be closed directly.- - - - - - - - - - ranking = 0.021853415093825keywords = jaw (Clic here for more details about this article) |
6/33. Radial forearm free tissue transfer for head and neck reconstruction: versatility and reliability of a single donor site.Since its description as a free flap, the radial forearm flap has undergone numerous modifications for reconstruction of various defects in the head and neck region. Fasciocutaneous, adipofascial, osteocutaneous, tendinofasciocutaneous, or osteotendinofasciocutaneous flaps may be designed and transferred from the radial forearm. This article illustrates the versatility and reliability of this donor site in 15 patients with a variety of head and neck oncologic defects who underwent immediate (12 patients) and delayed (3 patients) reconstruction using different free flaps from the radial forearm. skin flaps were used in 11 patients (73.3%) with floor of mouth (4 cases), hemiglossectomy (2 cases) and partial maxillectomy (2 cases) defects, and for scalp (1 case), lower lip (1 case) and a central face (anterior maxilla/upper lip/nasal) (1 case) defect. Osteocutaneous flaps were used in four patients (26.6%) for reconstruction of bilateral subtotal maxillectomy defects (2 cases), a complex forehead and nasal defect (1 case), and for mandible reconstruction (1 case). In addition, the palmaris longus tendon was included with the flap in the two patients that required oral sphincter reconstruction. One patient required reexploration due to vein thrombosis, and no flap failures were detected in this series. The donor site healed uneventfully in all patients, except one, who had partial skin graft failure. Because of their multiple advantages, free flaps from the radial forearm have a definite role for reconstruction of head and neck defects. New applications of composite flaps from this donor site may continue to emerge, as illustrated in some of our patients.- - - - - - - - - - ranking = 1keywords = mandible (Clic here for more details about this article) |
7/33. osteoradionecrosis of the mandible.osteoradionecrosis is a major complication of surgery or trauma in previously irradiated bone in the absence of tumor persistence. radiation-induced vascular insufficiency rather than infection causes bone death. It occurs most commonly in the mandible after head and neck irradiation. risk factors include the total radiation dose, modality of treatment, fraction size and dose rate, oral hygiene, timing of tooth extractions as well as the continued use of tobacco and alcohol. This condition is often painful, debilitating, and may result in significant bone loss. The recommended treatment guidelines are irrigation, antibiotics, hyperbaric oxygen therapy, and surgical techniques, including hemimandibulectomy and graft placements.- - - - - - - - - - ranking = 5keywords = mandible (Clic here for more details about this article) |
8/33. Distraction osteogenesis in functional reconstruction of mandible--report of 6 cases.OBJECTIVE: To study the application of distraction osteogenesis in mandibular function reconstruction. methods: Three types of mandibular distractors were used in 6 patients with different mandibular defects due to tumor resection. For 2 cases with ramus defects, specially designed distractors were used to restore the normal height of the ramus. In 1 case, the trifoci distraction principle was used and a trifoci distractor was designed. In 3 cases, vertical distractors made in germany or china were used. The patient average age was 31.5 years old (ages ranged from 8 to 54). RESULTS: In 5 cases the mandibular lengthenings were successful according to the direction and distance chosen before distraction. In 1 case, the trifoci distraction principle was applied and a proximal 23 mm mandibular defect was successfully corrected; however, the 23 mm distal mandibular defect was not corrected because the screws for fixation of the transport block were loosened. infection and dysosteogenesis did not occur in any cases. CONCLUSION: Distraction osteogenesis can successfully be used in mandibular functional reconstruction and is more advantageous than traditional techniques. The most favorable time for distraction osteogenesis in mandibular reconstruction is at the time of tumor resection.- - - - - - - - - - ranking = 4keywords = mandible (Clic here for more details about this article) |
9/33. Multiple congenital epulis of the alveolar ridge and tongue.Congenital granular cell tumor, also known as congenital epulis, is a very rare lesion seen in newborns. The typical presentation is a solitary nodule occurring on the gingiva of the anterior alveolar ridge of either jaw. Multiple-site involvement is seen very seldom but has been noted on the same or different alveolar ridges. However, tongue involvement is exceptional, and there have been only three cases reported involving both the alveolus and the tongue. A female newborn with multiple congenital epulis on the mandibular alveolar ridge and tongue is presented, and her preferred treatment and histopathological diagnosis are discussed.- - - - - - - - - - ranking = 0.021853415093825keywords = jaw (Clic here for more details about this article) |
10/33. Lateral mandibulectomy and partial glossectomy with plate application.The goals of composite resection with reconstruction plate application include removal of the primary tumor, any compromised portions of the mandible, and any involved lymph-bearing tissue. Recent advances in surgical technique and reconstruction have made this treatment a more appealing choice for patients. Although microvascular free flaps may be the treatment of choice in the younger patient with an excellent prognosis, the use of reconstruction plates with a myocutaneous flap remains a viable alternative for many patients with oral cancer. Regardless of the reconstructive technique utilized, both functional and aesthetic parameters must be addressed in treatment planning for patients with head and neck cancer.- - - - - - - - - - ranking = 1keywords = mandible (Clic here for more details about this article) |
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