Maxillofacial Tumors Research Articles

A Prospective Study on Odontogenic Tumors Among Patients Attending Muhimbili National Hospital, Dar Es Salaam, Tanzania

Introduction: Odontogenic tumors which may be benign or malignant, constitute a group of heterogeneous lesions that are derived from the tooth-producing tissues or their remnants that are entrapped either within the jawbones or into the adjacent soft tissues. Aim of the study was to determine the pattern of occurrence and clinicopathological presentation of odontogenic tumors among patients attending the oral and maxillofacial unit at Muhimbili National Hospital (MNH), Dar es Salaam, Tanzania using 2005 WHO classification. Material and Methods: This was a cross-sectional hospital-based study that included patients with oral and maxillofacial tumors. Patients’ information was gathered using a structured questionnaire. Clinical and histological examination was done, and the findings were recorded in a specially designed form. Data was processed and analyzed using Statistical Package for Social Sciences (SPSS) version 19. Results: A total of 102 patients with histological diagnosis of odontogenic tumors comprising 52 (51%) males and 50 (49%) females, were included in this study. The mean age of the patients was 34.07 ± 14.8 SD years and the most affected age group was 20-29 years. Majority 76 (74.5%) of the patients had odontogenic tumors comprised of odontogenic epithelium with mature fibrous stroma without odontogenic ectomesenchyme. Ameloblastoma was the most (65.7%) common odontogenic tumor followed by odontogenic myxoma/myxofibroma (5.9%) and Keratocystic Odontogenic Tumor (5.9%). Conclusion: Generally, the sociodemographic distribution and frequency of occurrence, of odontogenic tumors seen in this study is similar to that reported in other African and Asian studies but differed with American and European studies. Ameloblastoma was the most common odontogenic tumor with a high propensity for the mandible compared to the maxilla.

Perioperative Risk Factors for Radial Forearm-Free Flap Complications.

To determine perioperative risk factors predicted complications in elderly Chinese patients undergoing oral and maxillofacial reconstruction with radial forearm free flaps (RFFF). The authors implemented a retrospective study and enrolled a sample of patients at least 65-year old who underwent resection of oral and maxillofacial tumors and RFFF reconstruction from January 2011 to June 2018. Predictor variables were divided into: demographic variables (gender, age, weight, comorbidities, history of smoking, radiotherapy history, primary lesions); hemodynamic (preoperative and postoperative hemoglobin and albumin level, blood loss, blood transfusion, urine output (mL), and rate (mL/kg/h), and infusion rates for crystalloids and colloids (mL/kg/h, and volumes given intraoperatively and postoperatively for 24 hours); anesthetic and surgical (American Society of Anesthesiologists classification, visual analogue score, duration of tourniquet, and operation). The primary outcome was the presence of postoperative complications (yes/no), and secondary outcome was types of complications (medical and surgical). All the variables were analyzed by univariate and multivariable analysis and statistical significance was set at a P < 0.05 RESULTS:: The study sample was composed of 118 patients with a mean age of 72 years. There were 15 complications, of which 9 were surgical and 6 medical. Risk factors were: postoperative hypoproteinemia, crystal in 24 hours, and hypertension combined with diabetes. Although reconstruction with a RFFF is a common and safe treatment for elderly patients with oral and maxillofacial tumors, postoperative hypoproteinemia, crystal in 24 hours, and hypertension combined with diabetes are potential predictors of postoperative complications.

Fiberoptic intubation of a child with huge maxillofacial tumor under spontaneous respiration

Fiberoptic intubation of a child with huge maxillofacial tumor under spontaneous respiration

Dental rehabilitation in the complex treatment of children and adolescents with maxillofacial neoplasms

Of the study was to improve algorithms and methods of complex dental rehabilitation of children and adolescents with maxillofacial neoplasms. Sixty-seven patients aged from 2 to 17 years (average age 10.43±4.56; 30 boys, 37 girls) underwent complex rehabilitation as a part of neoplasm treatment (40 benign, 27 malignant). Patients were divided into 3 groups: group 1 aged 2 to 7 years; group 2 aged 8 to 12 years; group 3 aged 13 to 17 years. Structural integrity of upper and lower jaws was reconstructed using vascularized bone flaps (27 cases), non-vascularized bone flaps (5 cases), titanium reconstructive plates (11 cases) or individual titanium endoprostheses of the temporomandibular joint (2 cases). Orthodontic, orthopedic and surgical dental treatment was performed at all stages of rehabilitation of patients and had its own characteristics depending on the group affiliation. Algorithms for dental rehabilitation of children and adolescents with maxillofacial neoplasms have been improved on the base of performed treatment.

Health-Related Quality of life of Patients Surgically Treated for benign Oral and Maxillofacial Tumours and Tumour-like lesions at Muhimbili National Hospital, Tanzania

Health-Related Quality of life of Patients Surgically Treated for benign Oral and Maxillofacial Tumours and Tumour-like lesions at Muhimbili National Hospital, Tanzania

Paediatric jaw tumours: experiences and findings from a resource limited tertiary health care center.

Introductionprimary maxillofacial tumors are uncommon in pediatric patients. When they do occur, the tissue damage caused directly alters facial growth, development as well as psycho-social evolution. This study was carried out to determine the pattern, sociodemographic characteristics and histologic peculiarities of paediatric jaw tumors in our environment.Methodsa retrospective hospital-based study where the case notes of children below the age of 14 years who presented with jaw tumors and tumor-like lesions from January 2014 to December 2018 were studied.Resultseighty-two patients were studied; patients aged 10-14 years had the highest representation. Mean time of presentation was 8 months with jaw swelling being the commonest presentation (84.1%). Majority of the fathers were in their 4th decade of life while most of the mothers were in their third decade of life and both parents possessed primary school certificate as their highest level of educational attainment. Fathers were mostly traders, while mothers were mostly full-time housewives. The maxilla and mandible were most commonly affected with the left side showing higher preponderance. Burkitt lymphoma (19 (23.2%)) and adenomatoid odontogenic tumor (14 (17.1%)) were the commonest lesions. When the tumor involved both the maxilla and the mandible, the tumor was most likely malignant.Conclusionin our center, paediatric jaw tumors are commonest in male children with the 10-14 years´ age group most commonly affected. Burkitt lymphoma and adenomatoid odontogenic tumors were the commonest tumors. Early presentation must be encouraged since these tumors if presented early can be successfully treated.

Inhibition effect of miR-150 on the progression of oral squamous cell carcinoma by data analysis model based on independent sample T-test.

To explore the influence of mir-150 (M-150) ornithine decarboxylase (ODC) or inhibition in the development of oral squamous cell carcinoma (OSCC), the malignant tumor (MT) textures removed by surgical resection of maxillofacial tumors in patients with OSCC and the normal neighbor oral textures were collected. Then human OSCC cal-27 cell line was cultivated in vitro. The expression differences of M-150 in MT textures, neighbor textures and cal-27 cells were explored by fluorescence polymerase chain reaction (PCR). Cal-27 cells were transfected with M-150 mimic, M-150 inhibitor (M-150-I) and negative control of different concentrations, respectively, to test the transfection rate. After transfection (AF) with the optimum transfection concentration, the migration rate of transfected cells was explored by cell scratch test. Transwell assay was used to detect the change of aggression rate of transfected cells. Finally, independent sample t-test model was used to explore and compare the results between groups. The results manifested that the expression of M-150 (Eom) in MT textures and cal-27 cells was obviously less than that in neighbor normal textures (P < 0.05). Transfection rate results manifested that M-150 mimic of 100 nmol/L and M-150-I of 50 noml/L had the best efficiency. AF, cell migration and aggression (M&A) rates in the M-150 mimic group were obviously less than those in the negative control group (CP) (P < 0.05), while those in the M-150-I group were obviously upper (P < 0.05), which indicates that the over Eom could inhibit the M&A of OSCC cells, and thus play an effect in inhibiting the development of OSCC.

Anesthesia-Related Risk Factors for Anterolateral Thigh Free Flap Complications in 161 Elderly Chinese Patients Who Received Oral and Maxillofacial Reconstruction

The authors designed and implemented a retrospective study which enrolled patients at over 65-years-old who underwent resection of oral and maxillofacial tumors and ATFF reconstruction from January 2011 to March 2019. Predictor variables were divided into: 1) Demographic variables (gender; age; weight; comorbidities; smoking status); 2) Anesthetic (American Society of Anesthesiologists (ASA) classification.

Late reporting for health care among patients presenting with oral maxillofacial tumours or tumourlike lesions in Muhimbili National Hospital, Tanzania

Introduction: In developing countries patients with oro-facial tumours present for health care rather late with advanced disease, a situation that complicates management and negatively influences prognosis.&#x0D; Objective: To determine the reasons for late reporting for health care among patients with tumours and tumour-like lesions in the maxillofacial region attending the Muhimbili National Hospital.&#x0D; Materials and Methods: This was a descriptive cross-sectional study, which involved 144 patients with either tumours or tumour-like lesions in the oral and maxillofacial region. The study was conducted at the oral and maxillofacial surgery firm of the Muhimbili National Hospital (MNH). A structured questionnaire that was translated to Swahili language was used to gather information. The diagnosis was obtained from the histopathology department of the MNH. Data were analysed using SPSS version 20. Ethical clearance was obtained from the ethical committee of Muhimbili University of Health and Allied Sciences (MUHAS).&#x0D; Results: Findings revealed that 55.6% of the patients lived near health facilities (dispensaries, health centres or hospitals) which did not offer oral health services. The average time of reporting after a referral from primary health facilities was rather long (69 weeks). Ameloblastoma was the frequently encountered benign tumour and squamous cell carcinoma was the commonest malignant neoplasm. The absence of pain, transport and treatment costs, lack of perception that the lesion was a problem, attending to traditional healers and the use of herbal medicines were reported to be main reasons for the delay in reporting for health care. The odds of reporting late to the referral hospital was three folds higher in patients who had delayed to seek treatment from the primary health facility.&#x0D; Conclusion: Generally, there are varying levels of delay of patients with tumours in reporting to primary health facilities and to referral centres. The major reasons cited for delay in reporting for health care were cost implications and tendency to attend to traditional healers.

Late reporting for health care among patients presenting with oral maxillofacial tumours or tumourlike lesions in Muhimbili National Hospital, Tanzania

Introduction: In developing countries patients with oro-facial tumours present for health care rather late with advanced disease, a situation that complicates management and negatively influences prognosis.Objective: To determine the reasons for late reporting for health care among patients with tumours and tumour-like lesions in the maxillofacial region attending the Muhimbili National Hospital.Materials and Methods: This was a descriptive cross-sectional study, which involved 144 patients with either tumours or tumour-like lesions in the oral and maxillofacial region. The study was conducted at the oral and maxillofacial surgery firm of the Muhimbili National Hospital (MNH). A structured questionnaire that was translated to Swahili language was used to gather information. The diagnosis was obtained from the histopathology department of the MNH. Data were analysed using SPSS version 20. Ethical clearance was obtained from the ethical committee of Muhimbili University of Health and Allied Sciences (MUHAS).&#x0D; Results: Findings revealed that 55.6% of the patients lived near health facilities (dispensaries, health centres or hospitals) which did not offer oral health services. The average time of reporting after a referral from primary health facilities was rather long (69 weeks). Ameloblastoma was the frequently encountered benign tumour and squamous cell carcinoma was the commonest malignant neoplasm.The absence of pain, transport and treatment costs, lack of perception that the lesion was a problem, attending to traditional healers and the use of herbal medicines were reported to be main reasons for the delay in reporting for health care. The odds of reporting late to the referral hospital was three folds higher in patients who had delayed to seek treatment from the primary health facility.&#x0D; Conclusion: Generally, there are varying levels of delay of patients with tumours in reporting to primary health facilities and to referral centres. The major reasons cited for delay in reporting for health care were cost implications and tendency to attend to traditional healers.

Validation of Regional Lymph Node Excisional Biopsy for Staging Oral and Maxillofacial Malignant Neoplasms in 97 Dogs and 10 Cats (2006-2016).

The objective of this retrospective clinical study was to confirm the validity of excisional biopsy of regional lymphocentrums for staging oral and maxillofacial neoplasms in a population of 97 dogs and 10 cats. Patients diagnosed with oral and maxillofacial malignant neoplasms underwent ipsilateral excisional biopsy of the mandibular, parotid, and medial retropharyngeal lymphocentrums that receive afferent drainage from the oral and maxillofacial region followed by curative intent surgery of the neoplasm. Biopsy specimens and the resected neoplasm were submitted to a commercial pathology laboratory for histopathologic assessment. The incidence of metastasis to one or more regional lymphocentrums was 14.0%. Of the cases with metastatic disease, 26.7% did not involve the mandibular lymphocentrum. Although the incidence of regional lymph node metastasis was less than reported previously, regional lymph node assessment is warranted in cases of oral and maxillofacial neoplasia.

Advanced sinonasal malignancy – therapeutic challenge

Maxillofacial tumors are rare malignancies that constitute about 0.2-0.5% of all human malignancies. The initial symptoms of the disease are non-typical and imitate inflammation of paranasal sinuses. Most often, patients report one-sided nasal obstruction with bloody and purulent discharge and headaches. In addition to physical examination - often with the use of endoscopic nasal cavity assessment, it is necessary to perform computed tomography of the paranasal sinuses and magnetic resonance for accurate assessment of the extent of the lesions. Histopathological examination of tumor specimens is necessary for making the final diagnosis and planning treatment. Squamous cell carcinoma is the most common histological type in the sinonasal region. Other common malignancies in this area include adenocarcinoma, carcinoma adenoides cysticum, lymphomas, melanoma, and olfactory neuroblastoma. The treatment of choice of all malignant changes in the sinonasal complex, except for lymphomas, is surgical treatment. Unfortunately, a still high percentage of lesions is diagnosed at an advanced stage of the disease, when the infiltration includes the skull base. In these cases, the decision to perform a radical surgical treatment in the patient is very difficult and requires a lot of experience in the surgery of the skull base. However, due to the low radiosensitivity and low effectiveness of chemotherapy in sinonasal malignancy, resection of lesions and complementary treatment contribute to the prolongation of overall survival in this group of patients. The article discusses the cases of two patients with advanced cancer of the sinonasal complex reffered to the Otolaryngology Department of the Medical University of Warsaw.

Research progress on the application status of dysphagia assessment scale and functional training for patients with oral and maxillofacial tumors

This article summarizes the causes of dysphagia in patients with oral and maxillofacial tumors, the application of dysphagia assessment scale; and the current status of functional training for those patients, so as to provide the reference for delivering clinical and continued nursing care for the patients with dysphagia. Key words: Review; Dysphagia; Oral and maxillofacial tumor; Assessment scale; Functional training

Autologous Free Fat Graft for Repair of Concave Deformity After Total Parotidectomy.

Resectioning of giant maxillofacial tumors has been shown to cause facial depression deformity, representing a persistent challenge for surgeons. Here, the authors review their experience using autologous free fat grafts to repair total parotidectomy defects. This review aims to encourage the surgical field to pay more attention to this century-old treatment technique. Patients were included who underwent free fat transfer for tissue reconstruction after total parotidectomy at the Affiliated Stomatology Hospital of China Medical University between 2012 and 2018. Patients with bleeding disease or postoperative follow-up less than 6 months were excluded. Twenty-three patients between the ages of 35 and 68 were included in this analysis. Ten patients (6 males, 4 females) underwent fat grafting at the time of total parotidectomy, and a control group of 13 patients (9 males, 4 females) underwent total parotidectomy without correction of concave deformities. There were significant differences between fat graft group and control group in terms of age (44.9 ± 9.0117 years versus 56.385 ± 8.9586 years; P = 0.006), Frey syndrome questionnaire score (1 ± 0 versus 2.385 ± 1.0439; P = 0.00), blood loss (195.7 ± 54.8777 mL versus 107.769 ± 22.8916 mL; P = 0.001), postoperative drainage (319.8 ± 103.1803 mL versus 230.385 ± 53.5701 mL; P = 0.027), duration of postoperative drainage (122.4 ± 23.8663 hours versus 90.462 ± 22.2434 hours; P = 0.003), and satisfaction questionnaire score (8.5 ± 0.8498 versus 3 ± 1.1547; P = 0.00). The difference in operation time between the fat graft group and control group was not significant (417 ± 108.0062 min versus 351.538 ± 91.7475 min; P = 0.131). Autologous free fat grafting resulted in more blood loss as well as an increased volume and duration of postoperative drainage. Remarkably, however, patients had superior satisfaction, lower Frey syndrome scores, and similar operation times with use of free fat grafting after parotidectomy. The authors recommend such grafting be utilized to repair concave deformities secondary to total parotidectomy.

Correlation of factors associated with postoperative infection in patients with malignant oral and maxillofacial tumours: a logistic regression analysis

Patients with oral and maxillofacial malignant tumours have a relatively high incidence of postoperative infections. We have analysed the risk factors and the distribution of pathogens in infected patients to try and find out how to prevent them. We recruited 312 patients over 60 years old with malignant oral and maxillofacial tumours and investigated their incidence of postoperative infection between January 2007 and December 2017. Some factors were included in one way and multifactorial logistic analyses to find out which risk factors were likely to be associated with postoperative infections. Thirty-nine of the 312 (12.5%) developed postoperative infections, mainly at the surgical site (n = 21) and in the lower respiratory tract (n = 14). Pathogens were isolated from all patients and comprised aerobic (n = 4) and anaerobic (n = 5) bacteria, together with mixed infections (n = 30). Univariate analysis showed that age, size and site of tumour, body-mass index (BMI), diabetes, and duration of operation were risk factors. Multivariate logistic analyses, however, showed that BMI, the presence of diabetes, duration of operation, and American Society of Anesthesiologists (ASA) score were the main independent risk factors for postoperative infection. We conclude that there are abundant risk factors for postoperative infection in these patients, and it is important that they are evaluated preoperatively so that suitable postoperative treatments can be given.

Application of disposable drainage bag as an attachment of postoperative drainage device in oral and maxillofacial tumor surgery

Objective To explore the role of disposable drainage bag as an attachment of postoperative drainage device in oral and maxillofacial tumor surgery. Methods Using convenient sampling method, a total of 200 patients with wound drainage requiring postoperative maxillofacial tumor observation from December 2017 to March 2018 in the PACU of Peking University Hospital of Stomatology were selected as subjects. According to the enrollment time, they were divided into two groups. The first 100 cases were the control group, the negative pressure drainage device was used alone, and the latter 100 cases were the experimental group, the negative pressure drainage device was used to connect the disposable drainage bag. The working time of nurses with drainage device, contamination of drainage fluid and wound infection rate related to drainage device were compared between the two groups. Results The nursing operation time of the control group was (73.57±42.17) s; there were16 cases of drainage fluid contamination; the infection rate of drainage tube was 0. The nursing operation time of the experimental group was (49.20±22.35) s; the drainage fluid was contaminated in 2 cases; the drainage infection rate was 0. The working time of nurses with drainage device and contamination of drainage fluid in the experimental group were significantly lower than those in the control group (P<0.05) . Wound infection related to drainage device did not occur in either groups. Conclusions Disposable drainage bag as an attachment of postoperative drainage device can significantly decrease the time of nursing work, reduce contamination of drainage fluid and does not increase the incidence of drainage-related infections. It can be promoted to use in clinical work. Key words: Perioperative nursing; Drainage; Infection control; Oral and maxillofacial surgery; Negative pressure drainage device

Oral tumours

Dental, maxillofacial and oropharyngeal tumours develop in both cats and dogs, and depending on their type, location and behaviour can have a significant impact on the patient's quality of life and ability to perform their normal activities of daily living. This article aims to outline the incidence, types and behaviours of a variety of common oral, maxillofacial and oropharyngeal tumours encountered and their potential impacts on the patient, as well as current treatment options, as it is vital all veterinary professionals are aware of these facts and factors when advising and supporting clients regarding the treatment options for their pets.

Michigan Medicine: The University of Michigan Head and Neck Anesthesiology and Advanced Airway Management Fellowship

Michigan Medicine: The University of Michigan Head and Neck Anesthesiology and Advanced Airway Management Fellowship

Benefit of rehabilitation for patients with postoperative defects due to maxillofacial tumors

Benefit of rehabilitation for patients with postoperative defects due to maxillofacial tumors

Free Flap Transplantation on the repair of defects caused by oral and maxillofacial tumors resection.

Objective:To investigate the efficacy of free flap transplantation on the repair of tissue defects after oral and maxillofacial malignant tumor resection and its effects on serum sialic acid (SA) and interleukin-2 (IL-2).Methods:Fifty-eight patients with oral and maxillofacial tumors were enrolled and set as the observation group. After the tumor resection, free flap transplantation was performed for postoperative repair. The postoperative efficacy, adverse reactions and follow-up indicators were observed. Moreover, 55 patients with benign tumors were enrolled into the control group, and 55 healthy persons were set as the healthy group. The levels of SA and IL-2 of the three groups were detected.Results:In the observation group, 55 patients were successfully repaired (94.83%); 15 patients had adverse reactions after surgery. The follow-up duration was two to four years, and 45 patients survived for three years, with a survival rate of 77.59%. Before treatment, the serum SA level of patients with oral malignant tumor was significantly higher than those of the control group and healthy group, while the IL-2 level was significantly lower than those of the other two groups, and the differences were statistically significant (P<0.05). The serum IL-2 level in the observation group one day and fourteen days after surgery was higher than that before surgery, while the serum SA level was lower than that before surgery; the differences were statistically significant (P<0.05).Conclusion:The application of free flap transplantation in the repair of postoperative tissue defects of oral and maxillofacial tumor resection is effective and has less complications, and the determination of both serum SA and IL-2 levels offers important references to recovery of patients with oral and maxillofacial tumors and prognosis evaluation.