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Taguchi A, Yoshida T, Watanabe Y, Kusano J, Oe K, Okamura K, Tanaka C, Hiratsuka Y. Buccal fat pad flap for transoral repair of radiation-induced necrosis in the lateral oropharyngeal wall. Auris Nasus Larynx 2023:S0385-8146(22)00244-9. [PMID: 36621449 DOI: 10.1016/j.anl.2022.12.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 12/13/2022] [Accepted: 12/28/2022] [Indexed: 01/09/2023]
Abstract
Soft tissue necrosis (STN) is a late toxicity after radiotherapy. Extensive tissue defects due to STN near the carotid artery, such as in the lateral oropharyngeal wall, may lead to infectious pseudoaneurysms associated with fatal bleeding. Such defects are usually treated with transcervical reconstructive surgeries, which are highly invasive and technically difficult. We report a case in which a buccal fat pad (BFP) flap was used for minimally invasive transoral repair of tissue defects due to radiation-induced STN in the lateral oropharyngeal wall. The BFP flap covered the tissue defect, and the wound epithelialized completely. The patient had no dysfunctional mouth opening, speech, or swallowing. The BFP flap can be easily harvested via a minimally invasive transoral approach and is expected to be further utilized for radiation-induced STN in the lateral oropharyngeal wall.
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Affiliation(s)
- Atsushi Taguchi
- Department of Otolaryngology, Head and Neck Surgery, Japan Red Cross Osaka Hospital, 5-30, Fudegasaki-cho, Tennoji-ku, Osaka 543-8555, Japan; Department of Otolaryngology, Head and Neck Surgery, Graduate School of Medicine, Kyoto University, 54, Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
| | - Takao Yoshida
- Department of Otolaryngology, Head and Neck Surgery, Japan Red Cross Osaka Hospital, 5-30, Fudegasaki-cho, Tennoji-ku, Osaka 543-8555, Japan.
| | - Yoshiki Watanabe
- Department of Otolaryngology, Head and Neck Surgery, Japan Red Cross Osaka Hospital, 5-30, Fudegasaki-cho, Tennoji-ku, Osaka 543-8555, Japan; Department of Otolaryngology, Head and Neck Surgery, Graduate School of Medicine, Kyoto University, 54, Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
| | - Junko Kusano
- Department of Otolaryngology, Head and Neck Surgery, Japan Red Cross Osaka Hospital, 5-30, Fudegasaki-cho, Tennoji-ku, Osaka 543-8555, Japan
| | - Kengo Oe
- Department of Otolaryngology, Head and Neck Surgery, Japan Red Cross Osaka Hospital, 5-30, Fudegasaki-cho, Tennoji-ku, Osaka 543-8555, Japan
| | - Kana Okamura
- Department of Otolaryngology, Head and Neck Surgery, Japan Red Cross Osaka Hospital, 5-30, Fudegasaki-cho, Tennoji-ku, Osaka 543-8555, Japan
| | - Chisato Tanaka
- Department of Otolaryngology, Head and Neck Surgery, Japan Red Cross Osaka Hospital, 5-30, Fudegasaki-cho, Tennoji-ku, Osaka 543-8555, Japan
| | - Yasuyuki Hiratsuka
- Department of Otolaryngology, Head and Neck Surgery, Japan Red Cross Osaka Hospital, 5-30, Fudegasaki-cho, Tennoji-ku, Osaka 543-8555, Japan
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El-Mahallawy Y, Sweedan AO, Al-Mahalawy H. Pycnodysostosis: a case report and literature review concerning oral and maxillofacial complications and their management. Oral Surg Oral Med Oral Pathol Oral Radiol 2021; 132:e127-e138. [PMID: 34148846 DOI: 10.1016/j.oooo.2021.05.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 04/09/2021] [Accepted: 05/03/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE There is a lack of knowledge regarding pycnodysostosis (PYCD), which is commonly misdiagnosed as other, similar malformations. This study aims to report a patient with PYCD and conjointly present a comprehensive literature review regarding oral complications after oral surgery procedures. STUDY DESIGN This study aims to report a noteworthy case of a 40-year-old woman with PYCD who suffered from a midface defect after iatrogenic fracture during extraction of the upper right molars. A comprehensive electronic search was carried out in January 2020 for detection and analysis of the most commonly encountered dentoalveolar PYCD-related complications. The study was granted an exemption from the local institutional review board. RESULTS The electronic search yielded 35 articles reporting 41 PYCD cases with 62 various reported dentoalveolar complications. The survey reported a prevalence of osteomyelitis (n = 39) followed by pathologic fracture (n = 17), iatrogenic fracture (n = 5), and oronasal communication (n = 1). CONCLUSIONS This study advocates handling patients with PYCD with care through the use of extensive clinical and radiographic examinations, giving priority to any conservative treatment modalities, atraumatic surgical procedures, prophylactic antibiotic prescriptions, and a regular follow-up schedule to tackle any anticipated complications.
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Affiliation(s)
- Yehia El-Mahallawy
- Assistant Lecturer, Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.
| | - Ahmed Ossama Sweedan
- Lecturer, Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Haytham Al-Mahalawy
- Associate Professor, Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Fayoum University, Fayoum, Egypt
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Abstract
BACKGROUND Regardless of the technique chosen to treat the aging midface, the isolated lateral approach facelift has a limited impact on the midface volume deficit. In an effort to overcome this limitation, modern facial rejuvenation procedures incorporate an additional modality for replenishing the midface volume. Some of the author's facelift patients present with bulging buccal fat pads despite volume deficiency in the inframalar region. The author's technique is designed to utilize the buccal fat pad to replenish the inframalar volume deficit. OBJECTIVES The author sought to present the fat pad transposition surgical technique along with objective outcome data. METHODS This study was a retrospective review of nonconsecutive cases where the sub-superficial-musculo-aponeurotic-system transposition of the buccal fat pad was performed. A total of 22 patients underwent the fat pad transposition technique by the author (O.B.) between July 2013 and December 2017. Patient data were obtained from patient records, 3-dimensional models, magnetic resonance images, and standardized photography. Preoperative differences in midface volume were assessed utilizing curvilinear surface measurements on 3-dimensional models and the Allergan midface volume deficit scale on standardized photography. RESULTS The average midface volume deficit score significantly improved, and the average midfacial curvilinear surface measurement significantly increased after surgery. Magnetic resonance imaging confirmed a stable position of the buccal fat pad after surgery. CONCLUSIONS The sub-superficial-musculo-aponeurotic-system transposition of the buccal fat pad is an effective technique that can be safely employed for autologous inframalar augmentation in patients with a favorable facial morphology. LEVEL OF EVIDENCE: 4
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Assad M, Alkhaled M, Alhajj MN. Evaluation of a New Surgical Technique for Closing Oroantral Fistula Using Auto-transplanted Upper Third Molar: A 1-Year Follow-Up Study. J Maxillofac Oral Surg 2018; 17:84-88. [PMID: 29383000 DOI: 10.1007/s12663-017-1010-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Accepted: 03/27/2017] [Indexed: 10/19/2022] Open
Abstract
Background Oroantral fistula (OAF) is considered a frequent complication in dental practice. Many surgical techniques/methods have been proposed to close it. The aim of this study was to evaluate the auto-transplantation of upper third molar for closing OAF. Materials and Methods Twenty patients participated in this study aged between 20 and 40 years old. The OAF was closed by auto-transplantation of upper third molar placed directly in the socket of the extracted tooth. Results were evaluated clinically and radiographically through the period of observation which lasted for 1 year. Results Final results showed that the success rate of closing OAF was 95% while the success rate of upper third molar auto-transplantation was 90%. Conclusion This technique is simple, applicable, provides immediate replacement of the missing tooth, and does not require complicated instruments or procedures.
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Affiliation(s)
- Mounzer Assad
- 1Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Tishreen, Lattakia, Syria
| | - Maysaa Alkhaled
- 1Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Tishreen, Lattakia, Syria
| | - Mohammed N Alhajj
- 2Department of Prosthodontics, Faculty of Dentistry, Thamar University, Dhamar, Yemen
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