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Davis SJ, Park C, Shipchandler IT, Abdulhak A, Vernon D, Lee HB, Mantravadi AV, Ting J, Shipchandler TZ. Buccal Fat Advancement-Transposition Flap for Reconstruction of Midface Volume Defects. Facial Plast Surg Aesthet Med 2024. [PMID: 38597716 DOI: 10.1089/fpsam.2023.0303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2024] Open
Abstract
Background: The buccal fat pad (BFP) has previously been utilized for repair of various defects of the head and neck. Objectives: We explore the utility of a pedicled buccal fat advancement-transposition (BFAT) flap in various forms of midface reconstruction through a variety of surgical approaches and characterize its volume and axial reach in human anatomic specimens. Methods: Ten adult full-head human anatomic specimens were dissected, and a single surgical case demonstrating the use of a BFAT flap is described. Results: Nasolabial, subciliary, and deep plane facelift incisions all provided access to the BFP for use as a BFAT flap. The mean volume of mobilizable fat contained within a BFAT flap accessible through external incision was 7.1 cm3. Once fully mobilized, the externalized BFAT flap had a mean axial reach of 6.9 cm without tension. We also present a case illustrating the successful use of a BFAT flap for volumization of a large midface defect secondary to Mohs micrographic surgical resection of a cutaneous malignancy. Discussion: The BFAT flap, which exhibited substantial volume and reach in this study, can be harvested through multiple dissection windows or pre-existing defects and be used to reconstruct a variety of midface defects.
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Affiliation(s)
- Seth J Davis
- Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Palo Alto, CA, 94301
| | - Christopher Park
- Department of Otolaryngology-Head and Neck Surgery, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Isaac T Shipchandler
- Department of Otolaryngology-Head and Neck Surgery, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Abraham Abdulhak
- Department of Dermatology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Dominic Vernon
- Department of Otolaryngology-Head and Neck Surgery, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Hui Bae Lee
- Department of Ophthalmology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Avinash V Mantravadi
- Department of Otolaryngology-Head and Neck Surgery, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Jonathan Ting
- Department of Otolaryngology-Head and Neck Surgery, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Taha Z Shipchandler
- Department of Otolaryngology-Head and Neck Surgery, Indiana University School of Medicine, Indianapolis, Indiana, USA
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Arini APK, Namangkalakul W, Limraksasin P, Osathanon T. Effects of lactalbumin enzymatic hydrolysate on human squamous cell carcinoma cells-an in vitro study. J Oral Biol Craniofac Res 2024; 14:222-229. [PMID: 38495954 PMCID: PMC10940804 DOI: 10.1016/j.jobcr.2024.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Revised: 01/08/2024] [Accepted: 02/26/2024] [Indexed: 03/19/2024] Open
Abstract
Objectives Alpha-lactalbumin, the protein from human and bovine milk has been found to be promising as an alternative of anticancer agent. This study was aimed to investigate the effects of lactalbumin enzymatic hydrolysate (LAH) on cell proliferation, migration, and mRNA expression of matrix metalloproteinase (MMP) on human squamous cell carcinoma (hSCC) cell lines, in vitro. Methods Tongue (HSC-4 and 7) and pharyngeal (HN-30 and 31) hSCC cell lines were treated with a two-fold dilution of LAH (0.39-100 mg/ml). Cell viability and cell proliferation were examined by MTT assay. Colony forming unit (CFU) was assessed by crystal violet blue staining. Cell migration was investigated by scratch wound healing assay. Gene expression of metastasis-associated MMPs was assessed by RT-qPCR. Statistical analyses were evaluated at p value = 0.05. Results LAH at concentration of 50 and 100 mg/ml exhibited cytotoxicity on hSCC cells. The proliferation and CFU ability of hSCC cells were significantly attenuated after LAH treatment. The mRNA expression of MMP2, MMP9, and MMP14 was reduced in HN-30 and HN-31 cells while expression of MMP2 and MMP14 was downregulated in HSC-7 cells. Only MMP1 mRNA level was reduced in HSC-4 cells. However, cell migration of all hSCC cell lines did not alter after LAH treatment. Conclusion LAH treatment exhibits inhibitory effects on hSCC cell growth, proliferation and MMPs gene expression. Thus, LAH should be the promising alternative agent to develop the prospective anti-cancer drug.
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Affiliation(s)
| | - Worachat Namangkalakul
- Department of Anatomy, Faculty of Dentistry, Chulalongkorn University, Bangkok, 10330, Thailand
- Center of Excellence for Dental Stem Cell Biology, Faculty of Dentistry, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Phoonsuk Limraksasin
- Department of Anatomy, Faculty of Dentistry, Chulalongkorn University, Bangkok, 10330, Thailand
- Center of Excellence for Dental Stem Cell Biology, Faculty of Dentistry, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Thanaphum Osathanon
- Department of Anatomy, Faculty of Dentistry, Chulalongkorn University, Bangkok, 10330, Thailand
- Center of Excellence for Dental Stem Cell Biology, Faculty of Dentistry, Chulalongkorn University, Bangkok, 10330, Thailand
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Lee HW, Hong SO, Bae H, Shin Y, Jee YJ. The use of a pedicled buccal fat pad for reconstruction of posterior mandibular defects. Maxillofac Plast Reconstr Surg 2021; 43:23. [PMID: 34228210 PMCID: PMC8260705 DOI: 10.1186/s40902-021-00306-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 06/15/2021] [Indexed: 11/15/2022] Open
Abstract
Background The pedicled buccal fat pad has been used for a long time to reconstruct oral defects due to its ease of flap formation and few complications. Many cases related to reconstruction of defects in the maxilla, such as closing the oroantral fistula, have been reported, but cases related to the reconstruction of defects in the mandible are limited. Under adequate anterior traction, pedicled buccal fat pad can be a reliable and effective method for reconstruction of surgical defects in the posterior mandible. Case presentation This study describes two cases of reconstruction of surgical oral defects in the posterior mandible, all of which were covered by a pedicled buccal fat pad. The size of the flap was sufficient to perfectly close the defect without any tension. Photographic and radiologic imaging showed successful closure of the defects and no problems were noted in the treated area. Conclusion In conclusion, the pedicled buccal fat pad graft is a convenient and reliable method for the reconstruction of surgical defects on the posterior mandible.
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Affiliation(s)
- Hyen Woo Lee
- Department of Oral and Maxillofacial Surgery, Kyung Hee University Dental Hospital at Gangdong, #892 Dongnam-ro, Gangdong-gu, Seoul, 05278, Republic of Korea
| | - Sung Ok Hong
- Department of Oral and Maxillofacial Surgery, Kyung Hee University Dental Hospital at Gangdong, #892 Dongnam-ro, Gangdong-gu, Seoul, 05278, Republic of Korea
| | - Heeyeon Bae
- Department of Oral and Maxillofacial Surgery, Kyung Hee University Dental Hospital at Gangdong, #892 Dongnam-ro, Gangdong-gu, Seoul, 05278, Republic of Korea
| | - Youngjin Shin
- Department of Oral and Maxillofacial Surgery, Kyung Hee University Dental Hospital at Gangdong, #892 Dongnam-ro, Gangdong-gu, Seoul, 05278, Republic of Korea
| | - Yu-Jin Jee
- Department of Oral and Maxillofacial Surgery, Kyung Hee University Dental Hospital at Gangdong, #892 Dongnam-ro, Gangdong-gu, Seoul, 05278, Republic of Korea. .,Department of Oral and Maxillofacial Surgery, College of Dentistry, School of Dentistry, Kyung Hee University, Seoul, Republic of Korea.
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Dhara V, Kudva A, Chithra A, Rajan J, Singh A. Reconstruction of buccal mucosa: A minimalist symbiotic approach with local flaps. Oral Oncol 2020; 114:105081. [PMID: 33162321 DOI: 10.1016/j.oraloncology.2020.105081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Accepted: 10/27/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND Buccal mucosa defects following resection of premalignant or malignant lesions require adequate reconstruction. Both locoregional and microvascular flaps have been extensively used based on operator and patient factors. This paper focuses on the outcomes of a simplified approach for reconstruction of large buccal mucosa defects with posterior extent using a combination of two loco regional flaps. METHOD A combination of buccal fat pad graft and nasolabial flap was used to reconstruct large defects spanning the buccal mucosa extending to the soft palate or retromolar trigone areas. Post operative outcomes were noted in patients who underwent reconstruction using this combination technique. RESULT This paper highlights the favourable results and ease of technique with this combination of flaps, i.e complete coverage of large buccal mucosa defects extending to critical areas such as soft palate, retromolar trigone or tonsillar pillars; avoiding sophisticated free flaps. Satisfactory healing with adequate functional and esthetic outcomes were seen. CONCLUSION Defects post ablation of buccal mucosa lesions, larger than 5 cm × 5 cm, can be reconstructed using double local flaps. Buccal fat pad and nasolabial flaps heal excellently with nil morbidities and their combination provides a simple and an economical alternative option for reconstructive surgeons.
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Affiliation(s)
- Vasantha Dhara
- Department of Oral & Maxillofacial Surgery, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Udupi, Karnataka 576104, India
| | - Adarsh Kudva
- Department of Oral & Maxillofacial Surgery, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Udupi, Karnataka 576104, India.
| | - A Chithra
- Department of Oral & Maxillofacial Surgery, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Udupi, Karnataka 576104, India
| | - Jyotsna Rajan
- Department of Oral & Maxillofacial Surgery, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Udupi, Karnataka 576104, India
| | - Anupam Singh
- Department of Oral & Maxillofacial Surgery, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Udupi, Karnataka 576104, India
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Watson AH, Homer N, Somogyi M, Shore J, Nakra T. Pedicled Buccal Fat Flap: An Underutilized Source of Vascularized Periorbital Volume. Facial Plast Surg Aesthet Med 2020; 22:61-63. [PMID: 32053422 DOI: 10.1089/fpsam.2019.29003.nak] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Pedicled buccal fat flaps have demonstrated great utility for oral reconstructions. We present a retrospective case description detailing the utility of the buccal fat pad (BFP) as an anterior maxillary flap for midfacial and lower eyelid volumization and reconstruction. A 64-year-old healthy female had undergone bilateral lower blepharoplasty with silicone tear tough implantation, complicated by infection of the right tear trough implant. Delayed implant removal resulted in chronic infection and inflammation producing significant right lower eyelid retraction, and full-thickness scarring to the orbital rim. Reconstruction was performed, featuring the creation of a midfacial subperiosteal pocket and to access the BFP, which was mobilized and secured to the inferior orbital rim. Long-term follow-up confirms ongoing viability of the surgical intervention. Herein, the BFP is shown to be a source of vascularized volume in reconstructive periorbital surgery.
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Affiliation(s)
- Alison H Watson
- Oculoplastic and Orbital Surgery Department, Wills Eye Hospital, Philadelphia, Pennsylvania
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Sim YC, Hwang JH, Ahn KM. Overall and disease-specific survival outcomes following primary surgery for oral squamous cell carcinoma: analysis of consecutive 67 patients. J Korean Assoc Oral Maxillofac Surg 2019; 45:83-90. [PMID: 31106136 PMCID: PMC6502750 DOI: 10.5125/jkaoms.2019.45.2.83] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2018] [Revised: 03/16/2018] [Accepted: 03/22/2018] [Indexed: 11/17/2022] Open
Abstract
Objectives This study evaluated the predictive factors for survival of patients with oral squamous cell carcinoma (OSCC) and investigated the overall and disease-specific survival (DSS) outcomes. Materials and Methods A total of 67 consecutive patients who underwent surgery for OSCC from January 2006 to November 2014 were included in this study. Patients were classified according to age, sex, pTNM stages, primary sites, smoking and alcohol drinking habits, depth of invasion, perineural and lymphovascular invasion, cell differentiation and postoperative radiotherapy. Kaplan-Meier methods were used to estimate the survival categorized by patient groups. Cox regression methods were used to investigate the main independent predictors of survival. Results Nineteen patients died of OSCC during follow-up periods. Another five patients died of other diseases including lung adenocarcinoma (n=1), cerebral infarction (n=1), general weakness (n=2), and pneumonia (n=1). The tongue (n=16) was the most common site for primary origin, followed by buccal mucosa (n=15), mandibular gingiva (n=15), maxillary gingiva (n=9), floor of mouth (n=9), retromolar trigone (n=2), and palate (n=1). Eleven patients had pTNM stage I disease, followed by stage II (n=22) and stage IV (n=34). No patients had pTNM stage III disease in this study. The overall survival of all patients was 64.2% and the DSS was 71.6%. DSS of patients with stage I and II disease was 100%. Stepwise Cox regression showed the two predictors for DSS were pTNM stage (P<0.0001, odds ratio=19.633) and presence of metastatic lymph nodes (P=0.0004, odds ratio=0.1039). Conclusion OSCC has been associated with poor prognosis; however, there were improved survival outcomes compared with past studies. Advanced-stage disease and presence of metastatic lymph nodes were associated with poorer survival compared with early-stage OSCC and absence of neck node metastasis. Stage I and II OSCC were associated with excellent survival results in this study.
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Affiliation(s)
| | - Jong-Hyun Hwang
- Department of Oral and Maxillofacial Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Kang-Min Ahn
- Department of Oral and Maxillofacial Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
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