Topical oral cavity chemoprophylaxis using isotretinoin rinse: A 15-year experience

Objectives/Hypothesis

To determine the utility of isotretinoin oral rinses as a method of chemoprevention for recurrent oral cavity squamous cell carcinoma (SCC), carcinoma in situ, and dysplasia.

Study Design

Retrospective cohort study.

Methods

One hundred forty-three patients were initially enrolled in the study; however, 18 were excluded due to inability to tolerate therapy. The included patients were classified into four groups. Group 1 included patients with multiple early stage oral cavity lesions following initial resection. Group 2 included patients with SCC in situ after excision. Group 3 included patients with multifocal dysplasia following initial CO₂ laser ablation. Group 4 included patients with a history of treated oral cavity SCC with new leukoplakia lesions proven to be dysplastic. Fifty-three patients in the control group did not use post-treatment isotretinoin rinses due to various reasons, whereas 72 patients completed therapy. Minimum use of isotretinoin rinses was 12 months, and minimum follow-up was 24 months. During the follow-up period, all recurrences of carcinoma, in situ disease, and dysplasia were noted and compared with a Fisher test of fit. A Bonferroni correction was applied to increase accuracy and strength of comparison.

Results

Using a Bonferroni correction, the significance threshold was 0.0125. By that cutoff, isotretinoin rinses were found to be associated with lower recurrence in groups 1 and 3 (P = .00014, P = .00002, respectively) but not in groups 2 and 4 (P = .4, P = .3846, respectively).

Conclusions

Oral isotretinoin as chemoprophylaxis for patients treated for oral cavity squamous cell carcinoma, in situ disease, or dysplasia may be beneficial in decreasing recurrence rate.

Level of Evidence

4. Laryngoscope, 2016

http://ift.tt/2hTYYqd

Double paddle ulnar perforator free flap in reconstruction of through-and-through and fistulous defects of the head and neck

http://ift.tt/2hZtJaw

Effect of hypoxia on the proliferation of porcine bone marrow−derived mesenchymal stem cells and adipose-derived mesenchymal stem cells in 2- and 3-dimensional culture

Bone marrow-derived mesenchymal stem cells (MSCs) and adipose-derived mesenchymal stem cells (ASCs) currently represent a promising tool for the regeneration of large bony defects. Therefore, it is pivotal to find the best cell source within the body and the best conditions for in vitro cellular expansion. This study compared cellular response of MSCs and ASCs from a porcine animal in normoxic (21% O2) and hypoxic (2% O2) cell culture conditions via 2D and 3D experimental settings.

http://ift.tt/2iekUcc

Preoperative ultrasonography for evaluation of clinically N0 neck in oral cavity carcinoma

The aim of this study was to evaluate preoperative ultrasound criteria to detect lymph node (LN) cervical metastasis in patients with clinically node-negative neck (cN0) oral cavity squamous cell carcinoma (OCSCC). A prospective, single-center, observational study was conducted in 90 patients undergoing cancer excision with or without elective neck dissection (END) between 2005 and 2012. A surgeon and an experienced radiologist performed preoperative cervical ultrasonography in all cases. The primary objective was to obtain an a priori sensitivity of 90% and specificity >50% in cN0 OCSCC staging.

http://ift.tt/2h8POVR

Are there risk factors for osseous mandibular inferior border defects after bilateral sagittal split osteotomy?

Bone defects of the inferior mandibular border (osseous inferior border defects) can cause unesthetic postoperative outcomes after bilateral sagittal split osteotomy (BSSO). The aim of this study was to estimate the frequency of osseous inferior border defects after BSSO and to identify risk factors for this complication.

http://ift.tt/2iek7rP

Effect of an evidence-based guideline on the treatment of maxillofacial cancer: A prospective analysis

In 2012, a guideline for the diagnosis and treatment of oral cavity cancer based on the best available evidence was implemented at certified German cancer centres for head and neck carcinomas. The present analysis was performed to determine whether the implementation of the guideline via certification improved the level of care, leading to a benefit for the patients.

http://ift.tt/2h8X4Rj

Levator alae nasi muscle v-y island flap for nasal tip reconstruction

Nasal tip reconstruction can be very challenging. It requires close attention to skin texture, colour and thickness matching, with the respect of the nasal aesthetic units and symmetry. Flaps are usually preferred to skin grafts where possible. Based on different donor areas, various flaps have been described for reconstruction of this region. Here we present a new V-Y myocutaneous island flap based on the levator alae nasi muscle (LAN muscle) blood supply. This flap may represent an alternative to the nasalis myocutaneous sliding V-Y flap previously described by Rybka.

http://ift.tt/2ieiRoA