Oral cancer involving masticator space (T4b): Review of literature and future directions.

The oral cancer with masticator-space involvement is classified as T4b disease. The limited data suggest that the masticator space is a complex anatomic area and tumors with varying degrees of infiltration may have different oncologic outcomes. It is not advisable to group all T4b tumors as one and consider them for palliative-intent treatment.

Versatility of adipofascial anterolateral thigh flap for reconstruction of maxillary defects with infratemporal fossa extension.

Tumors arising from the posterior hard palate or posterolateral maxilla may extend to involve the infratemporal fossa (ITF). Resection of these tumors results in infrastructural maxillectomy with ITF defects. In this study, we describe the use of an adipofascial anterolateral thigh flap (ALT) specifically for such defects.

Factors predicting outcome after salvage treatment for stage IV oral squamous cell carcinoma: Evidence of the potential importance of the cyclooxygenase-2-prostaglandin E2 pathway.

Background: We determined the clinicopathological factors that predicted outcome after salvage treatment for stage IV oral squamous cell carcinoma (OSCC). Additionally, the prognostic significance of the cyclooxygenase-2 (COX-2)/microsomal prostaglandin-E synthase-1 (mPGES-1) pathway was evaluated.

Methods: Thirty-one patients who underwent salvage surgery were included.

Microvascular free flap reconstruction for head and neck cancer in a resource-constrained environment in rural India.

Introduction: Reconstruction with free flaps has significantly changed the outcome of patients with head and neck cancer. Microsurgery is still considered a specialised procedure and is not routinely performed in the resource-constrained environment of certain developing parts of India.

Materials And Methods: This article focuses on the practice environment in a cancer clinic in rural India.

Reconstruction of large composite buccal defects using single soft tissue flap--analysis of functional outcome.

Resection of advanced gingivo-buccal tumors results in a posterolateral mandibular and large soft tissue defect. Because of large soft tissue requirement, these defects are difficult to reconstruct using a single osteocutaneous flap. A double free flap reconstruction of such defects is recommended.

Efficacy of per oral access in the surgical management of T2/T3 oral cavity squamous cell carcinoma.

Objective: Transcutaneous "access" procedures still continue to be widely employed for surgical management of medium-sized (T2, T3) oral cavity tumors in spite of the almost 4-cm mouth opening available to the surgeon to access the oral cavity. We undertook a retrospective study to objectively evaluate "per oral access" in managing these tumors with regard to the ability to achieve a clear surgical margin and enable reconstruction of resultant defect.

Study Design: Case series with chart review.

Morbidity profile and functional outcome of modified facial translocation approaches for skull base tumors.

The primary objective of this study was to evaluate morbidity associated with facial translocation approaches for skull base and results of various technical modifications. Forty consecutive patients who underwent facial translocation approaches for accessing skull base tumors from July 2005 to June 2010 were included in this study. There were 25 patients who underwent standard facial translocation, 4 patients medial mini, and 11 patients underwent extended facial translocation.

Single perforator based anterolateral thigh flap for reconstruction of large composite defects of oral cavity.

Composite defects of oral cavity are a reconstructive challenge. Anterolateral thigh flap provides large and pliable tissue for reconstruction of these defects. However, wide variations in the vascular anatomy, variable perforator number and location are reported.

Lateral arm free flap for oral tongue reconstruction: an analysis of surgical details, morbidity, and functional and aesthetic outcome.

The purpose of this study was to report the effectiveness of the lateral arm free flap (LAFF) in the reconstruction of oral tongue defects, the subsite in which it may have advantage over the other donor sites. This is a retrospective analysis of 48 consecutive cases of LAFF used for the reconstruction of partial glossectomy defects for squamous cell carcinoma of the oral tongue. Primary defect and donor-site morbidity and the functional and aesthetic outcomes were assessed in 37 evaluable patients, with a minimum of 6 months follow-up.

Vascularised fibula osteocutaneous flap for cervical spinal and posterior pharyngeal wall reconstruction.

We report a case of vascularised fibula osteocutaneous flap used for composite cervical spinal and posterior pharyngeal wall reconstruction, in a patient with recurrent skull base chordoma, resected by an anterior approach via median labio-mandibular glossotomy approach. Bone stability and pharyngeal wall integrity were simultaneously restored.

Anterior skull base surgery.

The basic principle of anterior skull base surgery is to provide adequate exposure to enable three dimensional resection of skull base tumors. Negative surgical margins, which is within the control of surgeon, is the principle prognostic factor in anterior skull base tumors. Open skull base approaches is the standard of care for malignant anterior skull base tumors.

Pathologic evaluation of sentinel lymph nodes in oral squamous cell carcinoma.

Background: The objective of this study was to determine the relative efficacy of different methods of pathologic evaluation of sentinel lymph nodes.

Methods: In this prospective study, sentinel nodes were evaluated for occult metastasis using frozen section, imprint-cytology, hematoxylin-eosin staining, serial step sectioning (SSS) with hematoxylin-eosin, and immunohistochemistry (IHC). Metastases were classified into macrometastasis (>2.

Free radial forearm adiposo-fascial flap for inferior maxillectomy defect reconstruction.

A free radial forearm fascial flap has been described for intraoral reconstruction. Adiposo-fascial flap harvesting involves few technical modifications from the conventional radial forearm fascio-cutaneous free flap harvesting. We report a case of inferior maxillectomy defect reconstruction in a 42-year-old male with a free radial forearm adiposo-fascial flap with good aesthetic and functional outcome with minimal primary and donor site morbidity.

Sentinel node biopsy in head and neck squamous cell carcinoma.

Purpose Of Review: Sentinel node biopsy (SNB) is emerging as a potential tool to evaluate neck node metastasis in head and neck cancer. The purpose of this article is to undertake a systemic review of published literature and to outline future directions for further studies.

Recent Findings: Existing data suggest that the status of the sentinel lymph node (SLN) predicts the pathologic stage of the nodal basin.

Comparison of quality of life in advanced laryngeal cancer patients after concurrent chemoradiotherapy vs total laryngectomy.

Objective: To compare quality of life (QOL) of patients with advanced laryngeal cancers treated by total laryngectomy with those who received concurrent chemoradiotherapy.

Study Design: This is a cross-sectional study of the patients treated in our institution who have completed one year of follow-up and were disease-free at the time of evaluation.

Subjects And Method: Forty patients treated for advanced cancer of the larynx (stage III/IV), either by concurrent chemoradiation (11) or total laryngectomy and postoperative radiation (29), have been included in this study.