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Surgical approaches to anterior and middle skull base
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Oral Presentation
L-shaped osteotomy zygomatic reduction
was decreased to increase the binding rate between 4E-BP1 and eIF4E, and expressions of the downstream functional factors were decreased. The tumor growth curves were decreased significantly after intra-tumoral injection of ARHI recombinant adenovirus in the xenograft models. ARHI could inhibit the phosphorylation of key factors in PI3K-Akt pathway, and promote programmed cell death of oral cancer. http://dx.doi.org/10.1016/j.ijom.2015.08.664
Mandibular outer cortex splitting ostectomy mandibular “V-line” ostectomy
Simultaneous correction of temporomandibular joint ankylosis and secondary dentofacial deformities in adult patients: surgical technique and treatment outcomes Y. Li ∗ , Y. Jiang, N. Zhang, S. Zhu Sichuan University, Chengdu, China
Sliding genioplasty
http://dx.doi.org/10.1016/j.ijom.2015.08.663 ARHI could regulate the programmed cell death and malignant progressing of oral cancer cells Y. Li ∗ , S.W. Shi, B. Han, L.J. Li State Key Laboratory of Oral Disease, West China Hospital of Stomatology, Sichuan University, Chengdu, China Background: Oral cancer is one of the most common diseases which threat human health severely. ARHI gene could regulate the autophagy of the cancer cells. Objectives: The present study was aimed to research the regulation of ARHI gene on the programmed cell death of oral cancer cells. Methods: We transfected ARHI gene into Cal-27 cells, and evaluated the levels of apoptosis by flow cytometry and TUNEL assay. The evaluations of autophagic levels were carried out by transmission electron microscope, and by the expression of LC3B via immunofluorescence and western-blot. The functions of ARHI gene were evaluated by the key factors in PI3K-Akt pathway and the downstream proteins. Finally, we testified the results of the cellular researches by a xenograft mouse model. Findings and conclusions: The expressions of p53, bcl-2, bax, p21 and stat3 were changed after ARHI gene transfections. We could observe the upregulation of the programmed cell death in Cal-27 cells 48 h after the gene transfections. The autophagic progresses were increased initially, but were blocked in the following steps. The phosphorylation of Akt in sites of Thr308 and Ser473 was decreased. Phosphorylation of 4E-BP1
Background: Temporomandibular joint (TMJ) ankylosis causes serious problems in oral functions, such as difficulty in mastication, speech, and oral hygiene. TMJ ankylosis occurred from the growth period even results in secondary dentofacial deformities as well as psychological disability. Objectives: Aim of this study is to evaluate the feasibility and efficacy of simultaneous correction of TMJ ankylosis and secondary dentofacial deformities in a single operation. Methods: Twenty-seven consecutive patients with TMJ ankylosis and secondary deformities, attending West China Hospital of Stomatology, Sichuan University from January 2009 to December 2013 were included. All patients underwent resection of ankylotic bony mass, condylar reconstruction and genioplasty. For those with severe skeletal deformities, sagittal split of ramus osteotomy (SSRO), intraoral vertical ramus osteotomy (IVRO), inverted L-shaped osteotomy of ramus or distraction osteogenesis (DO) was also applied to lengthen the shortened mandible. LeFort I osteotomy of the maxilla was also performed when indicated. Clinical outcome was assessed based on oral function, radiography, and medical photography. Findings: No relapse of TMJ ankylosis occurred in any patient during the follow-up period (16.7 months on average). Oral function and skeletal deformities were significantly improved in all patients. Most of the patients were satisfied with the final outcome. Conclusions: One stage treatment permits the simultaneous correction of the TMJ functional deficit and the skeletal deformities in a single operation, which is an effective approach for the treatment of patents with TMJ ankylosis and secondary dentofacial deformities. http://dx.doi.org/10.1016/j.ijom.2015.08.665 Surgical approaches to anterior and middle skull base G. Liao ∗ , Y. Su, G. Zheng, S. Zhang Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China Objectives: The complex anatomical structure that the tumor resection and postoperative reconstruction of the skull base involved is the main emphasis and difficulty of the multidisciplinary research of skull base surgery. There are various surgical approaches to the anterior and middle skull base and each has its own characteristic, but the indications of each approach remain controversial. This study aimed to determine the suitable approaches to various anterior and middle cranial base.
Oral Presentation Methods: The surgical approaches to tumor located in cranial base and endo–exocranial communication area in recent years were reviewed. In addition, respective advantages and disadvantages of these approaches were compared in the aspects of exposure of tumor, the protection of nerves and blood vessel postoperation complications and quality of life of patient. Results: Coronal incision with unilateral or bilateral frontal craniotomy is a suitable access to tumor at the base of anterior cranial fossa that involves the ethmoid sinus, sphenoid sinus, orbit and preglabellar area. Webber incision with maxillary swing approach provides the maximum direct exposure for anterior and middle skull base tumor that involves the base of orbit, sphenoid sinus and pterygopalatine fossa. The infratemporal fossa mastoid approach suits to lesions in the jugular foramen region. If the exocranial part of tumor is large and involves parapharyngeal, the mandibular swing approach should be considered, especially to benign tumor. The orbitozygomatic fronttemperal approach is suitable for the tumor extending prominently into the anterior and middle cranial base. Transoral trans-posterior wall pharynx is proper for tumor of clivus of the skull base and posterior pharyngeal wall. Conclusion: According to our study, choosing surgical approach as above can provide better tumor exposure protection of nerves and vessels improvement of quality of life and decrease the complications, especially when the tumor is large. http://dx.doi.org/10.1016/j.ijom.2015.08.666 Application of three transfer methods in computer-aided surgery technique in maxillary defect reconstruction J. Liang ∗ , X.F. Shan, J.W. Huang, K. Wang, Y. Zhang, L. Zhang, Z.G. Cai Department of Oral-Maxillofacial Surgery, School of Stomatology, Peking University, Beijing, China This study aims at proving the feasibility and comparing advantages and disadvantages of different CAS transfer methods in reconstruction of different classes of maxillary defects. 13 cases who received CAS assisted maxillary defect reconstruction surgery during March 2012–October 2014, were included in this study. Virtual surgical planning (VSP) conducted before surgery, transfer methods including: (1) individualized CAD/CAM implants, (2) 3D-printed models and (3) computer aided navigation surgery (CANS), were applied solely or in combination to convoy the VSP. CT scan were obtained in all patients pre- and post-operatively. The models of VSP and post-operation were introduced into Geomagic Qualify 12.0, deviation was calculated and shown in a color deviation map and a report. All patients achieved satisfying functional and aesthetical reconstruction outcome. All patients were able to take semi-fluid to normal food, with normal deglutition and speech function, no complication in eye movement and vision. Deviation between pre- and post-operative model surface under different tolerance is calculated, and indicates a trend that: (1) cases use CANS in reconstruction have smaller deviation than cases do not, (2) higher accuracy found in the cases using individualized CAD/CAM implants than those using 3D-printed model induced pre-formed Titanium Mesh. Conclusion: CAS is beneficial in maxillary defect reconstructions. CANS helps to control the safety, stability and accuracy of surgery, 3D printed model helps directly reflecting the VSP and implant shaping. Individualized CAD/CAM implant is beneficial in extensive defects reconstruction. Each transfer method has its advantages in convoying the VSP information,
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treatment suggestion is given based on the extent and anatomical characteristics of defect. http://dx.doi.org/10.1016/j.ijom.2015.08.667 Genome-wide analysis of Foxp3 target genes in human tongue squamous cell carcinoma cell Y. Liang ∗ , X. Lao, L. Liang, G. Liao Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China Objective: The forkhead transcription factor Foxp3 is essential for differentiation and activation of Tregs. In the recent years, Foxp3 expressed in tumor cells (cancer cell-derived Foxp3) is of great interest, but its function and molecular mechanisms remain incompletely understood. In the present study, we aimed to illustrate the genome-wide target genes of cancer cell-derived Foxp3 in tongue squamous cell carcinoma (TSCC) cells to provide molecular basis for its functional research. Materials and methods: Dynamic nuclear translocation of Foxp3 in TSCC cells was detected by immunofluorescent staining. After Foxp3 down-regulation using siRNA, genome-wide analysis of Foxp3 target genes in TSCC cells were performed using a combination of ChIP-on-chip and whole-genome microarray assays. Results: Foxp3 in TSCC cells was transported into nucleus without exogenous stimuli. There were 3573 Foxp3-binding genes in TSCC cells. When Foxp3 was down-regulated, 599 genes were different-expressed in TSCC cells. Cross-referencing showed that 152 genes were identical in the ChIP-on-chip and expression profiling. About 12% Foxp3-binding genes in human TSCC cells were also Foxp3-biding genes in human Tregs. Bioinformatics analysis suggested that direct and indirect targets genes of Foxp3 in TSCC cells had distinct function compared from each other and from that in Tregs. Conclusions: Genome-wide analysis indicates that Foxp3 in TSCC cells has distinct biological functions comparing with that in Tregs. Cancer cell-derived Foxp3 directly regulate the transcription of genes that affect certain internal biological processes of TSCC cells, and indirectly influence the extracellular microenvironment. http://dx.doi.org/10.1016/j.ijom.2015.08.668 The effect of presurgical nasoalveolar molding (PNAM) on nasal symmetry in unilateral complete cleft lip/palate after primary cheiloplasty Z. Liang 1,∗ , J. Yao 1 , K.T.C. Philip 2 , C. Zheng 1 , J. Yang 1 1
The Second Hospital of Shenzhen, Shenzhen, Guangdong Province, China 2 Craniofacial Center, Chang Gung Memorial Hospital, Taipei, Taiwan Purpose: Nasal deformity is one of the most intractable problems in unilateral cleft lip/palate treatment. The purpose of this study was to assess the effect of presurgical nasoalveolar molding (PNAM) on the long-term nasal symmetry and shape in unilateral complete cleft lip/palate after the primary cheiloplasty. Methods: 84 complete unilateral cleft lip/palate patients in Chang Gung Craniofacial Center, Taiwan were divided into 2 groups: 42 patients in PNAM group and 42 patients in non PNAM
Oral Presentation
L-shaped osteotomy zygomatic reduction
was decreased to increase the binding rate between 4E-BP1 and eIF4E, and expressions of the downstream functional factors were decreased. The tumor growth curves were decreased significantly after intra-tumoral injection of ARHI recombinant adenovirus in the xenograft models. ARHI could inhibit the phosphorylation of key factors in PI3K-Akt pathway, and promote programmed cell death of oral cancer. http://dx.doi.org/10.1016/j.ijom.2015.08.664
Mandibular outer cortex splitting ostectomy mandibular “V-line” ostectomy
Simultaneous correction of temporomandibular joint ankylosis and secondary dentofacial deformities in adult patients: surgical technique and treatment outcomes Y. Li ∗ , Y. Jiang, N. Zhang, S. Zhu Sichuan University, Chengdu, China
Sliding genioplasty
http://dx.doi.org/10.1016/j.ijom.2015.08.663 ARHI could regulate the programmed cell death and malignant progressing of oral cancer cells Y. Li ∗ , S.W. Shi, B. Han, L.J. Li State Key Laboratory of Oral Disease, West China Hospital of Stomatology, Sichuan University, Chengdu, China Background: Oral cancer is one of the most common diseases which threat human health severely. ARHI gene could regulate the autophagy of the cancer cells. Objectives: The present study was aimed to research the regulation of ARHI gene on the programmed cell death of oral cancer cells. Methods: We transfected ARHI gene into Cal-27 cells, and evaluated the levels of apoptosis by flow cytometry and TUNEL assay. The evaluations of autophagic levels were carried out by transmission electron microscope, and by the expression of LC3B via immunofluorescence and western-blot. The functions of ARHI gene were evaluated by the key factors in PI3K-Akt pathway and the downstream proteins. Finally, we testified the results of the cellular researches by a xenograft mouse model. Findings and conclusions: The expressions of p53, bcl-2, bax, p21 and stat3 were changed after ARHI gene transfections. We could observe the upregulation of the programmed cell death in Cal-27 cells 48 h after the gene transfections. The autophagic progresses were increased initially, but were blocked in the following steps. The phosphorylation of Akt in sites of Thr308 and Ser473 was decreased. Phosphorylation of 4E-BP1
Background: Temporomandibular joint (TMJ) ankylosis causes serious problems in oral functions, such as difficulty in mastication, speech, and oral hygiene. TMJ ankylosis occurred from the growth period even results in secondary dentofacial deformities as well as psychological disability. Objectives: Aim of this study is to evaluate the feasibility and efficacy of simultaneous correction of TMJ ankylosis and secondary dentofacial deformities in a single operation. Methods: Twenty-seven consecutive patients with TMJ ankylosis and secondary deformities, attending West China Hospital of Stomatology, Sichuan University from January 2009 to December 2013 were included. All patients underwent resection of ankylotic bony mass, condylar reconstruction and genioplasty. For those with severe skeletal deformities, sagittal split of ramus osteotomy (SSRO), intraoral vertical ramus osteotomy (IVRO), inverted L-shaped osteotomy of ramus or distraction osteogenesis (DO) was also applied to lengthen the shortened mandible. LeFort I osteotomy of the maxilla was also performed when indicated. Clinical outcome was assessed based on oral function, radiography, and medical photography. Findings: No relapse of TMJ ankylosis occurred in any patient during the follow-up period (16.7 months on average). Oral function and skeletal deformities were significantly improved in all patients. Most of the patients were satisfied with the final outcome. Conclusions: One stage treatment permits the simultaneous correction of the TMJ functional deficit and the skeletal deformities in a single operation, which is an effective approach for the treatment of patents with TMJ ankylosis and secondary dentofacial deformities. http://dx.doi.org/10.1016/j.ijom.2015.08.665 Surgical approaches to anterior and middle skull base G. Liao ∗ , Y. Su, G. Zheng, S. Zhang Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China Objectives: The complex anatomical structure that the tumor resection and postoperative reconstruction of the skull base involved is the main emphasis and difficulty of the multidisciplinary research of skull base surgery. There are various surgical approaches to the anterior and middle skull base and each has its own characteristic, but the indications of each approach remain controversial. This study aimed to determine the suitable approaches to various anterior and middle cranial base.
Oral Presentation Methods: The surgical approaches to tumor located in cranial base and endo–exocranial communication area in recent years were reviewed. In addition, respective advantages and disadvantages of these approaches were compared in the aspects of exposure of tumor, the protection of nerves and blood vessel postoperation complications and quality of life of patient. Results: Coronal incision with unilateral or bilateral frontal craniotomy is a suitable access to tumor at the base of anterior cranial fossa that involves the ethmoid sinus, sphenoid sinus, orbit and preglabellar area. Webber incision with maxillary swing approach provides the maximum direct exposure for anterior and middle skull base tumor that involves the base of orbit, sphenoid sinus and pterygopalatine fossa. The infratemporal fossa mastoid approach suits to lesions in the jugular foramen region. If the exocranial part of tumor is large and involves parapharyngeal, the mandibular swing approach should be considered, especially to benign tumor. The orbitozygomatic fronttemperal approach is suitable for the tumor extending prominently into the anterior and middle cranial base. Transoral trans-posterior wall pharynx is proper for tumor of clivus of the skull base and posterior pharyngeal wall. Conclusion: According to our study, choosing surgical approach as above can provide better tumor exposure protection of nerves and vessels improvement of quality of life and decrease the complications, especially when the tumor is large. http://dx.doi.org/10.1016/j.ijom.2015.08.666 Application of three transfer methods in computer-aided surgery technique in maxillary defect reconstruction J. Liang ∗ , X.F. Shan, J.W. Huang, K. Wang, Y. Zhang, L. Zhang, Z.G. Cai Department of Oral-Maxillofacial Surgery, School of Stomatology, Peking University, Beijing, China This study aims at proving the feasibility and comparing advantages and disadvantages of different CAS transfer methods in reconstruction of different classes of maxillary defects. 13 cases who received CAS assisted maxillary defect reconstruction surgery during March 2012–October 2014, were included in this study. Virtual surgical planning (VSP) conducted before surgery, transfer methods including: (1) individualized CAD/CAM implants, (2) 3D-printed models and (3) computer aided navigation surgery (CANS), were applied solely or in combination to convoy the VSP. CT scan were obtained in all patients pre- and post-operatively. The models of VSP and post-operation were introduced into Geomagic Qualify 12.0, deviation was calculated and shown in a color deviation map and a report. All patients achieved satisfying functional and aesthetical reconstruction outcome. All patients were able to take semi-fluid to normal food, with normal deglutition and speech function, no complication in eye movement and vision. Deviation between pre- and post-operative model surface under different tolerance is calculated, and indicates a trend that: (1) cases use CANS in reconstruction have smaller deviation than cases do not, (2) higher accuracy found in the cases using individualized CAD/CAM implants than those using 3D-printed model induced pre-formed Titanium Mesh. Conclusion: CAS is beneficial in maxillary defect reconstructions. CANS helps to control the safety, stability and accuracy of surgery, 3D printed model helps directly reflecting the VSP and implant shaping. Individualized CAD/CAM implant is beneficial in extensive defects reconstruction. Each transfer method has its advantages in convoying the VSP information,
e101
treatment suggestion is given based on the extent and anatomical characteristics of defect. http://dx.doi.org/10.1016/j.ijom.2015.08.667 Genome-wide analysis of Foxp3 target genes in human tongue squamous cell carcinoma cell Y. Liang ∗ , X. Lao, L. Liang, G. Liao Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China Objective: The forkhead transcription factor Foxp3 is essential for differentiation and activation of Tregs. In the recent years, Foxp3 expressed in tumor cells (cancer cell-derived Foxp3) is of great interest, but its function and molecular mechanisms remain incompletely understood. In the present study, we aimed to illustrate the genome-wide target genes of cancer cell-derived Foxp3 in tongue squamous cell carcinoma (TSCC) cells to provide molecular basis for its functional research. Materials and methods: Dynamic nuclear translocation of Foxp3 in TSCC cells was detected by immunofluorescent staining. After Foxp3 down-regulation using siRNA, genome-wide analysis of Foxp3 target genes in TSCC cells were performed using a combination of ChIP-on-chip and whole-genome microarray assays. Results: Foxp3 in TSCC cells was transported into nucleus without exogenous stimuli. There were 3573 Foxp3-binding genes in TSCC cells. When Foxp3 was down-regulated, 599 genes were different-expressed in TSCC cells. Cross-referencing showed that 152 genes were identical in the ChIP-on-chip and expression profiling. About 12% Foxp3-binding genes in human TSCC cells were also Foxp3-biding genes in human Tregs. Bioinformatics analysis suggested that direct and indirect targets genes of Foxp3 in TSCC cells had distinct function compared from each other and from that in Tregs. Conclusions: Genome-wide analysis indicates that Foxp3 in TSCC cells has distinct biological functions comparing with that in Tregs. Cancer cell-derived Foxp3 directly regulate the transcription of genes that affect certain internal biological processes of TSCC cells, and indirectly influence the extracellular microenvironment. http://dx.doi.org/10.1016/j.ijom.2015.08.668 The effect of presurgical nasoalveolar molding (PNAM) on nasal symmetry in unilateral complete cleft lip/palate after primary cheiloplasty Z. Liang 1,∗ , J. Yao 1 , K.T.C. Philip 2 , C. Zheng 1 , J. Yang 1 1
The Second Hospital of Shenzhen, Shenzhen, Guangdong Province, China 2 Craniofacial Center, Chang Gung Memorial Hospital, Taipei, Taiwan Purpose: Nasal deformity is one of the most intractable problems in unilateral cleft lip/palate treatment. The purpose of this study was to assess the effect of presurgical nasoalveolar molding (PNAM) on the long-term nasal symmetry and shape in unilateral complete cleft lip/palate after the primary cheiloplasty. Methods: 84 complete unilateral cleft lip/palate patients in Chang Gung Craniofacial Center, Taiwan were divided into 2 groups: 42 patients in PNAM group and 42 patients in non PNAM