• Korean Journal of Head & Neck Oncology
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• v.11 no.1
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• pp.47-55
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• 1995

A large lateral facial defects especially a through and through defect of the cheek remains as challenging field of reconstruction for the head and neck surgeons. Closure of these wounds is technically troublesome due to the magnitude and location of the soft tissue and skin defect, functional and aesthetic consideration. optimal cancer surveillance, and desire for good nourishment. Most traditional methods dealing with these defects, including split-thickness skin graft, local and regional flaps as well as musculocutaneous flaps have their limitations. We applied four different methods for these reconstruction in four cases. We utilized temporal muscle flap, forearm free flap and secondary healing for repair of mucosal defects, and medial base cervicopectoral flap, pectoralis major myocutaneous flap and cervicofacial flap for the reconstruction of external skin defects. In one case, both sides were reconstructed with single forearm free flap. In our experiences, secondary healing could be one of the useful method for mucosal repair in the defect between upper and lower gingivobuccal sulcus. However, forearm free flap was thought to be more ideal for the cases with mandibulectomy. For the external repair, the regional skin flap was considered to be superior to pectoralis major myocutaneous flap or forearm free flap especially on color matching.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.12 no.3
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• pp.23-33
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• 1990

A clinical study of selected patients with intraoral squamous cell carcinoma which were managed in the Department of Oral Oncology of Korea Cancer Center Hospital from January 1982 to August 1989 was done. And following results were obtained. 1. Males were involved more than females by intraoral squamous cell carcinoma in a ratio of 4:1. and most of the cases occurred in the 7th and 6th decades (69%). 79% of total patients and 92.5% of males were. 2. The mean duration of symptomatic period was 5.9 months. 3. The common symptoms were swelling (63%), pain (40%), ulceration (33%), and trismus (23%) 4. In the histologic findings, well differentiation comprised 58.0%. 5. The primary sites were the upper alveolar mucosa (32%), the floor of the mouth (21%), the lower alveolar mucosa (19%), tongue (14%), retromolar trigone (8%), palate (7%) and buccal mucosa (3%). 6. According to TNM system, Stage I, Stage II, Stage III, and Stage IV comprised 4%, 15%, 32%, and 49% respectively. 7. In the management of intraoral squamous cell carcinoma, surgeries were done in the 32 cases, 23 cases of which were managed by radiation therapy or chemotherapy concurrently. And radiation therapy alone was received in 35 cases. 8. Overall 3 and 5-year survival rates without regarding to stage were 27.6% and 21.4%. 9. 3-year survival rate of female patients was 47.2% and that of male patients was 22.6%. 10. 5-year survival rate was 53.9% for "early" cancer (stage I and II) and 15.6% for "advanced"cancer (stage III and IV). Survival rate of patients in the early stages of cancer appeared to be higher than that of patients with stage III and IV(p<0.05).

• Archives of Craniofacial Surgery
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• v.21 no.3
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• pp.161-165
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• 2020

Background: Microstomia is defined as a condition with a small sized-mouth that results in functional impairment such as difficulty with food intake, pronunciation, and poor oral hygiene and cosmetic problems. Several treatment methods for microstomia have been proposed. None of them are universally applicable. This study aims at analyzing the cases treated at our institution critically reviewing the pertinent literature. Methods: The medical records of all microstomia patients treated in our hospital from November 2015 to April 2018 were reviewed retrospectively. Of these, all patients who received surgical treatment for microstomia were included in the study and analyzed for etiology, chief complaint, surgical method, and outcomes. The functional outcomes of mouth opening and intercommissure distance before and after the surgery were evaluated. The cosmetic results were assessed according to the patients' satisfaction. Results: Five patients with microstomia were corrected. Two cases were due to scar contracture after chemical burn, two cases derived from repeated excision of skin cancer, and one patient suffered sequela of Stevens-Johnson syndrome. The following surgical methods were applied: one full-thickness skin graft on the buccal mucosa, three buccal mucosal advancement flaps after triangular excision of the mouth corner, and one local buccal mucosal flap. Mouth opening was increased by 6.0 mm, and the intercommissure distance improved by 7.2 mm on average. Follow-up was 9.6 months (range, 5-14 months). Cosmetic assessment was as follows: two patients found the results excellent, three judged it as good. Conclusion: Microstomia has several causes. In order to achieve optimal functional recovery and aesthetic improvement it is important to precisely evaluate the etiologic factors and the severity of the impairment and to carefully choose the appropriate surgical method.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.5
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• pp.2145-2152
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• 2014

Background: The survival rate for oral squamous cell carcinoma (OSCC) has remained generally unchanged in the past three decades, underlining the need for more biomarkers to be developed to aid prognostication and effective management. The prognostic potential of E-cadherin expression in OSCCs has been variable in previous studies while galectin-9 expression has been correlated with improved prognosis in other cancers. The aim of the present study was to investigate the expression of galectin-9 and E-cadherin in OSCC and their potential as prognostic biomarkers. Materials and Methods: E-cadherin and Galectin-9 expression was examined by immunohistochemistry in 32 cases of OSCC of the buccal mucosa (13 with and 19 without lymph node metastasis), as well as 6 samples of reactive lesions and 5 of normal buccal mucosa. Results: The expression of E-cadherin in OSCC was significantly lower than the control tissues but galectin-9 expression was conversely higher. Median E-cadherin HSCOREs between OSCCs positive and negative for nodal metastasis were not significantly different. Mean HSCOREs for galectin-9 in OSCC without lymph node metastasis ($127.7{\pm}81.8$) was higher than OSCC with lymph node metastasis ($97.9{\pm}62.9$) but this difference was not statistically significant. Conclusions: E-cadherin expression is reduced whilst galectin-9 expression is increased in OSCC. However, the present results suggest that E-cadherin and galectin-9 expression may not be useful as prognostic markers for OSCC.

• Korean Journal of Head & Neck Oncology
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• v.26 no.1
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• pp.41-44
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• 2010

Hemangiomas are the most common benign tumors or tumor-like malformations of blood vessels or blood filled cavernous spaces. Hemangiomas of the oral cavity represents 14% of all hemangiomas. Most hemangiomas are detected by one year of age and most commonly occurred in the lips, tongue, buccal mucosa and palate. But hemangiomas are sometimes reported in adults. We report one case of extensive hemangioma of the tongue in adult. Our case is a 48-year-old male who presented with a hemangioma occupying entirely two-third of the tongue. Treating those lesions pose a challenge to the surgeon. This paper discusses one case of extensive tongue hemangiomas treated with alcoholic sclerotherapy with satisfactory results supporting this particular approach in the management of these lesion.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.19 no.4
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• pp.414-434
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• 1997

Though many genetic and epigenetic alterations have been identified in hamster oral carcinogenesis model, there is no information about the possible role of transforming growth factor related with oral cancer. The purpose of this paper was to find the expression patterns of transforming growth factor alpha and beta during the stages of complete oral carcinogenesis model in hamster. 0.5% 9, 10-dimethyl-1, 2-benzanthracene(DMBA) in mineral oil was topically applied to the buccal pouch of 75 hamster three times a week during the experimental periods. The experimental animals were subdivided into two groups of control and experiment. Only the mineral oil was applied to the control group. 0.5% DMBA in mineral oil was applied to the experimental groups of 6, 8, 10, 12, 14, 16, 18 and 20 weeks. The expression of the $TGF-{\alpha}$ and $TGF-{\beta}$ protein were evaluated by the distribution and intensity of positive cells during the carcinogenesis using the immunohistochemical study. The following results were obtained ; 1. The buccal pouch epithelium of hamster was histologically changed to the dysplasia at 6, 8, 10 weeks, carcinoma in situ at 12 weeks, and squamous cell carcinoma at 14 weeks. 2. The expression of the $TGF-{\alpha}$ was restricted to the parabasal and basal layers of the normal and dysplastic mucosa, but those positive cells were extended to the spinous layers of the epithelium in the carcinoma. 3. The degree of $TGF-{\alpha}$ expression was markedly decreased in the carcinoma at 16, 18, 20. The strong positive staining in the center of cancer islands and weak positive staining in periphery of tumor were seen at the stage of squamous cell carcinoma. 4. The positive index of the $TGF-{\alpha}$ had a tendency to increase with DMBA- applied time. There was a statistically significant difference between 12, 18, 20 experimental group and control group (p<0.05). 5. The expression of the $TGF-{\beta}$ was shown at the cytoplasm of all control and experimental groups, and the parabasal and basal layers of the normal and dyslastic mucosa, but it was shown at the basal layers of the epithelium in the carcinoma. 6. $TGF-{\beta}$ was expressed diffusely at 16, 18, 20 experimental group. The strong positive staining in the center of cancer islands and positive staining in periphery of tumor were seen at the stage of squamous cell carcinoma. From the above findings, the expression of $TGF-{\alpha}$ and ${\beta}$ in oral carcinogenesis model seems to have two formal stages, the first being an overexpression step as reaction to uncontrolled growth and the second being one in which external protein accumulate in the surrounding stroma and intracytoplasm. Overexpression of $TGF-{\alpha}$ and ${\beta}$ may have important cooperative roles for the promotion of cancer and factor of prognosis.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.7
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• pp.3541-3544
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• 2016

Background: As the treatment modalities for oral cancer have been relatively consistent during the last two-decades, this study was conducted to compare survivals of oral cancer patients in Khon Kaen Province before and after the universal coverage scheme (UC) was launched in Thailand. Materials and Methods: The data were retrieved from the population-based cancer registry of Khon Kaen for oral cancer patients diagnosed during 1992-2001 (pre-UC), and 2004-2012 (post-UC). To compare survival of the two cohorts, Kaplan Meier and log rank tests were employed. Results: Of 1,196 patients, 65% were females and the median age was 65 years. The most common primary sites were lip (31.0%), tongue (29.9%), and buccal mucosa (14.6%). The proportion of early stage cancer increased from 20.4 % in pre-UC to 41.3% in post-UC. The overall 5-year survival rate was 36.5% (95% CI =32.6-40.9) for pre-UC and 32.4% (95% CI = 28.8-36.4) for post-UC. The declining survival was mainly due to an increasing proportion of tongue cancer. However, no survival improvement was demonstrated on subgroup analysis of the tongue cancer patients. Conclusions: After the universal coverage scheme had been launched, early diagnosis increased, but no significant gain in survival for oral cancer patients was achieved.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.2
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• pp.585-589
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• 2012

Background: Israeli Arabs are considered as a developing society characterized by poverty and high levels of smoking among men. The purpose of this study was to describe their incidence, mortality and survival rates for oral and pharyngeal cancer between the years 1970-2006. Studies such as this in the Arab world, where the population is almost the same as the Arab population in Israel, are rare. Methods: The incidence and survival data were derived from all relevant registered data at the National Cancer Registry. The group of lesions included cancer of the lips, tongue, buccal mucosa, floor of the mouth, salivary glands, gums, palate and pharynx. Morphological description was according to WHO classification. Results: Most diagnosed patients were male. The mean age was 54.4 years, and mean years of survival were 3.83. The oropharynx was the most common site (28.3%) while the palate was the least frequent (3.12%). Squamous cell carcinoma (SCC) was the most common histological feature (66.3%), while basal cell carcinoma (BCC) was the least (3.9%). The overall 5 years survival rate was 59.4%, this being highest for BCC (82.1%), while SCC was significantly lower (56.2%) (p<0.001). Lip cancers survived better than other sites. Conclusions: Data from this society are similar to other developing societies in the majority of the results. The incidence of oral and pharyngeal cancer is lower among the Arab population, in comparison to the Jewish population in Israel.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.10
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• pp.5567-5577
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• 2013

The prevalence of oral cancers (OC) is high in Asian countries, especially in South and Southeast Asia. Asian distinct cultural practices such as betel-quid chewing, and varying patterns of tobacco and alcohol use are important risk factors that predispose to cancer of the oral cavity. The aim of this review is to provide an update on epidemiology of OC between 2000 and 2012. A literature search for this review was conducted on Medline for articles on OC from Asian countries. Some of the articles were also hand searched using Google. High incidence rates were reported from developing nations like India, Pakistan, Bangladesh, Taiwan and Sri Lanka. While an increasing trend has been observed in Pakistan, Taiwan and Thailand, a decreasing trend is seen in Philippines and Sri Lanka. The mean age of occurrence of cancer in different parts of oral cavity is usually between 51-55 years in most countries. The tongue is the leading site among oral cancers in India. The next most common sites in Asian countries include the buccal mucosa and gingiva. The 5 year survival rate has been low for OC, despite improvements in diagnosis and treatment. Tobacco chewing, smoking and alcohol are the main reasons for the increasing incidence rates. Low socioeconomic status and diet low in nutritional value lacking vegetables and fruits contribute towards the risk. In addition, viral infections, such as HPV and poor oral hygiene, are other important risk factors. Hence, it is important to control OC by screening for early diagnosis and controlling tobacco and alcohol use. It is also necessary to have cancer surveillance at the national-level to collect and utilise data for cancer prevention and control programs.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.23 no.2
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• pp.124-136
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• 2001

Heat shock protein (HSP) expression is unregulated in tumor cells and, HSP expression is likely marker of the malignant potential of oral epithelial lesion. Furthermore, the 70kDa HSP is implicated in the degree of tumor differentiation, the rate of tumor proliferation and the magnitude of the anti-tumor Immune response. Accordingly, the distribution and intensity of HSP70 and HSP47 expression was assessed in the DMBA induced oral carcinogenesis in hamster. Golden Syrian hamsters which were 3 months-age and $90{\sim}120g$ were collected. 9,10-dimethyl -1,2-benzanthracene (DMBA) in a 0.5% solution in mineral oil was painted on the buccal pouch mucosa 3 times per week in the study group. In each control and experimental groups of 6, 8, 10, 12, 14, 16, 18, 20 weeks, specimen were sectioned for immunohistochemical study with anti-HSP47 and anti-HSP70 antibody. The following results were obtained. 1. HSP47 positive cells were race or negative of normal oral mucosa, increased mildly in basal and suprabasal basal layer, and spinous cell layer after experimental 6 weeks (dysplastic or CIS stage). In CIS stage, HSP47 expression is prominent in dysplastic free or normal adjacent epithelium. 2. HSP47 positive cells in connective tissue were mainly inflammatory cells, which is gradually increased from control to precancerous and cancer stage. But HSP47 positive cells after 14 weeks were decreased, especially normal and cancer adjacent epithelium. 3. The positive staining cells of HSP70 in control, dysplastic, and CIS stage were not seen. But they were mild findings in basal layer and moderate findings in spinous layer after experimental 14 weeks (cancer stage). 4. HSP70 positive cells were increased in precancerous and cancer stage than control group in connective tissue. After experimental 16 weeks, we could not find the HSP expression in cancer cells according to cancer differentiation or cancer stage. It is concluded that HSP70 or HSP47 expression is not a definitive marker of oral malignancy or malignant potential. However, with further development, HSP immunoreactivity may be valuable as an adjunct to conventional histology for assessing the malignant potential of oral mucosal lesions.