• Title/Summary/Keyword: Subtotal maxillectomy

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Simultaneous Reconstruction of a Subtotal Maxillectomy and Columella Deficit using Radial Forearm and Preauricular Free Flaps (요측전완과 이개전부 유리피판을 이용한 아전상악절제술과 비주결손의 동시 재건)

  • Yoon, Taekeun;Eun, Seokchan;Cho, Sung-Woo;Rhee, Chae-Seo
    • Korean Journal of Head & Neck Oncology
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    • v.38 no.1
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    • pp.53-57
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    • 2022
  • Reconstruction of subtotal maxillectomy defects with columella deficit is challenging. We report a unique case of facial reconstruction using a free radial forearm flap and a free preauricular flap for the maxillectomy and columella deficit. A 73-year-old woman was diagnosed with recurrent sebaceous carcinoma of the nose. We performed wide excision, including areas of the right cheek, nose, upper lip, maxilla, and columella. The resultant subtotal maxillectomy defect was reconstructed using a three-dimensional flap. First, a free radial forearm flap was transfered to resurface the nasal, oral, and external facial side. Second, a preauricular flap was positioned into the columella defect and anastomosed with the distal portion of the radial forearm flap pedicle. The two flaps survived, and the patient recovered uneventfully. We believe the radial forearm and preauricular double free flaps with the pedicle connection method were effective in reconstructing the present case of subtotal maxillectomy defect.

CLOSURE OF ORO-ANTRAL FISTULA USING SINUS LIFTING AND SKIN GRAFT IN MAXILLARY MALIGNANT CASES : CASE REPORT (상악골 악성종양환자에서 상악동점막거상술과 피부이식술을 이용한 구강-상악동누공의 폐쇄 : 증례보고)

  • Kim, Il-Kyu;Kang, Ho-Sik;Choi, Jin-Ho;Ryu, Seong-Hyun;Oh, Nam-Sik
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.28 no.1
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    • pp.86-90
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    • 2002
  • Sinus lifting was introduced for prosthetic reconstruction in 1960 decades by Boyne and is specifically used for implant surgery in maxillary posterior region with insufficient bony height and has been indicated for reconstruction of oro- antral and palato-alveolar cleft. We report that subtotal maxillectomy using sinus lifting and skin graft in mild maxillary cancer cases results in good prevention of oro-antral and oro-nasal fistula by preserving intact maxillary sinus mucosa and improves better functional outcome after maxillectomy.

MALIGNANT PERIPHERAL NERVE SHEATH TUMOR ON PALATE: A CASE REPORT (구개골에 발생한 악성 Peripheral Nerve Sheath Tumor의 증례보고)

  • Kwon, Min-Su;Lee, Hyun-Sang;Kim, Hyun-Chang;Ko, Seung-O;Shin, Hyo-Keun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.30 no.3
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    • pp.228-233
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    • 2004
  • Summary: The malignant peripheral nerve sheath tumor(MPNST) is an aggressive neoplasm and can either arise independently or result from malignant change in preexisting neurofibromatosis (von Recklinghausen's disease). Its histologic characteristics remain controversial, but currently it is believed that the schwann cell is the origin of the peripheral nerve sheath tumors. MPNST is an uncommon neoplasm of the head and neck region, and its presentation in the oral cavity is quite rare. In this study, we report a patient with a rare case of a MPNST involving the maxilla. A case report: A 29-year-old female presented with a chief complaint of painless swelling with bleeding tendency on the left maxillary tuberosity area 2 months ago. Clinical examination showed a $5.0{\times}3.0cm^2$ sized, indurative swelling on the site. Conventional radiographs showed a relatively well-defined soft tissue mass involving the left maxillary sinus, and destruction of the anterior, posterolateral walls of the left maxillary sinus. Subtotal maxillectomy and split-thickness skin graft from thigh were undertaken. In histochemical and immunohistochemical studies, the specimen revealed positive reactivities to Vimentin and S-100 protein. Final diagnosis was made as MPNST.

Squamous cell carcinoma occurring with aspergillosis in the maxillary sinus: a case report and histological study (상악동내 국균증과 편평상피세포암의 동시발생 증례: 조직학적 연구 및 문헌고찰)

  • Byun, June-Ho;Lee, Jeong-Hee;Rho, Gyu-Jin;Park, Bong-Wook
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.36 no.2
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    • pp.125-127
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    • 2010
  • The coexistence of aspergillosis and squamous cell carcinoma (SCC) in the maxillary sinus was very rare. To our knowledge, this is the second report of coexistent SCC and aspergillosis in the maxillary sinus. A 58-year-old man underwent surgery for unilateral maxillary sinus infection with oroantral fistula. In the surgical specimen, SCC and aspergillosis were co-detected with routine and immunohistochemical stainings. Moreover, human papillomavirus 18 (HPV-18) was detected by polymerase chain reaction in the sinus specimen. The patient was re-operated with subtotal maxillectomy and has been followed up for two years without any evidence of recurrence or metastasis. Although it is not understood how aspergillosis could induce carcinoma formation, the chronic inflammation caused by prolonged fungal infection might be carcinogenic. Moreover, HPV-16 and -18 were another causative pathogens of SCC in the head and neck region. We recommend careful examination, including preoperative cytology, in patients with maxillary sinus fungal infections because of the potential for cancer development.

A CASE REPORT AND RIVIEW OF LITERATURE ON OSSIFYING FIBROMA IN MAXILLA (상악골에 발생한 화골성 섬유종의 증례보고 및 문헌고찰)

  • Lee, Sang-Chull;Kim, Yeo-Gab;Ryu, Dong-Mok;Yoon, Ok-Byung
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.11 no.2
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    • pp.29-39
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    • 1989
  • Ossifying fibroma is a relatively slow growing tumor, and likely to have presented for some years before its clinical diognosis. The usually well circumscribed nature of ossifying fibroma in jaws lends itself to relative ease of excision and hence the favorable therapeutic results. On occasion, however, particulary in juvenile patient, if maxilla the tumor assumes an aggressive behavior. In that case, because the tumor grows invasively, resection with a margin of healthy tissue is indicated. The case presented is 34 - year old female. The patient had noticed a gradual swelling of the right side of the face approximately 2 months in duration correlation with a intermittent pain on the right maxillary molar area. Palpation disclosed firm swelling on the right anterior and lateral walls of the maxillary sinus extended to the maxillary tuberosity area. The radiographic examination revealed soft tissue mass with multiple dense round calcifications with destruction of anterior and posterolateral wall of the right maxillary sinus and right alveolar process, and hard palate. The mass totally obliterated maxillary sinus and extended to the pterygopalatine fossa. The histologic diagnosis from the biopsied specimen revealed ossifying fibroma. The tumor mass was resected by subtotal maxillectomy procedure due to a recent rapid infiltrative growth. In 5 months of postoperative follow - up period, the patient has favorable prognosis.

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