Preresection application of reconstruction plates for temporary mandibular reconstruction

Small and medium-sized benign mandibular tumors such as ameloblastoma, odontogenic myxoma, and odontogenic keratocysts are generally resected intraorally when possible. This leaves extraoral soft tissues at the future recipient site untouched and simplifies dissection during delayed mandibular reconstruction. Superior results can be anticipated because of better blood supply and less scar tissue. In such cases, temporary reconstruction of the mandibular continuity defect resulting from the ablative tumor surgery with a reconstruction plate can preserve both normal facial contour and oral functions. The plate bridges the gap temporarily to maintain the mandibular segments in correct position and favors repair of the soft tissue. This article presents a modified application technique for the three-dimensional, bendable reconstruction plate (3-DBRP) after intraoral resection of benign mandibular tumors

Introducing the ‘walk-up’ flap

Reconstructive oral and maxillofacial surgeons often find the need for additional soft tissue even when a myocutaneous flap has been previously placed. This article introduces the principles, technique, and results of 32 “walk-up” muscle flaps derived from existing myocutaneous flaps. The anastomotic vascular ingrowth at the original myocutaneous flap's distal end permits its proximal detachment and axial vessel ligation to rotate the proximal two thirds to a tissue-deficient site. In our experience at the University of Miami, these flaps have been predictable (97% viable transfer rate), have provided vascular soft tissue in deficient areas, and have been skin grafted at their surface to increase oral lining or skin cover, among several other uses

Relationship of oxygen dose to angiogenesis induction in irradiated tissue

This study was accomplished in an irradiated rabbit model to assess the angiogenic properties of normobaric oxygen and hyperbaric oxygen as compared with air-breathing controls. Results indicated that normobaric oxygen had no angiogenic properties above normal revascularization of irradiated tissue than did air-breathing controls (p=0.89). Hyperbaric oxygen demonstrated an eight- to ninefold increased vascular density over both normobaric oxygen and air-breathing controls (p=0.001). Irradiated tissue develops a hypovacular-hypocellular-hypoxic tissue that does not revascularize spontaneously. Results failed to demonstrate an angiogenic effect of normobaric oxygen. It is suggested that oxygen in this sense is a drug requiring hyperbaric pressures to generate therapeutic effects on chronically hypovascular irradiated tissue

Burkitt’s Lymphoma Presenting as Late-Onset Posttransplant Lymphoproliferative Disorder following Kidney and Pancreas Transplantation: Case Report and Review of the Literature

Posttransplant lymphoproliferative disorders (PTLD) are a rare, but serious complication following transplantation. Late-onset PTLD are often associated with more monoclonal lesions and consequently have a worse prognosis. There are only isolated case reports of Burkitt’s lymphoma presenting as PTLD. We present an extremely rare, aggressive Burkitt’s lymphoma years after kidney and pancreas transplantation which was successfully treated with combination chemotherapy along with withdrawal of immunosuppression. The patient remains in complete remission more than 2 years after his diagnosis. We also provide a succinct review of treatment of various PTLD and discuss the role of Epstein-Barr virus infection in the pathogenesis of PTLD