〈Originals〉Initial swallowing function in those undergoing subtotal mobile tongue component resection and reconstruction with a myocutaneous pectoralis major flap

[Abstract] Purpose : The swallowing function was evaluated 2 months postoperatively in eight tongue cancer patients who had undergone subtotalresection of the mobile tongue component and reconstruction with a pectoralis major myocutaneous flap. The association between the form of the flap and initial postoperative swallowing function was also evaluated. Materials and methods : Video fluorography was used to evaluate swallowing function. The test food consisted of 10 ml liquid. Results : The form of the flap was a bulge and flat in 6 and 2 patients, respectively. Contact between the flap and hard palate was favorable in 6 patients but poor in 2. The 6 patients with favorable flap and hard palate contact showed neither residue of the test food in the recessus piriformis nor aspiration. The 2 patients with poor flap and hard palate contact showed marked test food residue in the recessus piriformis and aspiration. Conclusion : It is suggested that decreased flap volume could reduce swallowing pressure, promoting aspiration, and so the mobile tongue component should be reconstructed with a bulge flap to facilitate flap and hard palate contact, considering initial postoperative swallowingfunction

〈Originals〉Histological change of cbronic ulcers following negative-pressure wound therapy

[Abstract]We treated various ulcerative lesions associated with different causes of ulceration using negative-pressure wound therapy, and investigated the characteristics of the histological changes during the treatment period. The wound surface was then entirely sealed and maintained with a closed dressing material and managed by applying approximately 125 mmHg of continuous negative pressure to the wound surface. Tissue was collected from the central region of the ulcer floor and the collected specimen was macroscopically and histologically evaluated. Using this de-vice, the remission of edema, neutrophil infiltration, capillary blood vessel formation, and collagen fibers advancing in the vertical direction from the wound floor were observed regardless of the cause of ulceration. The results of histological examinations also confirmed that favorable granulation is achievable in chronic ulcers. Although this method necessitates the monitoring of the negative pressure load and infection level in the wound during device application, it is simple, less invasive, and effective

A patient with levator dysfunction resulting from slight blunt trauma

In clinical practice of plastic surgery, patients with palpebral/orbital swelling/hematoma due to facial bruise/fracture who can not open their eyelids are often encountered. However, most patients can open their eyelids after a few days with improvement in swelling/hematoma, and few develop blepharoptosis as a sequela. We reported a very rare patient with blepharoptosis due to slight blunt trauma without an open wound of the eyelid who did not show recovery in levator function. In this patient, paralytic blepharoptosis due to oculomotor injury caused by blunt trauma in a very localized area was considered

An analytical study of neocartilage from microtia and otoplasty surgical remnants: A possible application for BMP7 in microtia development and regeneration.

To investigate auricular reconstruction by tissue engineering means, this study compared cartilage regenerated from human chondrocytes obtained from either microtia or normal (conchal) tissues discarded from otoplasties. Isolated cells were expanded in vitro, seeded onto nanopolyglycolic acid (nanoPGA) sheets with or without addition of bone morphogenetic protein-7 (BMP7), and implanted in nude mice for 10 weeks. On specimen harvest, cartilage development was assessed by gross morphology, histology, and RT-qPCR and microarray analyses. Neocartilages from normal and microtia surgical tissues were found equivalent in their dimensions, qualitative degree of proteoglycan and elastic fiber staining, and quantitative gene expression levels of types II and III collagen, elastin, and SOX5. Microarray analysis, applied for the first time for normal and microtia neocartilage comparison, yielded no genes that were statistically significantly different in expression between these two sample groups. These results support use of microtia tissue as a cell source for normal auricular reconstruction. Comparison of normal and microtia cells, each seeded on nanoPGA and supplemented with BMP7 in a slow-release hydrogel, showed statistically significant differences in certain genes identified by microarray analysis. Such differences were also noted in several analyses comparing counterpart seeded cells without BMP7. Summary data suggest a possible application for BMP7 in microtia cartilage regeneration and encourage further studies to elucidate whether such genotypic differences translate to phenotypic characteristics of the human microtic ear. The present work advances understanding relevant to the potential clinical use of microtia surgical remnants as a suitable cell source for tissue engineering of the pinna