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20 February 2024, Volume 22 Issue 2 Previous Issue   

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Expert Consensus

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Expert consensus on surgical treatment of hemangiomas and vascular malformations in the head and neck WANG Yan-an, QIN Zhong-ping, ZHENG Jia-wei, LI Chun-jie, LIU Shao-hua, YANG Yao-wu, CHEN Gang, CHEN Wei-liang, LIU Xue-jian, DU Zhong, ZHANG Lei, WANG Ye-fei, WANG De-ming, SU Li-xin, XIE Feng, DONG Chang-xian, GUO Lei, LI Kai, GU Song, HE Yue, ZHANG Zhi-yuan 2024, 22 (2):  105-117.  doi: 10.19438/j.cjoms.2024.02.001 Abstract ( 52 )   PDF (2515KB) ( 61 )   Hemangiomas and vascular malformations are common benign vascular diseases in the head and neck region. The evolution and extensive implementation of non-surgical therapeutic modalities have resulted in considerable improvement or even total remission in a significant number of patients in minimally invasive or non-invasive procedures. Nonetheless, under certain circumstances, surgical treatment remains an irreplaceable treatment modality within the comprehensive treatment sequence for hemangiomas and vascular malformations in the head and neck. However, there is no established standard or consensus in the academic community on how to choose and apply surgical treatment. Therefore, to enhance the treatment efficacy of hemangiomas and vascular malformations amongst domestic peers, and to standardize surgical treatment protocols, this consensus brings together the discussion opinions of relevant experts from many medical schools and affiliated hospitals nationwide. Based on the latest domestic and international research results and diagnosis and treatment experience, we formulated this expert consensus from the aspects of preoperative diagnosis and preparation, surgical treatment indications and strategies, postoperative care and observation, common complications and treatment after surgery, follow-up and social psychological support. It is expected to be used in clinical practice and to guide relevant professional doctors carrying out treatment. References | Related Articles | Metrics

Tutorial

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A perspective of evidence-based medicine on exploring the treatment strategy of head and neck cancer in pregnancy LI Chen-xi, DING Yi, LIU Hui, GONG Zhong-cheng, ZHANG Wei-na, ZHAO Hua-rong 2024, 22 (2):  118-127.  doi: 10.19438/j.cjoms.2024.02.002 Abstract ( 38 )   PDF (1573KB) ( 22 )   The occurrence of malignant tumor during pregnancy is relatively rare, but with the increased age of pregnant women and the decreased age of patients suffering from head and neck cancer(HNC), the incidence of HNC complicated with pregnancy is slightly increasing. However, at present, there has been a lack of standardized diagnosis and treatment standards for pregnant woman with HNC. This paper evaluated the frequency, tumor type, associated factors, and specific biomarkers in HNCs occurring in pregnant women (including peripartum), based on systematic literature retrieval that performed on PubMed databank. From an evidence-based medicine view, this review presents a comprehensive description of the studies of pregnancy complicated with HNC, and intends to provide guidance in clinical practice. References | Related Articles | Metrics

Orignal Article

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Integration of WGNCA and PPI networks to identify key genes for oral squamous cell carcinoma LI Jin-cun, ZHAI Kun, HU Chen, LIU Xu-ying, MA Xing-ping, MA Jian 2024, 22 (2):  128-136.  doi: 10.19438/j.cjoms.2024.02.003 Abstract ( 30 )   PDF (4935KB) ( 27 )   PURPOSE: To screen important biomarkers associated with oral squamous cell carcinoma (OSCC) by using bioinformation technology. METHODS: The gene expression profiles of OSCC were obtained from GEO database and differentially expressed genes (DEGs) extracted. WGCNA was used to obtain the core genes in the module with the most significant relationship with OSCC and intersected with DEGs. At the same time, pathway analysis as well as protein network analysis(PPI) were performed. The CytoHubba was used to extract candidate key genes. Secondly, survival analysis was used to identify key genes, and verify expression in OSCC. Furthermore, the association between key genes and immune infiltrating cells and immune checkpoints was explored in OSCC. GraphPad Prism 8 software was used for data analysis. RESULTS: A total of 53 co-expressed DEGs were identified. Enrichment analysis revealed that these genes mainly involved in extracellular matrix, extracellular region, PI3K-Akt and other pathways. Twenty candidate core genes were identified from PPI networks, among which 5 key genes(SERPINE1, SERPINH1, LAMC2, ITGA5 and ITGA3) were identified using survival analysis. GEPIA and GSE30784 showed that these five genes had differential expression in OSCC tissues (P< 0.05). SERPINE1 was not expressed at the protein level of OSCC through HPA database, but SERPINH1, LAMC2, ITGA5 and ITGA3 were highly expressed. They significantly correlated with immune infiltration cells such as CD8+ T cells and dendritic cells and immune checkpoints such as CD276, VEGFA, and PDCD1(P< 0.05). CONCLUSIONS: SERPINE1, SERPINH1, LAMC2, ITGA5 and ITGA3 can be used as biomarkers of OSCC, providing new clues for the diagnosis, prognosis and treatment of OSCC. References | Related Articles | Metrics

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Risk factors for obstructive sleep apnea in snoring adults ZHENG Tong, YAO Kan, QIAN Yi-feng, SUN Hong-xia, LU Xiao-feng, YU Wen-wen 2024, 22 (2):  137-142.  doi: 10.19438/j.cjoms.2024.02.004 Abstract ( 33 )   PDF (757KB) ( 37 )   PURPOSE: To explore the risk factors for obstructive sleep apnea in snoring adults. METHODS: A cross-sectional study was conducted in 1 155 adult snoring patients who were overnight polysomnography(PSG) monitored for obstructive sleep apnea(OSA) from January 2012 to October 2021 in Sleep Medicine Center of Shanghai Ninth People's Hospital. The patients were divided into two groups based on apnea hypopnea index (AHI): non-OSA and OSA groups. The prevalence and risk factors of OSA were analyzed. RESULTS: The prevalence of OSA was 88.23%, and the male to female ratio was 4.12∶1. The risk factors for OSA in snoring adults were age, neck circumference/height ratio, gender and waist circumference, of which the thresholds were 30.5 years old, 22.93, male, 86.25 cm. WRAG-N was proposed to predict OSA, with an AUC of 0.789, a sensitivity of 87.2%, and a specificity of 29.4%. CONCLUSIONS: For adult snoring population, the risk factors for OSA were over 30 years old, male and waist circumference greater than 86.25 cm. Meanwhile, neck circumference/height ratio is one of the key risk factors for OSA. WRAG-N, innovatively proposed as the predictive tool for OSA, may help communities screen OSA in high-risk snoring adults to provide efficient and high-quality diagnosis and treatment. References | Related Articles | Metrics

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A primary study on application of neuralized fibula flap for mandibular reconstruction and sensory restoration of the lower lip ZHANG Bing-qing, SHI Jing-cun, WU Zi-qian, ZHANG Yu-han, WANG Jie-yu, XIAO Meng, WANG Lei 2024, 22 (2):  143-147.  doi: 10.19438/j.cjoms.2024.02.005 Abstract ( 30 )   PDF (1359KB) ( 28 )   PURPOSE: To explore a new method of simultaneous jaw reconstruction and sensory recovery after resection of the mandible and inferior alveolar nerve due to tumor, so as to provide reference for clinical practice. METHODS: Segmental resection of mandibular bone was performed in a patient with mandibular ameloblastoma. The inferior alveolar nerve closely associated with the lesion was removed during the operation, neurovascularized fibula free flap was transplanted at the same time. The graft resorption was observed by postoperative imaging, and sensory preservation was evaluated by applying two-point discriminative sensation and touch test using sensory test wire. RESULTS: At the 9-month postoperative follow-up, the patient exhibited a naturally symmetrical facial appearance, with the flap displaying excellent survival and blood supply. The grafted bone remained stable without noticeable resorption, and the lower lip regained good sensory function while sensory function was partially restored to the chin. There were no issues such as lip-biting or salivation. Furthermore, neither recipient nor donor areas exhibited adverse complications. CONCLUSIONS: This innovative approach of simultaneous nerve reconstruction demonstrates promising efficacy in restoring lower lip sensation and preventing postoperative grafted bone resorption in fibula flap transplantation for mandibular reconstruction. References | Related Articles | Metrics

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Risk factors for complications and ICU care of 144 cases with oral and maxillofacial space infection ZHANG Yin-yin, ZHU Yan-yan, DING Jia-hui, SUN Yu-hua 2024, 22 (2):  148-152.  doi: 10.19438/j.cjoms.2024.02.006 Abstract ( 30 )   PDF (544KB) ( 28 )   PURPOSE: To analyze the related risk factors of complications and intensive care unit(ICU) monitoring in patients hospitalized for oral and maxillofacial space infection(OMSI). METHODS: A total of 144 patients with OMSI admitted to the Affiliated Hospital of Xuzhou Medical University from January 2021 to March 2022 were selected. The patient's age, gender, length of hospital stay, systemic diseases, body mass index(BMI), source of infection and number of involved sites, complications, and laboratory indicators including white blood cell count(WBC), neutrophil percentage (NEU%), C-reactive protein (CRP) were collected. SPSS 25.0 software package was used for data analysis. RESULTS: Among 144 patients with OMSI, 52 cases (36.1%) had complications, of which 34.6% had symptoms of airway obstruction; 54 cases (37.5%) were transferred to ICU. Multivariate logistic regression analysis showed that high CRP value (OR=1.005, 95%CI: 1.000-1.011, P=0.048) were risk factors for patients with possible complications. Complications(OR=5.249, 95% CI: 1.644-16.754, P=0.005), hospital stay longer than 10 days (OR=1.166, 95%CI: 1.049-1.295, P=0.004), more space involvement(OR=2.719, 95%CI: 1.658-4.460, P<0.001), and high BMI (OR=1.262, 95%CI: 1.050-1.515, P=0.013) were independent risk factors affecting ICU monitoring. CONCLUSIONS: High CRP and BMI values and the number of infected spaces are closely related to the complications of patients and ICU monitoring. Therefore, it is necessary to strengthen the management of such patients and take comprehensive consideration in the treatment process to avoid the occurrence of adverse prognosis. References | Related Articles | Metrics

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Clinical application of vacuum sealing drainage in the treatment of descending necrotizing mediastinitis caused by maxillofacial and neck space infection ZHAO Ran-ran, LI Chen-xi, REZIWANGULI Yasen, GONG Zhong-cheng 2024, 22 (2):  153-157.  doi: 10.19438/j.cjoms.2024.02.007 Abstract ( 31 )   PDF (1009KB) ( 28 )   PURPOSE: To explore the clinical therapeutic effect of vacuum sealing drainage(VSD) on descending necrotizing mediastinitis(DNM) caused by maxillofacial and neck space infection. METHODS: The clinical data of 53 DNM patients treated with VSD in the First Affiliated Hospital of Xinjiang Medical University from July 2014 to July 2023 were reviewed, and the therapeutic effect was summarized and analyzed. SPSS 26.0 software package was used for data analysis. RESULTS: Of the 53 patients, 3 gave up treatment, 1 died, and the remaining were cured and discharged. Among the 53 patients, the average hospitalization time was (25.3±13.75) d, the average placement time of VSD was (16.15±8.22) d , the average monitoring time of ICU was (12.02±11.56) d, the average number of replacements of VSD was 1.57±1.32. There were significant differences between patients with diabetes and patients with normal blood glucose in length of hospital stay, ICU stay, VSD use, antibiotic use, total hospitalization cost, neutrophil to lymphocyte count ratio(N/L value), interleukin-6(IL-6) and D-dimer (D-D) value at admission. CONCLUSIONS: VSD has little surgical trauma in the treatment of DNM, promotes inflammatory absorption, and reduces the pain of dressing change during the course of the disease. For cases of infection to the anterior and lower diaphragm and total mediastinum, combined with closed thoracic drainage or mediastinial incision, the drainage effect is certain and has a distinct clinical application value. References | Related Articles | Metrics

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Retrospective analysis of risk factors for prolonged mechanical ventilation in patients with oral and maxillofacial space infections after surgery under general anesthesia FAN Jing-xian, WU Jia-jun, GE Kui, XU Bing, WANG Qi, YANG Tian-ye, WANG Fan-lin 2024, 22 (2):  158-164.  doi: 10.19438/j.cjoms.2024.02.008 Abstract ( 26 )   PDF (884KB) ( 15 )   PURPOSE: To analyze the risk factors of prolonged mechanical ventilation(PMV) in patients with oral and maxillofacial space infections(MSI) after surgery under general anesthesia. METHODS: A total of 74 patients with oral and maxillofacial multiple space infection who underwent general anesthesia in Department of Emergency, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine were retrospectively analyzed. The medical history, results of auxiliary examinations, and clinical outcomes of patients were collected for analysis. Univariate and multivariate logistic regression analyses were performed to assess risk factors associated with PMV. Receiver operator characteristic curve (ROC curve) was performed to evaluate the predictive value of related factors for PMV. Statistical analysis was conducted with SPSS 11.5 software package. RESULTS: The mean age of the patients was (62.53± 17.74) years , while 62.2% were male. The median duration of mechanical ventilation was 2 days and 43.3% were in PMV group. The incidence of postoperative pneumonia in PMV group was significantly higher than non-PMV group(P=0.04) and LOS was longer in PMV group(P=0.01). Multivariate analysis showed that the infections involved parapharyngeal space(OR=4.06,95%CI: 1.38-12.04, P=0.01) and arterial carbon dioxide partial pressure(PaCO2)(OR=1.10, 95%CI: 1.02-1.18, P=0.01) before SBT test were independent risk factors for PMV. The serum level of prealbumin(PAB) in PMV group was significantly lower than non-PMV group(P< 0.01). ROC curve analysis showed that PAB had good predictive value for PMV, the area under the ROC curve（AUC）was 0.772（95%CI: 0.602-0.843, P=0.01). CONCLUSIONS: PMV could be detrimental to prognosis of patients with MSI. Identifying risk factors of PMV early is conductive to clinical intervention and successful weaning after surgery. References | Related Articles | Metrics

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Evaluation of the effect of nitrous oxide combined with local anesthesia in extraction of impacted teeth KANG Cheng, ZHU Ting, HAN Shuang, LOU Yi-yi 2024, 22 (2):  165-169.  doi: 10.19438/j.cjoms.2024.02.009 Abstract ( 32 )   PDF (575KB) ( 14 )   PURPOSE: To evaluate the effect of nitrous oxide combined with local anesthesia in the extraction of impacted teeth and its effect on patients' anxiety. METHODS: A total of 188 patients undergoing impacted tooth extraction in Shaoxing Stomatological Hospital from December 2021 to December 2022 were selected and randomly divided into experimental group and control group, with 94 patients in each group. The control group was treated under local anesthesia, and the experimental group was treated under local anesthesia combined with nitrous oxide. The heart rate(HR), Ramsay sedation score and pain VAS score during local anesthesia, tooth extraction and 5 min after tooth extraction were compared between the 2 groups. The Modified Dental Anxiety Scale(MDAS) scores and the comfort level of patients after treatment were compared between the two groups. SPSS 22.0 software package was used for data analysis. RESULTS: With the change of treatment time, HR in both groups showed a trend of increasing at first and then decreasing (P<0.05). HR in the experimental group was significantly lower than that in the control group during local anesthesia, tooth extraction and 5 minutes after tooth extraction(P<0.05). The MDAS score of the experimental group was significantly lower than that of the control group(P<0.05). Ramsay sedation scores in both groups decreased at first and then increased with the change of treatment time(P<0.05). The Ramsay sedation score of the experimental group was significantly higher than that of the control group during local anesthesia, tooth extraction and 5 minutes after tooth extraction (P<0.05). With the change of treatment time, the VAS score of the two groups gradually increased (P<0.05). The VAS score of the experimental group was significantly lower than that of the control group during local anesthesia, tooth extraction and 5 min after tooth extraction(P<0.05). The comfort of the experimental group was significantly better than that of the control group(P<0.05). CONCLUSIONS: Nitrous oxide combined with local anesthesia for extraction of impacted teeth can reduce HR, improve patients' anxiety and sedation, reduce pain and improve comfort. References | Related Articles | Metrics

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A study on the current status of dyadic coping and factors influencing oral cancer patients ZHOU Xin-kai, ZHANG Yue-ying, TENG Xiao-ju, ZOU Wei-zhen, WU Rui-fang 2024, 22 (2):  170-174.  doi: 10.19438/j.cjoms.2024.02.010 Abstract ( 35 )   PDF (611KB) ( 18 )   PURPOSE: To explore the current situation of dyadic coping in oral cancer patients and analyze the influencing factors. METHODS: Using a convenience sampling method, a total of 128 oral cancer patients who were hospitalized in the Department of Stomatology of a tertiary hospital from June 2021 to November 2022 were selected as study subjects and investigated using the binary coping scale and the general self-efficacy scale. SPSS 25.0 software package was used for data analysis. RESULTS: The total binary coping score of oral cancer patients was 129.85±11.282 and the total general self-efficacy score was 25.45±4.463, which were positively correlated(r=0.822, P<0.05). General self-efficacy and whether they had received oral cancer-related health education were the influencing factors of the binary coping level of oral cancer patients (adjusted R2=0.716, P<0.05). CONCLUSIONS: The binary coping level of oral cancer patients is at a moderate level and needs to be further improved. Medical staff and other social support forces need to strengthen the daily publicity and education of oral cancer-related knowledge and health education; at the same time, the general self-efficacy of oral cancer patients can be improved as a starting point, so as to improve the binary coping level of patients. References | Related Articles | Metrics

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Construction and validation of a risk prediction model for emergence agitation in children with obstructive sleep apnea syndrome WANG Jia-hui, DUAN Xiao-wen, ZHOU Xu-hui, QIU Lin, LI Jing-jie, CAI Mei-hua, ZHENG Yong-chao 2024, 22 (2):  175-180.  doi: 10.19438/j.cjoms.2024.02.011 Abstract ( 25 )   PDF (823KB) ( 11 )   PURPOSE: To construct and validate the risk prediction model of emergence agitation (EA) after surgery in children with obstructive sleep apnea syndrome(OSAS). METHODS: A total of 665 children aged 3-12 years who received OSAS surgery under general anesthesia were selected as the study subjects and randomly divided into modeling group (n=499) and verification group (n=166). According to the occurrence of emergence agitation, the patients were divided into EA group and non-EA group. Logistic regression analysis was used to screen the risk factors of EA after OSAS in children, so as to establish a risk prediction nomogram model. The prediction efficiency of the model was verified by the area under C-index, calibration curve and receiver operating characteristic curve (ROC), and the risk model was internally verified. SPSS 26.0 software package and R software (V4.1.2) were used for data analysis. RESULTS: The incidence of emergence agitation after OSAS operation was 38.68%. Logistic regression analysis showed that age(OR: 0.494, 95%CI: 0.313-0.778), extubation time(OR: 0.971, 95%CI: 0.953-0.990) and postoperative pain (OR: 1.530, 95%CI: 1.378-1.699) were independent risk factors for emergence agitation after OSAS operation in children (P<0.05). Based on these findings, a risk prediction model was established, and the area under ROC curve was 0.782(95%CI: 0.741-0.823), the sensitivity was 0.599, the specificity was 0.837. The area under ROC curve of the verification group was 0.773 (95%CI: 0.697-0.849), the sensitivity was 0.676, and the specificity was 0.814. CONCLUSIONS: Age, extubation time and postoperative pain are independent risk factors for the occurrence of emergence agitation in children with OSAS operation, and the nomogram model constructed by this method has a good predictive effect on emergence agitation in children with OSAS operation. References | Related Articles | Metrics

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Comparison of stress response and safety of nasotracheal extubation following orthognathic surgery under different body position WANG Ye, HUANG Hui-min, WANG Yuan, LYU Xiang 2024, 22 (2):  181-185.  doi: 10.19438/j.cjoms.2024.02.012 Abstract ( 20 )   PDF (573KB) ( 14 )   PURPOSE: To explore the differences in stress response and safety of nasotracheal extubation in different positions under light sedation after orthognathic surgery and to provide a reference for the selection of extubation position after orthognathic surgery. METHODS: According to the extubation position, patients under general anesthesia from Jan.2022 to Dec. 2022 were divided into supine position group(n=115) and lateral position group (n=115) following the orthognathic surgery. The stress response indexes including SBP, DBP and HR of the two groups were monitored and compared at 5 min before extubation (T0), 1 min before extubation(T1), 1 min after extubation (T2), and 5 min after extubation (T3). The incidence of oral bleeding, hoarseness, sore throat, laryngeal spasm, cough, agitation and retroglossal falling were compared between the two groups as the safety indexes of extubation. SPSS 26.0 software package was used for data analysis. RESULTS: Different time points, SBP, DBP and HR were significantly higher in the lateral group than that in the supine group at T1(P<0.05). SBP, DBP and HR were significantly lower in the lateral group than that in the supine group at T2 and T3(P<0.05). The incidence of retroglossal falling and cough in the lateral group were significantly lower than that in the supine group(P<0.05). There was no significant difference in the incidence of nasal bleeding, oral bleeding, hoarseness, wheezing, laryngospasm and agitation, between the two groups(P>0.05). CONCLUSIONS: It is more conductive to reduce stress response and improve the extubation safety under light sedation in lateral position than in supine position after orthognathic surgery. References | Related Articles | Metrics

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Imaging and clinical analysis of 25 cases of osteosarcoma of the jaw ZHANG Qiang, LI Qing, ZHANG Jia 2024, 22 (2):  186-191.  doi: 10.19438/j.cjoms.2024.02.013 Abstract ( 34 )   PDF (1657KB) ( 24 )   PURPOSE: To investigate the clinical, imaging and prognosis of osteosarcoma of the jaw. METHODS: A total of 25 patients with osteosarcoma of the jaw confirmed by pathology and relevant preoperative examinations were collected from Xuzhou Central Hospital from January 2015 to December 2021. The clinical and imaging findings of the patients were summarized, and the factors influencing the prognosis of the patients were analyzed. SPSS 25.0 software package was used for data analysis. RESULTS: The male and female ratio of osteosarcoma of jaw was 9∶16, but there was no significant difference in gender and age distribution of osteosarcoma of jaw. The incidence of osteosarcoma in maxilla and mandible was 11∶14, involving zygomatic bone in 2 cases. The main clinical symptoms were maxillofacial mass/swelling, followed by numbness or pain. A total of 19 patients were followed up, including 11 negative surgical margins and 8 positive ones. Six cases(32%) had no recurrence and no metastasis, 11 cases(57%) had local recurrence with/without distant metastasis, and 2 cases(11%) had only distant metastasis. The most common site of metastasis was the lung, followed by the thoracolumbar spine. Plain CT showed bone destruction, continuous/discontinuous cortical bone (6∶19), with or without periosteum reaction (18∶7), with/without soft tissue mass formation (20∶5), with/without tumor bone formation (17∶8). Enhanced CT showed annular enhancement at the edge of the soft tissue mass but no enhancement at the center. MRI showed slightly low signal intensity in the bone destruction area and soft tissue mass on T1WI, equal or high signal intensity on T2WI, unclear signal of bone cortex, fluid accumulation along the edge of jaw bone, unclear boundary with adjacent muscle space. Prognostic analysis showed that there was significant difference in surgical margin status between maxillary osteosarcoma and mandibular osteosarcoma (P=0.024), and there was significant difference in the influence of surgical margin status on postoperative recurrence/metastasis of patients (P=0.018). CONCLUSIONS: The main clinical manifestations of osteosarcoma of jaw bone were maxillofacial mass/swelling, followed by numbness or pain. The diagnosis of osteosarcoma of the jaw can be indicated when the bone destruction of the jaw is accompanied by soft tissue mass and tumor bone formation, and the mass has obvious circular enhancement at the edge and no central enhancement. The location of osteosarcoma of jaw bone affected the status of surgical margin, and the status of surgical margin had significant influence on postoperative recurrence/metastasis. References | Related Articles | Metrics

Review Articles

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Research progress of adoptive T cell therapy in head and neck squamous cell carcinoma CHEN Yin-yu, CHEN Lin, XU Feng, ZOU Zi-chuan, GE Liang-yu, MENG Jian 2024, 22 (2):  192-197.  doi: 10.19438/j.cjoms.2024.02.014 Abstract ( 26 )   PDF (585KB) ( 31 )   Adoptive T cell therapy(ACT) is a new adoptive cell immunotherapy, which is developing rapidly in clinical research. Several studies have shown that ACT could enhance the specificity and reactivity of tumor tissue by increasing the number of T cells, thereby overcoming the suppression of tumor immune deficiency. There are three main modes of ACT: tumor infiltrating lymphocytes(TILs), chimeric antigen receptor T cells(CAR-T), and T cell receptor engineered T cells(TCR-T). In this review, we discussed the classification and research progress of various ACT therapies, including TILs, TCR-T, CAR-T and adoptive T cell therapy based on organoid co-culture, and explored the application prospects of ACT as a treatment method for head and neck squamous cell carcinoma. References | Related Articles | Metrics

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Research progress of the machanism of ossification in maxillary sinus after maxillary sinus floor elevation GUAN Xiang-yu, GAO Yi-ming 2024, 22 (2):  198-201.  doi: 10.19438/j.cjoms.2024.02.015 Abstract ( 24 )   PDF (448KB) ( 30 )   In posterior maxillary area, due to progressive bone resorption and the limitation of anatomic location of maxillary sinus after tooth loss, routine implant surgery was restricted. Maxillary sinus floor elevation is the main mean to solve the problems. In this paper,the mechanism of ossification in the maxillary sinus and its influential factory, and problems which need to be further studied were summarized. References | Related Articles | Metrics

Case Reports

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The bur broken into soft palate during tooth extraction: a case report and literature review GUO Lei, LEI Rong-chang, QU Bin-bin, GUO Ge, CHAI An, LUO Ying 2024, 22 (2):  202-205.  doi: 10.19438/j.cjoms.2024.02.016 Abstract ( 38 )   PDF (986KB) ( 21 )   When high-speed dental handpiece combined with surgical cutting bur are used to remove impacted teeth, instrument separation is rare, and bur breaking into the soft palate is even rarer. This paper reported a rare case in which the bur broke into the soft palate during tooth extraction and was successfully removed under local anesthesia with the help of imaging and 3D visualization techniques. Combined with literature review, this paper discussed the causes of this complication and corresponding treatment methods, and explored how to reduce the occurrence of this complication. References | Related Articles | Metrics

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Clear cell odontogenic carcinoma in the posterior mandibular region: a case report and literature review DENG Lei, HUANG Hai-tao, ZHANG Rui 2024, 22 (2):  206-208.  doi: 10.19438/j.cjoms.2024.02.017 Abstract ( 28 )   PDF (805KB) ( 25 )   Clear cell odontogenic carcinoma(CCOC) is a rare odontogenic epithelial carcinoma, which is difficult to be accurately diagnosed by clinical and imaging manifestations before surgery. Simple resection may result in recurrence, cervical lymph node metastasis, distant metastasis and even death. This paper reported the diagnosis and treatment of a patient with clear cell odontogenic carcinoma in the posterior dental region of the mandible and the disease was discussed based on literature. References | Related Articles | Metrics