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Objectives: The current research investigated the impact of adding immunonutrition mixture before surgery to the standard feeding regimen for patients undergoing oral cavity or mandibular tumor resections. Methodology: This randomized double-blind controlled trial comprised 176 cancer patients undergoing resection of oral cavity or mandibular tumors. Participants were evenly divided into two groups: Group I (Immunonutrition group) got perioperative supplementation with omega-3 taken orally and L-Alanyl-L-Glutamine (Dipeptiven) administered via intravenous infusion, in addition to the standard feeding. Group C (Control group) received only standard feeding, which included a caloric distribution of protein 10-35%, fats 20-35%, and carbohydrates 45-65%. Both groups were followed for the primary outcome, set as wound infection and duration of hospital stays. The secondary outcome, included total dose of intraoperative opioids, postoperative VAS at 0 h, 4 h, 8 h and 12 h, intraoperative hemodynamics and any postoperative complications e.g., fever, neutropenia and pneumonia. Results: A significant difference in postoperative complications in both groups was observed; wound i nfection was (1.14% vs. 7.95%) for Groups I and C respectively (P = 0.03). Group I was significantly lower in fever and neutropenia vs Group C (P < 0.01). No significant difference in hospital stay, intraoperative opioid consumption, Postoperative VAS score at 0 h, 4 h, 8 h and 12 h and intraoperative HR, MAP, SBP, DBP in both groups. Conclusion: Immunonutrition has a substantial effect in lowering the rate of postoperative complications. However, it does not affect decreasing postoperative pain or length of hospital stay. [ABSTRACT FROM AUTHOR]

Introduction: Surgical excision forms the principal treatment of oral cavity squamous cell carcinomas. The comprehensive surgical management consists of Wide Local Excision of the tumor and Neck Dissection with removal of Submandibular gland. The submandibular gland accounts for 70-90 % of unstimulated salivary volume. Its excision as a part of neck dissection has been found to cause high Incidence (21% vs 7%) of postoperative xerostomia. Recent studies have highlighted that the preservation of the SMG is possible and oncologically safe in early-grade OCSCC with N0 neck as the involvement of SMG in such cases is low and its preservation decreases the chances of xerostomia. Materials and Methods: 80 subjects were included in the study to estimate the prevalence of metastatic submandibular gland involvement in oral cavity squamous cell carcinomas. The presence of metastasis into the salivary gland was studied and the mechanism/route of involvement was analysed. The comparison was made between the early and advanced tumors for SMG metastasis irrespective of the primary subsite involvement. Results: In the current study low prevalence (6.2 %) of metastasis to SMG was seen. It was seen in high-grade tumors only. None of the early-grade tumors showed any evidence of SMG metastasis. The most common pattern (80%) of glandular involvement was a direct extension from the primary tumor. Conclusions: Our study concludes that SMG preservation neck dissections can be carried out in early-grade OCSCC irrespective of primary tumor site involvement. The advantages of preserving the SMG are multiple. Furthermore, the morbidity is markedly decreased with its preservation without any compromise on oncological safety. [ABSTRACT FROM AUTHOR]

Copyright of RSBO: Revista Sul-Brasileira de Odontologia is the property of UNIVILLE and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Mohs micrographic surgery (MMS) may be an effective treatment modality for oral cavity cancers (OCC) due to possibility of more effective visualization of tumor margins and greater preservation of benign tissue. The objective of this study is to review the existing literature on the use of MMS for the treatment of OCC and categorize its uses and limitations. A systematic review was performed in accordance with Assessing the Methodological Quality of Systematic Reviews (AMSTAR) guidelines. PubMed, Scopus, and Google Scholar from inception of databases to January 20, 2023 identified all published studies on the use of MMS for OCC. Nine studies met inclusion criteria. Seventy-seven patients were treated with MMS for OCC, 74 of which (96%) were treated for squamous cell carcinoma (SCC). The tongue was the most common site (n = 57). Six out of seven studies showed no recurrence of disease during the follow-up periods, which ranged from 8 to 42 months, and one study reported significantly lower loco-regional recurrence over a 2-years follow-up period (10.5% vs 25.7%). Mohs technique did not cause a statistically significant increase in operating time. Applicability of MMS is limited by operator comfort with surgical technique and pathological interpretation of specimens in the oral cavity. The main limitation was that various studies did not report specific patient characteristics. In conclusion, MMS may be an effective treatment for OCC, especially for squamous cell carcinomas, and tumors involving the tongue. [ABSTRACT FROM AUTHOR]

We aimed to investigate the impact of the worst pattern of invasion (WPOI-V), an indicator of biological aggressiveness, on survival outcomes, as well as the potential need for adjuvant radiotherapy in squamous cell oral cavity cancers. A total of 162 patients who underwent surgical procedures at our center between 2017 and 2023 were included in the study. The median age of the patients was 65 years (range, 18-91 years). Tumor locations encompassed the lip (n=60), tongue (n=49), gingiva and buccal mucosa (n=23), and other sites (n=30). Patients were categorized into two groups: those with early-stage disease (T1 -2 or N0) (n=80) and those with locally advanced disease (T3-4 or N+) (n=82). Cancer-specific survival (CSS) was defined as the time to local, regional, or systemic progression, while overall survival (OS) was defined as the time to death from any cause following the date of surgery. The Kaplan-Meier method was employed for survival analysis, and statistical significance was set at p<0.05. The median follow-up duration was 36 months, with a range from 0 to 72 months. Local, regional, and/or systemic progression was observed in 26 patients, resulting in distant metastasis in 13 cases, local regional relapse in 8 cases, and second primary lung cancer in 2 cases. The three-year Cancer-Specific Survival (CSS) was significantly worse in patients with the presence of WPOI-V (63% vs. 86.9%, p=0.000) (see Figure 1). The difference was notably more pronounced in early-stage or younger patients. In multivariate analysis, the only significant factor influencing CSS in the early stage was WPOI-V (p=0.008) (Figure 1).There was no significant difference observed in OS. [Display omitted] The presence of WPOI-V in both early-stage and locally advanced patients serves as an indicator of a poor prognosis. This finding may represent a novel factor that warrants consideration for the inclusion of adjuvant therapy in the treatment of early-stage patients. [ABSTRACT FROM AUTHOR]

Copyright of Nővér is the property of Chamber of Hungarian Health Care Professionals and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: Oral cavity malignancies (OCC) and oropharyngeal malignancies (OPC) historically have higher rates of positive surgical margins (PSM) compared to other solid malignancies. The objective of this study is to understand trends and predictors in positive surgical margins (PSM) for OPSCC and OCSCC using the National Cancer Database (NCDB)., Study Design: Retrospective Cohort Study., Setting: National Cancer Database., Methods: Retrospective analysis of patients with OCC and OPC between 2004 and 2020 in the NCDB. Linear regression analysis between PSM rates and year was performed. Multivariable logistic regression was used to investigate the effect of the year of diagnosis on PSM after adjusting for patient, tumor, and healthcare system-related factors., Results: We analyzed 60,695 patients with OCC and 31,950 patients with OPC. Overall PSM rate was 16.1% in OCC and 33.1% in OPC. OCC PSM rate decreased from 17.7% in 2004 to 15.8% in 2020. OPC PSM rate decreased from 32.5% to 25.0%. Later date of diagnosis was associated with a reduction in positive margins for both OCC (odds ratio [OR] 0.99, 95% confidence interval [CI] 0.99-1.0, P < .001) and OPC (0.99, 0.98-0.99, P < .001). For patients with available minimally-invasive surgery data, both later year of diagnosis (0.95, 0.93-0.96, P < .001) and use of minimally-invasive techniques (0.830, 0.75-0.92, P < .001) were associated with a reduction in PSM in OPC., Conclusion: Positive margins for OCC/OPC have been decreasing over the past 2 decades. Robot use has been associated with a reduced PSM rate in OPC. Understanding factors that may contribute to trends in PSM is important in promoting continued improvement., (© 2024 American Academy of Otolaryngology–Head and Neck Surgery Foundation.)

Objective: Depth of invasion (DOI) has been incorporated in the new AJCC 8th classification. However, even with this new AJCC classification stage III oral tongue squamous cell carcinoma (OTSCC) remains a heterogenous group. The study aims at finding a discreet group within stage III using DOI as a cut‐off of 10 mm. Methods: The institutional database was reviewed from 2012 to 2018 for postoperative stage III OTSCC patients who subsequently received postoperative radiotherapy. Ninety‐six patients matched the inclusion criteria. Two groups were created using a DOI cut‐off of 10 mm (superficial and deep groups). The groups were analyzed for overall survival (OS) and relapse‐free survival (RFS). Results: The baseline and treatment characteristics were comparable between the groups except for the higher number of extensive surgeries, endophytic configuration, pT3 and, DOI in the deep group. For a median follow‐up of 40.5 (range: 4–139) months, the median OS and RFS for the superficial group were not reached. The median OS and RFS for the deep group were 101 (range: 73.7–128.3) and 60 (range: 46.6–73.4) months, respectively. The difference was statistically significant for median RFS (P =.008) and trended toward significance for median OS (P =.066) for the superficial group. Multivariate Cox regression analysis showed DOI cut‐off as a significant predictor for RFS but not for OS. Conclusion: DOI significantly predicts poor RFS. However, showed a trend toward poor OS. This study hints toward a possibility of sub‐dividing stage III OTSCC based on DOI cut‐off. Level of Evidence: 3 (Retrospective cohort study) Laryngoscope, 132:1594–1599, 2022 [ABSTRACT FROM AUTHOR]

INTRODUCTION[|]We aimed to review our data about the functional outcomes of the buccinator myomucosal flap used for head and neck reconstruction after oncologic ablative surgery.[¤]METHODS[|]Retrospective chart analysis was performed of 15 patients between the ages 52 and 78 years (mean age 66 years) who had buccinator myomucosal flaps for oral cavity reconstruction after tumor ablation. All the resections and reconstructions were performed by the first author (BK) at two tertiary referral centers. The demographic feature of the patients, anatomical subsites of the cancer, operation type, flap raising time, total operation time, blood loss during flap harvesting, wound problems and other postoperative complications, decannulation time and postoperative oral feeding time were collected from the patients` medical charts.[¤]RESULTS[|]One patient had minimal distal flap loss. There was no need for additional surgery for this patient. Two patients had partial wound dehiscence, which was resutured in the operating theatre. The donor sites were closed primarily in all cases. One of the patients had wound dehiscence in donor site which healed by secondary intention. Mean flap size was 7x3.2 cm. All flaps needed a second operation for pedicle separation due to the pedicled flap nature. All separations of pedicles were performed using sedation and adequate analgesia in operating theatre without general anesthesia. Mean separation time was 12 days after the first surgery. Three patients had tracheostomy and the mean decannulation time was three days for those. Soft diet was started in the postoperative 2nd day in all patients. However, mean postoperative oral feeding time without any nasogastric tube assistance was five (3–9 days) days. Mean flap harvesting time was 35 minutes (25–49 minutes). Mean intraoperative blood loss during flap harvesting was 25 ml (20–40 ml).[¤]DISCUSSION AND CONCLUSION[|]Buccinator myomucosal flap should be in the armamentarium of every head and neck surgeon for oral cavity reconstruction.[¤]

Copyright of Hungarian Medical Journal / Orvosi Hetilap is the property of Akademiai Kiado and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Neurofibroma are rare occurrences in the oral cavity with the tongue as the most common location in the oral cavity being affected by neurofibroma. Neurofibroma are usually asymptomatic, irregular tissue masses of benign nature with a small rate of malignant conversion. Recurrence rates are also low in the neurofibromas of the oral cavity. It is rare in India with only a few cases reported to date. Hence, we report this case of a 63-year-old female with a tissue mass present on the right side of her tongue for the last five years, with a progressive nature. The mass was associated with pain during chewing food for the last three months. She was managed by a wide local incision and was reported well recovering at a three-month follow-up., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Narasimhan et al.)

Objective: We aimed to review our data about the functional outcomes of the buccinator myomucosal flap used for head and neck reconstruction after oncologic ablative surgery. Methods: Retrospective chart analysis was performed of 15 patients between the ages 52 and 78 years (mean age 66 years) who had buccinator myomucosal flaps for oral cavity reconstruction after tumor ablation. All the resections and reconstructions were performed by the first author (BK) at two tertiary referral centers. The demographic feature of the patients, anatomical subsites of the cancer, operation type, flap raising time, total operation time, blood loss during flap harvesting, wound problems and other postoperative complications, decannulation time and postoperative oral feeding time were collected from the patients' medical charts. Results: One patient had minimal distal flap loss. There was no need for additional surgery for this patient. Two patients had partial wound dehiscence, which was resutured in the operating theatre. The donor sites were closed primarily in all cases. One of the patients had wound dehiscence in donor site which healed by secondary intention. Mean flap size was 7x3.2 cm. All flaps needed a second operation for pedicle separation due to the pedicled flap nature. All separations of pedicles were performed using sedation and adequate analgesia in operating theatre without general anesthesia. Mean separation time was 12 days after the first surgery. Three patients had tracheostomy and the mean decannulation time was three days for those. Soft diet was started in the postoperative 2nd day in all patients. However, mean postoperative oral feeding time without any nasogastric tube assistance was five (3-9 days) days. Mean flap harvesting time was 35 minutes (25-49 minutes). Mean intraoperative blood loss during flap harvesting was 25 ml (20-40 ml). Conclusion: Buccinator myomucosal flap should be in the armamentarium of every head and neck surgeon for oral cavity reconstruction. [ABSTRACT FROM AUTHOR]

Hemangiomas are benign proliferative vascular malformations characterized by hyperplasia of venous and capillary structures embedded in the submucosal connective tissue. In adults, hemangiomas are rare lesions, and 50% patients are aged >40 years. Most hemangiomas are observed in the head and neck region; however, the oral cavity is a rare location. The soft palate is one of the rarest locations in the oral cavity for hemangiomas. In this report, a large cavernous hemangioma in the soft palate of male adult is presented. Literature review and current diagnostic and treatment modalities are discussed.

Introduction: Among head and neck cancers, those of the oral cavity and oropharynx are the second most prevalent following the larynx. This study aimed to research immunohistochemical expression of survivin, HPV positivity and microvessel density in tumors and their relationships with prognosis.Material and methods: Pathological materials and demographic properties of 46 patients were retrospectively evaluated. Survivin, HPV and CD34 (for microvessel density evaluation) antibodies were applied tumoral tissues. Survival times, clinical stage and differentiation were evaluated.Results: In univariate analysis, we observed that survivin, microvessel density and stage were significantly associated with survival time (p < 0.05). In multivariate analysis, only survivin and microvessel density were associated with survival time (p < 0.05). But we did not find significant correlation between neither tumor differentiation nor HPV positivity and survival (p > 0.05).Conclusions: Survivin levels and microvessel density were found to be effective prognostic factors and were related to survival in oral cavity and oropharyngeal cancers. Treatments targeting survivin expression and angiogenesis might be employed against these tumor groups. [ABSTRACT FROM AUTHOR]

Background Preoperative staging is crucial for oral cancer management. The purpose of this study was to assess the tumor thickness using ultrasound and to correlate the level of histological infiltration with the tumor superficial extension and lesion thickness. Methods Thirty-two subjects affected by oral cavity carcinoma were prospectively evaluated with intraoral ultrasound. The ultrasound sensitivity, the correlation between the ultrasound level of infiltration, and lesion diameters and thickness were assessed. Results A 91% ultrasound sensitivity was found with no significant correlation between tumor diameter and level of histological infiltration ( P >.05). A thickness of <2 mm was associated to tumor extension to the lamina propria, a value of >6 mm to muscular layer infiltration. Lymph adenopathies were identified in 21% of cases, associated to muscular layer infiltration in all cases. Conclusion In the study of early oral cavity tumors, ultrasound is accurate for demonstrating the level of tumor infiltration and contributes to the therapeutic choice. [ABSTRACT FROM AUTHOR]

Copyright of Revista ADM is the property of Asociacion Dental Mexicana and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Hemangiomas are benign proliferative vascular malformations characterized by hyperplasia of venous and capillary structures embedded in the submucosal connective tissue. In adults, hemangiomas are rare lesions, and 50% patients are aged >40 years. Most hemangiomas are observed in the head and neck region; however, the oral cavity is a rare location. The soft palate is one of the rarest locations in the oral cavity for hemangiomas. In this report, a large cavernous hemangioma in the soft palate of male adult is presented. Literature review and current diagnostic and treatment modalities are discussed. [ABSTRACT FROM AUTHOR]

Background. Only few reports have been published about the use of the three-dimensional ultrasound in the field of otorhinolaryngology. With conventional ultrasound investigation usually enough information can be obtained. One of the most important ultrasound applications in otorhinolaryngology is investigation in patients with head and neck tumors to establish the extent of metastatic disease.Methods. In the article we present our experience with threedimensional ultrasound. We used it in patients with head and neck tumors, where we established the volume of lymph nodes and their relations to the carotid artery and jugular vein. We also established the volumes of the oral cavity tumors and made a comparison with the T cathegory of TNM classification of malignant tumors.Results and conclusions. The average size of all tumors was 9,6 cm3. We found the significant correlation between the tumor volumes and T cathegory (p < 0,05).Despite the fact that not all tumors in the field of otorhinolaryngology are accesible for the ultrasound investigation, we think that the tumor volume could be an important parameter in the treatment of patients with head and neck tumors. Three-dimensional ultrasound offers us also better possibilities to recognise the metastatic infiltration of major vessels on three orthogonal planes.One of the important advantages of three-dimensional ultrasoun is also in the possibility of digital recording of the obtained data.

Összefoglaló. A szájüregi daganatok kuratív kezelésében az elsődlegesen választandó műtét mellett a sugárterápiának is jelentős szerepe van. A lokális tumormentesség biztosításához azonban dóziseszkaláció szükséges. Ennek külső besugárzással való megvalósítása a környező normálszövetek fölösleges dózisterhelésével és az ebből következő mellékhatások előfordulásának emelkedésével jár. A brachytherapia (BT) - amelynek során radioaktív sugárforrást/sugárforrásokat juttatunk a tumorba vagy annak közelébe - lehetővé teszi a helyileg magasabb dózis leadását a környező ép szövetek kímélésével. A BT a korai, T1-2N0 stádiumú szájüregi tumoroknál - kedvező prognosztikai faktorok mellett - akár kizárólagosan vagy mint posztoperatíve egyedül alkalmazott terápiás modalitás jön szóba. Kedvezőtlenebb prognózis esetén vagy előrehaladottabb stádiumban (T3-4 vagy N+) a műtétet és/vagy a percutan irradiációt kiegészítő eljárásként alkalmazható kedvező sugárfizikai tulajdonságai miatt. A kis dózisteljesítményű (low-dose-rate, LDR) BT-t már évtizedek óta alkalmazzák a terápiában, de ezt kezdi kiszorítani a nagy dózisteljesítményű (high-dose-rate, HDR), illetve a pulzáló dózisteljesítményű (pulse-dose-rate, PDR) BT. A jelen áttekintő tanulmány célja irodalmi adatok alapján a BT szerepének és indikációjának ismertetése a szájüregi daganatok kuratív kezelésében, alrégiókra lebontva. Orv Hetil. 2021; 162(37): 1471-1479. Summary. Radiation therapy plays a significant role in the curative treatment of oral cavity tumors, in addition to the primary choice of surgery. However, dose escalation is required to ensure local tumor control. Its implementation with external irradiation is accompanied by an unnecessary dose exposure to the surrounding normal tissues and an increase in the incidence of consequent side effects. Brachytherapy (BT), in which a radiation source/sources is/are placed inside or close to the tumor, allows a higher dose to be delivered locally, sparing the surrounding intact tissues. In addition to favorable prognostic factors in early T1-2N0 stage oral cavity tumors, BT is considered either exclusively or as a sole postoperative therapeutic modality. At less favorable prognosis or at a more advanced stage (T3-4 or N+), BT can be used as a complementary procedure after surgery and/or percutaneous irradiation based on its favorable radio-physical properties. Low-dose-rate (LDR) BT has been used in the therapy for decades, but recently it has been replaced by high-dose-rate (HDR) and pulse-dose-rate (PDR) BT. The purpose of this review is to describe the role and indications of BT in the treatment of oral cavity tumors categorized into subregions, based on the literature data. Orv Hetil. 2021; 162(37): 1471-1479.

Head and neck squamous cell carcinoma (HNSCC) shows wide disparities, association with human papillomavirus (HPV) infection, and prognosis. We aimed at determining HPV prevalence, and its prognostic association with overall survival (OS) in Saudi HNSCC patients. The study included 285 oropharyngeal and oral-cavity HNSCC patients. HPV was detected using HPV Linear-Array and RealLine HPV-HCR. In addition, p16INK4a (p16) protein overexpression was evaluated in 50 representative cases. Oropharyngeal cancers were infrequent (10%) compared to oral-cavity cancers (90%) with no gender differences. Overall, HPV-DNA was positive in 10 HNSCC cases (3.5%), mostly oropharyngeal (21%). However, p16 expression was positive in 21 cases of the 50 studied (42%) and showed significantly higher OS (p = 0.02). Kaplan–Meier univariate analysis showed significant associations between patients' OS and age (p < 0.001), smoking (p = 0.02), and tumor stage (p < 0.001). A Cox proportional hazard multivariate analysis confirmed the significant associations with age, tumor stage, and also treatment (p < 0.01). In conclusion, HPV-DNA prevalence was significantly lower in our HNSCC patients than worldwide 32–36% estimates (p ≤ 0.001). Although infrequent, oropharyngeal cancer increased over years and showed 21% HPV-DNA positivity, which is close to the worldwide 36–46% estimates (p = 0.16). Besides age, smoking, tumor stage, and treatment, HPV/p16 status was an important determinant of patients' survival. The HPV and/or p16 positivity patients had a better OS than HPV/p16 double-negative patients (p = 0.05). Thus, HPV/p16 status helps improve prognosis by distinguishing between the more favorable p16/HPV positive and the less favorable double-negative tumors. [ABSTRACT FROM AUTHOR]

Background: Retromolar trigone squamous cell carcinoma is relatively uncommon and due to its complex anatomy has always remained a challenge in terms of loco-regional control and survival. Surgery, radiotherapy, and chemotherapy as combined modalities have been used but high recurrence rates result in poor outcome., Methods: We have retrospectively evaluated records of 62 patients treated in Head and Neck Oncology unit of Shaukat Khanum Memorial Cancer Hospital and Research Centre (SKMCH and RC), Lahore, Pakistan from 2004 to 2014 who were included based on the criteria of histopathological proven squamous cell carcinoma of retromolar trigone (RMT) treated with radical intent. Diagnostic workup for all patients involved clinical examination, imaging modalities usually magnetic resonance imaging (MRI), computerized tomography (CT), Orthopantomogram (OPG), and chest x-ray (CXR) to evaluate regional and distant metastasis, respectively. Kaplan-Meier survival curves were used to depict survival., Results: The study was comprised of 36 male and 26 female patients. Treatment modalities used are surgery only (n = 1), radiotherapy alone (n = 13), radiotherapy followed by surgery (n = 10), chemoradiotherapy (n = 16), induction chemotherapy followed by concurrent chemoradiotherapy (n = 19), induction chemotherapy followed by surgery, and radiotherapy (n = 2). Surgical interventions include wide local excisions (n = 6), marginal mandibulectomy (n = 4), and segmental mandibulectomy (n = 4). Surgical margins were clear in 54%, close in 38%, and involved in 8% of patients. AJCC 7th edition showed cT1 8%, cT2 22%, cT3 14%, and cT4 56% while pT1 2%, pT2 3%, and pT4 8%. During follow-up, 18% patients have come up with local recurrence, 22% showed persistent disease while 9% have presented with distant metastasis. The five-year and overall survivals are 38% and 22%, respectively., Conclusion: Retromolar trigone involvement poses many vital structures at risk of involvement. Late presentation results in involvement of masticator space compromising both mouth opening and surgical outcomes. Surgery and radiotherapy have shown comparable results in disease control. Bone invasion has shown poor outcome in terms of loco-regional control and overall survival., Competing Interests: The authors have declared that no competing interests exist.

The use of sentinel lymph node biopsy in squamous cell carcinoma of the oral cavity is still subject to debate although some studies have reported its feasibility. The main reason for this debate is probably due to the high false-negative rate for floor-of-mouth tumors per se. We report the case of a 54-year-old man with a T1N0 floor-of-mouth squamous cell carcinoma who underwent the sentinel lymph node procedure. Lymphoscintigraphy and SPECT/CT imaging were performed for lymphatic mapping with a conventional gamma camera. Sentinel lymph nodes were identified at right Ib, left IIa and Ia levels. However, these sentinel lymph nodes were difficult to detect intraoperatively with a gamma probe owing to the activity originating from the injection site. The use of a portable gamma camera made it possible to localize and excise all the sentinel lymph nodes. This case demonstrates the usefulness of this tool to improve sentinel lymph node detecting in floor-of-mouth tumors, especially those close to the injection area., (Copyright © 2013 Elsevier España, S.L. and SEMNIM. All rights reserved.)

Surgery is the primary intervention in oral and maxillofacial tumors and under ideal circumstances is curative. There is no evidence to support the use of induction or adjuvant chemotherapy in initial therapy of early stage tumors. Locally advanced tumors, non-resectable tumors as well as recurrence in early stage disease, need a multi-modality therapeutic approach involving chemotherapy. Palliative chemotherapy plays an important role in the treatment patients with metastatic oral and maxillofacial tumors. Chemotherapy and targeted agents plays an important role in the treatment of patients with rare oral and maxillofacial tumors such as sarcomas, lymphomas, and giant cell tumors., (Copyright © 2014 Elsevier Inc. All rights reserved.)