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The study aimed to introduce the closure technique using palatal island flap with or without hinge flap for oroantral or oronasal fistula. We explained the surgical methods, assessed the efficacy of these techniques and compared with other closure methods. This study included nine patients who were diagnosed with oroantral or oronasal fistula and underwent treatment; closure technique using palatal island flap with hinge flap (double flap closure) or that without hinge flap (single flap closure) between 2000 and 2022. Etiological factors included malignant tumors, benign tumors, cyst, and trauma. Double flap closure was performed in five cases, wherein primary closure was achieved with hinge flap created using surrounding palatal mucosa and secondary closure was achieved with palatal island flap. Single flap closure was performed in four cases. All nine patients were treated successfully, and follow-up showed no evidence of flap necrosis or major postoperative complications. The main advantages of this double flap closure technique include effective primary closure with hinge flap, which can prevent perforation into the nasal cavity and/or sinus even if the secondary flap (palatal island flap) becomes loose due to palatal mucosa irritation, and rich blood supply in the palatal island flap from the greater palatine artery. These factors confirm the validity of this technique. Secure closure with single palatal island flap was achieved; however, more secure closure can be achieved by using double flap closure technique. Therefore, it is important to choose single or double flap closure technique depending on the case. [ABSTRACT FROM AUTHOR]

Background: Fish bones commonly stray into the tongue base, palatine tonsils, and pharyngeal mucosa but rarely into the submandibular gland duct. Case presentation: A 74‐year‐old man developed acute sialadenitis after a fish bone strayed into the submandibular gland duct. Laboratory data revealed elevated S‐amylase level; computed tomography (CT) revealed linear opacification along the submandibular gland duct. Electron microscopic analysis confirmed the object to be a fish bone; the bone discharged spontaneously prior to a scheduled excision. Conclusion: Identification of foreign bodies is difficult with CT or other imaging modalities alone. Additional detailed examination, such as electron microscopy analysis, is required. [ABSTRACT FROM AUTHOR]

Background: There have been a number of reports suggesting that LDL apheresis, including LDL adsorption and double filtration plasmapheresis (DFPP), can be applied for the treatment of lower extremity peripheral arterial disease (PAD) in hemodialysis patients, whereas there is no definitive recommendation for the use of LDL apheresis. Study Design: The change of skin perfusion pressure (SPP) during LDL apheresis was measured in every single treatment to determine the effect of LDL adsorption and DFPP on improving blood flow in lower extremity PAD hemodialysis patients. Eleven hemodialysis patients treated with more than two series of LDL apheresis were involved in the study. "One series" included 10 treatments of LDL apheresis according to the Japanese health care insurance system. Results: In total, 320 treatments (32 series) of LDL apheresis were performed utilizing either LDL adsorption or DFPP treatment in 11 patients. The SPP values pre‐ and post‐apheresis were recorded in 315 treatments (228 LDL adsorption and 87 DFPP). The SPP was significantly improved after both LDL adsorption (P <.001) and DFPP (P =.002) treatment. The median change of SPP was significantly larger in the LDL adsorption group (12.6 mm Hg, range: −48.5, 77.0 mm Hg) than in the DFPP group (6.7 mm Hg, range: −42.0, 72.5 mm Hg) (P =.003). The LDL adsorption consistently offered a significant increase in the SPP, whereas DFPP treatment seemed to have modest effects on the improvement of SPP compared to the LDL adsorption. Conclusions: These data indicate that LDL adsorption should be considered the primary LDL apheresis therapy for lower extremity PAD in hemodialysis patients to achieve improvement of blood flow. [ABSTRACT FROM AUTHOR]