T.G. Bui

Technological Advances in the Treatment of Facial Trauma

Tuan G. Bui, MD, DMD*, R. Bryan Bell, DDS, MD, Eric J. Dierks, DMD, MD Head and Neck Surgical Associates, Portland, OR, USA Legacy Emanuel Medical Center, Providence Portland Medical Center, Portland, OR, USA Oral and Maxillofacial Surgery, Oregon Health & Science University, Portland, OR, USA Oral, Head and Neck Cancer Program, Providence Cancer Center, Robert W. Franz Cancer Research Center, Providence Portland Medical Center, Portland, OR, USA Trauma Service/Oral and Maxillofacial Surgery Service, Legacy Emanuel Medical Center, Portland, OR, USA

Survival of microvascular free flaps in mandibular reconstruction: A systematic review and meta-analysis

Free tissue transfer is commonly used in the reconstruction of post‐ablative defects of the mandible. Due to lack of statistical power, comparing the survival of various free flaps, even in large studies, is challenging. The purpose of this study was to perform a meta‐analysis comparing the survival of the most commonly used free flaps for mandibular reconstruction.

Post-therapeutic surveillance schedule for oral cancer: is there agreement?

IntroductionPatients with oral cavity squamous cell carcinoma represent a diverse group, and the treatment these patients undergo also varies widely. Some patients undergo local excision alone while others require extensive surgery, often with adjuvant chemoradiotherapy. The post-therapeutic surveillance schedule for these patients tends to be a “one size fits all” formula for all head and neck squamous cell carcinoma patients, which has often been dictated by institutional doctrine or a senior surgeon’s dogma. The post-therapeutic needs and risks of a T1 oral cancer patient treated with surgery alone differ from those of a patient with advanced laryngeal carcinoma, and the follow-up regimen should be tailored to the specific patient’s risk of loco-regional recurrence, distant metastasis, and other related medical issues.Resources and materialsA total of 65 papers were identified, 18 of which either focused on follow-up strategy for oral cavity squamous cell carcinoma or their tabular data allowed these cases to be extracted. Internationally recognized cancer entities were also queried.ConclusionsNo international consensus was achieved about the follow-up strategies. The value of post-therapeutic surveillance schedule following oral cancer treatment is generally not in dispute, although patient-initiated symptom-driven visits can be effective in identifying tumor recurrence for oral cancer patients. The range of appointment interval schemes tends to identify a progressive escalation of visit intervals such that there are more visits in the first year than in the second, and fewer yet during the third. Patients may fail to comply with their clinic visit structure. Most references agree that follow-up beyond the third year is unnecessary and may waste medical resources as well as the time of both patient and surgeon. There is no agreement as to the need for or interval of imaging studies.