口腔颌面部恶性肿瘤治疗指南

口腔颌面部恶性肿瘤约占全身恶性肿瘤的3%～5%,其组织病理学类型多样,以鳞状细胞癌最多见,约占90%以上。由于解剖部位特殊,口腔颌面部恶性肿瘤不仅影响外观,而且造成咀嚼、吞咽、呼吸和语音等功能障碍,严重降低患者的生存质量,并危及生命。手术、放疗和化疗是治疗口腔颌面部恶性肿瘤的3大治疗手段,免疫治疗、生物治疗对某些类型的肿瘤和晚期患者是必要的补充和辅助措施。早期患者以手术治疗为主,晚期患者则提倡综合序列治疗,并鼓励患者参加临床试验。口腔颌面部恶性肿瘤患者的5年总生存率在65%左右,晚期患者的5年生存率不足30%。为了规范口腔颌面部恶性肿瘤的治疗,进一步提高患者的远期生存率,中华口腔医学会口腔颌面外科专业委员会肿瘤学组牵头,组织国内从事口腔颌面部恶性肿瘤治疗的知名专家,参考国内外文献,尤其是2009年美国NCCN指南中的相关内容,撰写了《口腔颌面部恶性肿瘤治疗指南》,希望对口腔颌面部恶性肿瘤的规范治疗起到指导作用。随着医学科学技术的发展,新的技术、方法、药物会不断出现,本指南将及时予以更新,以反映和纳入最新的研究成果,为广大患者提供最新的治疗方案。     

口腔颌面部恶性肿瘤微转移的研究进展

口腔颌面部恶性肿瘤为全身恶性肿瘤的8.2%,其中上皮组织来源最多,尤其是鳞状上皮细胞癌（oral squamous cell carcinoma,OSCC）最为常见,约占口腔颌面部肿瘤的80%以上。口腔颌面部恶性肿瘤的治疗主要是以手术为主的综合治疗,虽然经手术、化疗、放疗等综合治疗,但总的生     

面部皮肤癌46例临床病理分析

皮肤癌是常见的恶性肿瘤,我院面部皮肤癌占面部上皮性恶性肿瘤97％,占口腔颌面部恶性肿瘤的14.4％。现将资料完整的46例皮肤癌手术标本的组织形态学观察和临床资料进行分析,并对各类型皮肤癌的特征、生物学特性、治疗及预后作一探讨。     

牙源性肿瘤诊疗指南

牙源性肿瘤的发生与牙的发育密切相关,其发病、临床表现及治疗等均具有特殊性,是口腔颌面外科特有的一类肿瘤。牙源性肿瘤的发病率高,占口腔颌面部肿瘤的6%,其基本治疗是以手术治疗为主的综合序列治疗。中华口腔医学会口腔颌面外科专业委员会肿瘤学组组织相关专家,结合国内外牙源性肿瘤相关文献及2005年WHO头颈肿瘤新分类,制定了《牙源性肿瘤诊疗指南》,希望对规范牙源性肿瘤的诊断与治疗起到指导作用。本指南将根据基础与临床研究的最新成果及时更新。     

颌面部恶性肿瘤手术前后D-二聚体含量变化及临床意义

目的:探讨颌面部恶性肿瘤手术前后D-二聚体含量的变化及其临床意义.方法:回顾性分析2017年9月—2019年4月在西安交通大学口腔医院进行手术治疗的176例颌面部恶性肿瘤患者的临床资料,术后参考《口腔颌面部恶性肿瘤治疗指南》疗效判定标准将患者分为治疗有效组(152例)和治疗无效组(24例).采用酶联免疫吸附法(enzy...     

Hedgehog信号通路及其在口腔颌面部肿瘤中的研究进展

<正>口腔颌面部肿瘤包括囊肿、瘤样病变在内,一般良性较多。口腔颌面部良性肿瘤以牙源性及上皮源性肿瘤最为多见,其次为间叶组织肿瘤。恶性肿瘤以上皮组织来源最多,尤其是鳞状上皮细胞癌最为常见,约占口腔颌面部恶性肿瘤的80%以上。我国口腔颌面部恶性肿瘤好发于男性,男女构成比约为2:1,好发年龄为40～60岁;据病理资料统计,约占全身恶性肿瘤的8.2%。口腔颌面部肿瘤由于发生部位的特殊性,其发生或手术后都会严重影响患者的面     

应重视口腔颌面部恶性肿瘤的综合序列治疗

口腔颌面部恶性肿瘤约占全身恶性肿瘤的3％，虽然所占比例不高，但l大l其解剖部位特殊．涉及美观和重要的生理功能，冈此对患者机体和心理的影响不容忽视。早期（Ⅰ、Ⅱ期）口腔颌面部恶性肿瘤无论采用手术和（或）放射治疗，均能取得良好效果。但遗憾的是，大多数患者就诊时，已属局部一区域晚期（Ⅲ、Ⅳ期）。由于受到局部解剖和维持功能的限制，单纯通过扩大手术切除范围和改进现有手术技术，除能改善患者生存质量外，已无法提高此类患者的生存率，延长其生存时间。     

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目的    观察综合序列治疗口腔鳞癌临床疗效,探索治疗口腔鳞癌合理治疗方案。方法    对2000年8月至2005年8月在枣庄矿业集团中心医院及山东大学口腔医院确诊并住院的口腔鳞癌中晚期患者60例,经过采用平阳霉素新辅助化疗、手术、术后放疗等手段进行规范的综合序列治疗,观察5年存活率及复发转移情况。结果        60例患者1年后复发率20.0％,2年后复发率23.3％,5年后复发率30.0％,5年存活率75.0％。结论    规范合理的综合序列治疗方法是治疗口腔鳞癌比较有效的手段,能明显提高口腔癌患者的存活率。     

口腔颌面部肉瘤的临床与治疗

<正> 口腔颌面部肉瘤近年来少有专题报道,一般对这些疾病尚认识不足。肉瘤发生于口腔颌面部者较少,丁氏报告口腔颌面部肉瘤约占口腔颌面部恶性肿瘤的9.2％,笔者报告肉瘤约占1.5％。本文就我科卅余年来收治的口腔颌面部肉瘤发病和临床诊治情况分析报告如下。临床材料我科自1956～1989年中共收治口腔颌面部肉瘤108例。全部病例均经病理确诊,其中末经治疗的有2例,对106例进行治疗,并对58     

湖南地区5443例口腔颌面部恶性肿瘤临床分析

目的：调查湖南地区1989—2008年口腔颌面部恶性肿瘤患者发病情况及各类肿瘤的构成比。方法：对湖南地区12家大型三甲医院1989—2008年住院并经病理确诊的口腔颌面部恶性肿瘤患者的临床资料进行回顾分析。结果：患者平均年龄52.7岁,好发年龄段为41～70岁;男女性别比2.23∶1.00;口腔、唾液腺、颌骨分列口腔颌面部恶性肿瘤原发部位的前3位,口腔黏膜恶性肿瘤以舌、牙龈最多见。组织来源以上皮源性肿瘤最多,占94.9%;病理类型上,鳞癌3268例,占60.0%。唾液腺恶性肿瘤病理类型前4位依次为黏液表皮样癌、腺样囊性癌、腺癌、恶性多形性腺瘤;发病部位前3位依次为腮腺、下颌下腺、腭腺。2004—2008年口腔黏膜鳞癌患者中,有咀嚼槟榔习惯者平均年龄48.6岁,好发部位以舌、颊最为多见。结论：湖南地区口腔颌面部恶性肿瘤以41～70岁为好发年龄段,口腔黏膜恶性肿瘤好发部位以舌、牙龈最多,近10年来舌、颊部恶性肿瘤有明显升高趋势,而牙龈部则有下降趋势。     

Top 100 cited systematic reviews and meta-analyses in the major journals of oral and maxillofacial surgery: a bibliometric analysis

The aim of this bibliometric research was to identify and analyze the top 100 cited systematic reviews in the field of oral and maxillofacial surgery in order to guide any professional level with interest in this topic and to map the current trends the field of oral and maxillofacial surgery. Using the Web of Science database without restrictions on publication year or language, a bibliometric analysis was performed for the five major journals of oral and maxillofacial surgery: International Journal of Oral and Maxillofacial Surgery (IJOMS), Journal of Oral and Maxillofacial Surgery (JOMS), Journal of Cranio-maxillofacial Surgery (JCMS), British Journal of Oral & Maxillofacial Surgery (BJOMS), and Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology (Triple-O). The most top-cited systematic review was published in 2015 with a total of 200 citations on survival and success rates of dental implants, consistent with the finding that “pre- and peri-implant surgery and dental implantology,” and “craniomaxillofacial deformities and cosmetic surgery” were the most frequently cited topics (22% each). The majority of top cited papers were published in IJOMS (43%), followed by JOMS (34%), Triple-O (8%), JCMS(8%) and BJOMS(7%). The highest number of contributions was from the Netherlands, followed by Italy and USA. The outcome of this article can be used as a source of information and to guide not just researchers but also clinicians and students to which areas are trending in the field of oral and maxillofacial surgery, thus also having a large impact on the field of oral and maxillofacial surgery. However, this article cannot reflect the quality of the included systematic reviews.

     

Three-dimensional reconstruction after oral oncologic surgery using single free radial forearm flaps or free rectus abdominis musculocutaneous flaps

This study reviews reconstruction of complex three-dimensional oral and maxillofacial defects using the single free radial forearm flap or the single free rectus abdominis musculocutaneous flap. Between 1996 and 2003, 124 patients underwent oral and maxillofacial reconstruction in the Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine. Outcomes for 22 patients who underwent three-dimensional reconstruction of multiple surfaces were evaluated. Reconstruction was performed after resection of malignant tumors in all 22 patients. Single FAFs were utilized for 11 patients and single RAMs for the remaining 11. Flap survival rate was 100%. No major donor morbidity was observed, and all surviving patients (20/22) were able to perform normal daily living activities. Single FAF and RAM are useful materials for one-stage reconstruction of complex three-dimensional oral and maxillofacial defects requiring replacement of skin, mucosa, and intervening soft tissues. Good to excellent aesthetic results can be attained in most patients.     

中国口腔颌面外科专科医师培训和教育指南

中华口腔医学会口腔颌面外科专业委员会(Chinese Society of Oral and Maxillofacial Surgery,简称CSOMS)是国际口腔颌面外科医师协会(IAOMS)和亚洲口腔颌面外科医师协会(AsianAOMS)成员。本培训和教育指南的制定,是为了提高患者在接受口腔颌面部疾病诊治过程中的医疗水平和条件。对于直接参与这些医疗工作的口腔颌面外科医师来讲,他们的专业水平和所接受的专业培训教育水平是其所提供医疗服务水平高低的决定性因素。中国     

第四次全国口腔颌面部肿瘤学术会议纪要

2005年10月15～16日，第四次全国口腔颌面部肿瘤学术会议在四川成都召开。本次会议由中华口腔医学会口腔颌面外科专业委员会主办．四川大学华西口腔医学院承办。由于本次会议与第四次国际暨第七次全国口腔颌面外科学术会议同期举行．根据大会安排．将肿瘤术后缺损的修复重建论文划归创伤会场，而将唾液腺疾病和脉管行疾病内容归在肿瘤会场．故会议收到的274篇论文（大会发言48篇）涉及口腔颌面部肿瘤及唾液腺疾病。主要范围包括口腔颌面部肿瘤外科和内科治疗、口腔颌面部肿瘤病理学和分子生物学研究进展、唾液腺疾病的临床与基础研究进展等，较全面地反映了国内在口腔颌面部肿瘤和唾液腺疾病的基础研究和临床工作方面所取得的成就。     

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?? In order to understand the status and characteristics of oral and maxillofacial surgery education in the United States and China?? and summarize the shortcomings of the education in China?? this study selected Department of Oral and Maxillofacial Surgery in University of Texas?? Southwestern Medical Center at Dallas as an example to introduce and compare the education differences between the two countries in order to provide references for Chinese oral and maxillofacial surgery education.     

口腔颌面外科手术在新型冠状病毒感染流行期管理的专家意见

由湖北省武汉市首先发现并蔓延至全国乃至世界多个国家的2019新型冠状病毒肺炎（2019-nCoV）主要通过呼吸道飞沫、分泌物或接触传播,具有极强的传染性。口腔颌面外科医师在诊疗过程中,无可避免地需接触患者的口腔、上呼吸道及其他分泌物,极易造成感染,属于高危医务工作者群体。如何提高口腔颌面外科医师的防护意识,在规范或合理建议下开展口腔颌面外科急诊或择期手术的相关工作,是疫情期间亟须解决的问题。为此,口腔颌面外科专业委员会特组织部分专家,撰写了口腔颌面外科手术在新型冠状病毒感染流行期管理的专家建议,为口腔颌面外科临床医师的诊疗提供参考。     

老年人口腔颌面部肉瘤33例临床分析

目的：探讨老年人口腔颌面部肉瘤的临床特点及预后。方法：收集2000—2009年治疗的33例老年人（〉60岁）口腔颌面部肉瘤病例进行回顾性分析。利用SPSS12.0软件包进行统计学分析,预后影响因素采用χ2检验。根据随访资料,采用乘积极限法统计生存率。结果：33例患者中,男23例,女10例。平均年龄71岁（61～88岁）,平均随访时间21个月（3～83个月）。随访患者29例,失访患者4例,随访率为87.88%。随访患者中,原发病例20例,因肉瘤复发就诊（复发病例）9例。随访病例均经手术治疗,其中单纯手术治疗12例,术后辅助放疗9例,术后辅助放化疗8例。经χ2检验,单纯手术治疗组和术后辅助放化疗组对预后有显著影响（P〈0.05）。原发病例中,术后局部复发11例,复发率55%。复发病例中,7例术后出现复发,2例出现远处转移。随访病例中,1年生存率为69%,3年生存率为40.8%,5年生存率为25.4%。单纯手术治疗组和术后联合放化疗组的生存函数采用Logrank检验进行比较,差异具有显著性。结论：手术是治疗老年人口腔颌面部肉瘤的主要手段。根治性手术联合术后放化疗对改善老年肉瘤患者的预后可能有益。     

Oral and maxillofacial surgery in The Netherlands: from Esser until today

In 2006, it was 50 years ago that the oral and maxillofacial surgery was officially recognized as a dental speciality in The Netherlands. During those five decades, oral and maxillofacial surgery significantly evolved, which is nicely reflected by the changes in the name of the scientific society supporting the speciality. Originally its name was The Netherlands Society for Oral Surgery and Surgical Prosthodontics, but in 1975 its name was changed into The Netherlands Society for Oral Medicine and Oral Surgery, and in 2006 into The Netherlands Society for Oral Medicine and Oral and Maxillofacial Surgery. Esser is considered to be the first oral and maxillofacial surgeon in The Netherlands. In The Netherlands, 2 schools of oral and maxillofacial surgery are recognized: the Utrecht School with Tjebbes as its founder and the Groningen School with Hut as its founder. Because of the 50th anniversary of the speciality, a thematic issue of the Dutch Journal of Dentistry offers a review of the current status of and expected future developments in oral medicine, head and neck oncology, maxillofacial traumatology, growth and development disorders of the maxillofacial skeleton, temporomandibular joint disorders and reconstructive surgery in The Netherlands.