Chang-Fu Sun

China Medical University (PRC), Shenyang, Liaoning, China

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Publications (43)38.57 Total impact

  • Xu Zhang, Meng-Jie Li, Qi-Gen Fang, Chang-Fu Sun
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    ABSTRACT: Our study investigated the quality of life (QoL) of Chinese patients after immediate reconstruction surgery on individuals with head and neck cancer. In addition, we compared the differences between pectoralis major myocutaneous flap (PMMF) and anterolateral thigh free flap (ALTFF). The University of Washington Quality of Life questionnaire, version 4, was used to assess the QoL. Assessments were performed at least 24 months postoperatively. A total of 110 patients' records were obtained. Among them, 86 patients completed a QoL questionnaire (78.2%). No significant differences could be found in age, primary site, T stage, N stage, and postoperative radiotherapy between PMMF and ALTFF groups. However, there were significant differences between both groups in sex, operation time, and complication. A matched analysis was performed to compare the differences in QoL between patients with head and neck cancers reconstructed with PMMF or ALTFF. Patients reconstructed with ALTFF had better shoulder but worse speech functions. There was a significant effect on the QoL of head and neck cancer patients who had undergone either PMMF or ALTFF reconstruction. The result of this study provide useful information for physicians and patients during their discussion of treatment modalities for head and neck cancers.
    The Journal of craniofacial surgery 04/2014; · 0.81 Impact Factor
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    ABSTRACT: To assess the effectiveness of double mental V-Y island advancement flaps for total lower lip reconstructions. During a 6-year period, from 2006 to 2012, total lower lip reconstruction was performed in 12 patients using double mental V-Y island advanced flaps. The resulting lip function and superiority of each flap were analyzed. To assess any cosmetic implications, patients were asked to answer the Appearance Domain section from the University of Washington Quality of Life Questionnaire at least 12 months after discharge from the hospital. All flaps survived completely and no short-term postoperative complications occurred. The mean follow-up time was 34.5 months (range, 15 to 69 months) and there was no recurrence of disease. All patients were capable of consuming a regular oral diet and no patients complained of an inability to eat in a public setting, drooling, or microstomia. The mean preoperative and postoperative open-mouth widths were 4.1 and 3.7 cm, respectively, and the mean reduced open-mouth width was 10%. The intercommissural width varied from 4.6 to 6.8 cm (mean, 5.5 cm). The mean postoperative 2-point discrimination was 11.2 mm (range, 9 to 13 mm). The mean score for the Appearance Domain section was 93.8 (range, 75 to 100). The mental V-Y island advancement flap reconstruction is a reliable procedure for total lower lip reconstruction.
    Journal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons 04/2014; 72(4):834.e1-6. · 1.58 Impact Factor
  • Shuang Bai, Chang-Fu Sun
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    ABSTRACT: Primary orofacial tuberculosis (TB) is uncommon, especially with regard to the jaw. We report an unusual case for which the final diagnosis was tuberculous osteomyelitis of the mandible with cervical tuberculous lymphadenitis. The follow-up examinations for our patient showed complete regression of the swelling and healing of the mandibular lesion after 4 months of TB antibiotic therapy. The purpose of the present study was to alert clinicians to our findings and encourage them to consider oral TB in the differential diagnosis for jaw lesions with multiple enlarged cervical lymph nodes.
    Journal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons 04/2014; 72(4):749.e1-6. · 1.58 Impact Factor
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    ABSTRACT: To investigate the expression of gene DEK in oral squamous cell carcinoma, and explore the role of DEK in the development and metastasis of oral squamous cell carcinoma. Thirty-three specimens of oral squamous cell carcinoma (OSCC), 28 specimens of cervical lymph nodes metastasis, and 33 specimens of normal oral mucosal tissues adjacent to the cancerous lesions were examined. Polymerase chain reaction with reverse transcription (RT-PCR) and immunohistochemistry were used to detect mRNA and protein expression of DEK, respectively.The results were analysed with SPSS17.0 software package. RT-PCR and immunohistochemistry showed that the expression of DEK mRNA and DEK protein in metastatic lymph nodes (82.1%, 82.1%) and cancerous tissues (81.2%, 76.8%) of OSCC were significantly higher than in the adjacent tissues (27.3%, 18.2%). The difference between cancerous tissues and adjacent tissues was significant (P<0.05). DEK may play an important role in the occurrence and metastasis of OSCC.
    Shanghai kou qiang yi xue = Shanghai journal of stomatology 02/2014; 23(1):75-79.
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    ABSTRACT: Purpose Our goal was to evaluate whether elderly patients can benefit from free flaps. Methods Clinical information of the included patients was reviewed, and these patients were asked to complete the University of Washington Quality of Life (UW-QoL) version 4 questionnaire. Comparisons regarding different scales between the two groups were performed. Results The difference in mouth-opening width before and after surgery did not differ significantly (P=0.621) in patients with or without free flap reconstruction; however, free flap placement tended to preserve the original mouth-opening width. There were no significant differences in recurrence-free survival or disease-specific survival rates between the two groups. The mean QoL score of the two groups was 77.5 (SD: 10.4) and 72.1 (SD: 10.8). There were significant differences in chewing domain scores between the two groups (P=0.039). Patients with free flap reconstruction tended to score better in the appearance and taste domains (P=0.073 and P=0.053), but required longer surgery times, longer postoperative hospital stays and higher hospital costs. Conclusion Free flap reconstruction could not benefit elderly patients in mouth-opening width or survival analyses, the only QoL domain that was significantly improved in patients undergoing free flap reconstruction was chewing. Free tissue transfer should be cautiously suggested for elderly patients with advanced oral cancer.
    Journal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons 01/2014; · 1.58 Impact Factor
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    ABSTRACT: To determine the effect of radial forearm free (RFF) flap harvest on patient-reported postoperative upper extremity disability. Patients undergoing RFF flap reconstruction following resection of head and neck cancer were recruited and matched with similar patients undergoing non-RFF reconstruction. All subjects completed the Disability of the Arm, Shoulder, and Hand (DASH) questionnaire preoperatively and at least 1 year postoperatively. Postoperative DASH scores were significantly higher (more severe disability) in patients undergoing RFF flap reconstruction (6.93 ± 5.54; n = 52) compared with those undergoing non-RFF flap surgeries (2.95 ± 4.42; n = 52). Preoperative DASH score, flap size, patient age and tumour stage were significantly correlated with postoperative DASH score. Excluding the effect of neck dissection, RFF flap reconstruction has a significant deleterious effect on upper extremity function.
    The Journal of international medical research 12/2013; · 0.96 Impact Factor
  • Zhong-Zheng Qi, Jie Liu, Fa-Yu Liu, Chang-Fu Sun
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    ABSTRACT: To study the effect of pituitary tumour transforming gene (PTTG) on invasion and metastasis of salivary adenoid cystic carcinoma. The expression of PTTG and bFGF was investigated in 40 salivary adenoid cystic carcinoma tissues and 20 normal salivary tissues by immunohistochemistry. Pearson's Chi-square test and Spearman correlation analysis were used to analyze the data using SPSS 11.5 software package. The expression of PTTG and bFGF were significantly higher in salivary adenoid cystic carcinoma tissues than in normal salivary gland tissues (P<0.01) and their expression levels were positively correlated (P<0.01). PTTG and bFGF are highly expressed in salivary adenoid cystic carcinoma. The invasion and metastasis of salivary adenoid cystic carcinoma are correlated with the expression of PTTG. Supported by National Natural Science Foundation of China (81102058).
    Shanghai kou qiang yi xue = Shanghai journal of stomatology 12/2013; 22(6):667-70.
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    ABSTRACT: A clinical study was undertaken to define the vascular anatomy of anteromedial thigh perforator flap (AMT) and evaluate the outcomes of the flap in head and neck reconstruction. The sizable perforators of AMT flaps and their origins were prospectively explored in 54 patients. For each patient, we recorded the sizable perforators' location, diameter, source vessel, numbers and anatomical types. Among them, 14 cases underwent head and neck reconstruction with AMT flaps. The complications and functions of donor and recipient sites were recorded and the operative techniques of AMT were described. Statistical analysis was performed with SPSS 13.0 software package. Eight of fifty-four thighs had no sizable AMT perforators. AMT flap was based on the medial branch of descending branch of lateral circumflex femoral artery (d-LCFA) and shared the same vascular pedicle with anterolateral thigh flap (ALT). The total sizable perforators were 56. Among them, 40.9%(25/61) were direct septocutaneous perforators, the remaining perforators were all musculocutaneous. Most of the sizable perforators (58/61, 95.1%) were located in the middle one-third of the thigh, with an average of (3.9±0.72) cm medial to a line connecting the anterior superior iliac spine and the superolateral patella and an average of (22.5±2.38) cm to anterior superior iliac spine. There was an negtive relationship between the number of sizable perforators of AMT and ALT flaps (P<0.01). 14 flaps survived completely. No complications were observed in recipient and donor site. The pedicle of AMT flap is the medial branch of d-LCFA. The AMT flap may be useful if ALT flap is without sizable perforators. AMT flap may be as a primary or an alternative choice of anterolateral thigh flap for head and neck reconstruction.
    Shanghai kou qiang yi xue = Shanghai journal of stomatology 12/2013; 22(6):690-4.
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    ABSTRACT: This study investigated the quality of life in patients younger than 40 years with tongue squamous cell carcinoma. We used the University of Washington Head and Neck Quality of Life scale to compare the quality of life outcomes between young and old patients. Cases were patients younger than 40 years who were treated for anterior tongue squamous cell carcinoma. Controls were patients older than 40 years who were matched to the cases regarding diagnosis, sex, and TNM classification. Two controls were matched for each case; thus, 21 cases and 42 controls were selected. Twenty-one of 33 questionnaires (63.6%) were returned. The median follow-up duration was 3.7 years (range, 1-12 y). In the group of young patients, the best-scoring domains were pain, chewing, and swallowing, whereas the lowest scores were for appearance, mood, and anxiety. Young patients (40 years or younger) reported better function, notably regarding activity, recreation, shoulder, taste, and saliva compared with the old patients with anterior tongue squamous cell carcinoma. The patients younger than 40 years tend to have a good quality of life. Most of them were not significantly affected by pain. Quality of life should be used as part of our treatment of anterior tongue squamous cell carcinoma.
    The Journal of craniofacial surgery 11/2013; 24(6):e558-61. · 0.81 Impact Factor
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    ABSTRACT: The aim of the present study was to evaluate the quality of life (QoL) of patients with oral cancer who had undergone resection of the tongue and floor of the mouth and reconstruction with the pectoralis major flap. The present study assessed 21 patients who had undergone pectoralis major flap reconstruction using the University of Washington QoL, version 4, questionnaire. A nonparametric Mann-Whitney U test was used to analyze the data. Of the 12 disease-specific domains, the best 3 scores from the patients were for pain, saliva, and anxiety, and the worst 3 scores were for taste, chewing, and swallowing. The mean UW-QoL composite score was 73.4. Swallowing was considered to be the most important issue within the previous 7 days, followed by chewing and speech. Those patients who had undergone wider excision had poorer speech. A significant effect was found on the QoL of patients with oral cancer who had undergone resection of the tongue and floor of the mouth with pectoralis major flap reconstruction.
    Journal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons 11/2013; 71(11):2004.e1-5. · 1.58 Impact Factor
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    ABSTRACT: This study investigated the quality of life (QoL) of patients with head and neck cancer undergoing immediate reconstruction of the mandible with free fibula flap. From March 2006 to January 2011, the QoL of 42 patients was assessed using the Medical Outcomes Study Short Form 36 and the University of Washington QoL (version 4) questionnaires. The assessments were performed at least 24 months after surgery. A total of 31 of the 42 questionnaires (73.8%) were returned. The length of harvested fibula varied from 17.5 to 26.1 cm. In the Short Form 36, the lowest-scoring domain was vitality, whereas the highest scores occurred in physical role. According to the University of Washington QoL, the key domains affected by surgery are chewing, speech, and appearance. The domain of pain has the best score. There was a significant effect on the QoL of patients with head and neck cancer with resections of the mandible who had undergone free fibula flap reconstruction. Data from this study may provide useful information for physicians and patients, which may be of value during discussion of treatment modalities for head and neck cancers.
    The Journal of craniofacial surgery 11/2013; 24(6):2010-3. · 0.81 Impact Factor
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    ABSTRACT: Our purpose was to evaluate the feasibility of radial forearm free (RFF) flap, platysma myocutaneous (PM) flap, and anterolateral thigh (ALT) flap in buccal reconstruction. This study consisted of 56 patients who were categorized into 3 groups. The Student t test was used to analyze the variables. Patients in group platysma flap were significantly older, the dissection of platysma flap was easier, and the defect was significantly smaller than those in group radial forearm flap and group ALT flap. The reduction in the widths of mouth opening between group PM, group RFF, and group ALT were compared. However, the reduction of mouth-opening widths in group RFF and group ALT was significantly less than that in group PM. Platysma myocutaneous flap may be more suitable in patients with small to middle-size defect and poor status, although the flap cannot achieve a reliable result; anterolateral thigh flap and radial forearm flap can preserve the interincisal distance well even for large buccal defect, but it takes more time and skills in the operation.
    The Journal of craniofacial surgery 09/2013; 24(5):e450-1. · 0.81 Impact Factor
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    ABSTRACT: Reconstruction of defects of the lip caused by cancer with its requirements of a complicated anatomical structure, important physiological function, and acceptable cosmetic result, is a challenge for oral and maxillofacial and plastic surgeons. A method that combines rotation and advancement flaps was described by Yu in 1989 for the reconstruction of defects of the lower lip. In our department between January 1992 and December 2012, 8 patients had reverse Yu flaps for the reconstruction of upper lip defects and 56 patients had classic Yu flaps for lower lip defects. Patients with defects located laterally to the upper lips, ranging from ⅓ to ½, had unilateral reverse Yu flaps, and bilateral procedures were done for defects of less than ⅔ of the lips. However, if the defects were located in the centre of the upper lips, between ⅓ and ½, they were treated with bilateral reverse Yu flaps. Patients with defects between⅓ and ⅔ of lower lips had unilateral Yu flaps, and if the defects were wider than ⅔ of the lower lips, the procedure was bilateral. No flap failed and desirable functional and aesthetic outcomes were recorded in all cases. Here we report our experience with the Yu flap for the benefit of other surgeons.
    British Journal of Oral and Maxillofacial Surgery 08/2013; · 2.72 Impact Factor
  • Zhonghua kou qiang yi xue za zhi = Zhonghua kouqiang yixue zazhi = Chinese journal of stomatology 08/2013; 48(8):502-4.
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    ABSTRACT: Platysma myocutaneous flap (PMF) is a generally used technique for defect reconstruction after an oral cancer resection. The aim of the study is to present our experience using vertical PMF that sacrificed the facial artery and vein for intraoral reconstruction. A retrospective review of the medical records of 54 patients who underwent vertical PMF that sacrificed the facial artery and vein for intraoral reconstruction was performed. A comparison between PMF that sacrificed and that preserved the facial vessels was made, and we also compared PMF that sacrificed the facial vessels with radial forearm free flap (RFFF). Statistics concerning the patients' clinical factors were gathered. The mean age of the 54 patients who underwent PMF that sacrificed the facial artery and vein was 62.0 +/- 10.98 years. The co-morbid disease rate of PMF was 53.7%. The flap size ranged from 12 x 5.5 cm to 7 x 5 cm. Survival of the flap was found in all of the cases, with partial necrosis in four cases (7.4%) and total loss in none of the cases. The operation time was 5.7 +/- 1.17 h. The complication and success rates were 27.8% and 92.6%, respectively. The 3-year and 5-year survival rates were 77.8% (21/27) and 69.23% (9/13), respectively. The majority of the patients (87.0%) in our series were satisfied with the results of the surgery. There was no significant difference between PMF that sacrificed or that preserved the facial vessels, both in success rate (P = 1) or complication rate (P = 0.72). The patients in the PMF group were older than the patients in the RFFF group (P = 0.011), the operation time was shorter (P < 0.001), and the co-morbid disease rate was higher (P = 0.002). Although the complication rate of PMF (15/54, 27.8%) was higher than that of RFFF (2/34, 5.9%) (P = 0.011), their success rates were similar (92.6%, 94.1%) (P = 1.00). Vertical PMF that sacrifices the facial artery and vein has specific advantages including in ease preparation and limitations. This technique may provide an effective method for intraoral reconstruction. Our experience in handling the flap may contribute to the success rate.
    World Journal of Surgical Oncology 07/2013; 11(1):165. · 1.09 Impact Factor
  • Qi-Gen Fang, Fa-Yu Liu, Chang-Fu Sun
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    ABSTRACT: We reported 1 case of primary Sjögren syndrome in a child. The patient complained recurrent submandibular inflammation for more than 2 years without apparent sicca presentations, and Schirmer test resulted negative. However, ultrasound showed hypoechoic areas in the gland, laboratory tests reported the positivity of Sjögren's syndrome A antigen and Sjögren's syndrome B antigen, and biopsy presented periductal lymphocytic infiltration. Therefore, a diagnosis of primary Sjögren syndrome was conducted. Treatment of it required a multidisciplinary team.
    The Journal of craniofacial surgery 07/2013; 24(4):e413-e415. · 0.81 Impact Factor
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    ABSTRACT: OBJECTIVE: The purpose of this study was to evaluate our 25-year experience of pediatric salivary tumors. METHODS: Patients less than 19 years old with a diagnosis of salivary tumor were identified at Oral-maxillofacial Head and Neck Tumor Center, China Medical University from 1987 to 2011. RESULTS: 122 patients were included in our study, 105 tumors were benign and 17 were malignant. The most common involved site was parotid gland, pleomorphic adenoma represented 91.4% in benign group, and mucoepidermoid carcinoma represented 47.1% in malignant group. All tumors in submandibular gland were benign. Warthin's tumor was diagnosed in one patient. In our follow-up, no regional recurrences occurred in patients without neck dissection. The 5- and 10-year overall survival rates of patients with malignant salivary tumors were 81.8% and 66.7% respectively. CONCLUSIONS: Epithelial salivary tumor was rare, parotid gland was most common involved site, pleomorphic adenoma and mucoepidermoid carcinoma were the most common benign and malignant tumor respectively. The prognosis of patients with malignant salivary tumors was not very favorable.
    International journal of pediatric otorhinolaryngology 06/2013; · 0.85 Impact Factor
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    ABSTRACT: Squamous cell carcinoma (SCC) of the buccal mucosa is a common malignancy in Southeast Asia. The purpose of this study was to present our clinical experience with buccal SCC over a period of 7 years and to analyze the factors associated with surgical outcome. We conducted a retrospective review on 67 buccal SCC patients (between September, 2005 and May, 2011) with tumors restricted to or originating from the buccal mucosa. In a univariate model, nodal stage, degree of tumor differentiation and composite resection were associated with recurrence, while in a multivariate model, the degree of differentiation was the only factor affecting locoregional control. In a survival analysis, recurrence, nodal stage and degree of differentiation were considered as significant factors. Buccal SCC is an aggressive malignant tumor and the degree of differentiation is the most significant factor affecting prognosis and survival. An adequate systemic treatment is required in the case of poorly differentiated tumors. Neck dissection (ND) exerts a positive effect on the locoregional control of buccal SCC staged as cT1-2N0. In the case of identification of positive lymph nodes during surgery, postoperative radiation is recommended in order to improve locoregional control.
    Molecular and clinical oncology. 05/2013; 1(3):531-534.
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    ABSTRACT: To evaluate the quality of life in patients who had resection of oral cancer and reconstruction by radial forearm free flaps. Quality of life of 49 patients was assessed by means of the 14-item oral health impact profile (OHIP-14) and the medical outcomes study-short form-36 (SF-36) questionnaires 12 months after operation. Forty-one questionnaires were collected (84%). SF-36: the highest-scoring domain were physical role (92.9 ± 2.6) and bodily pain (82.6 ± 5.7), the lowest-scoring domain were vitality (61.5 ± 9.1), followed by role emotion (64.9 ± 6.8) and social functioning (65.2 ± 8.2). OHIP-14: the best-scoring domain were handicap (37.1 ± 15.1) and psychological disability (45.7 ± 11.9), the best-scoring domain were physical pain (64.2 ± 11.7) and functional limitation (61.9 ± 12.9). Radial forearm free flaps for reconstruction of oral defects after cancer resection could significantly influence the patients' quality of life.
    Zhonghua kou qiang yi xue za zhi = Zhonghua kouqiang yixue zazhi = Chinese journal of stomatology 03/2013; 48(3):161-4.
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    ABSTRACT: BACKGROUND: The ideal method for buccal defects should provide good outcome of both function and appearance; our goal is to highlight the reliability of radial forearm flap in buccal reconstruction. METHODS: A retrospective study was conducted. From 2005 to 2012, 20 radial forearm flaps were used to repair the defects. We analyzed the superiority and reliability of the flap; in addition, we reviewed some related literature and made a comparison between radial forearm flap and platysma flap. RESULTS: All radial forearm flaps totally survived, but two flaps suffered venous obstruction, hematoma, respectively. Radial forearm flap preserved the original interincisal distance well. In our follow-up, all patients had sufficient mouth-opening width (mean: 4.3 cm). CONCLUSION: Radial forearm flap is a reliable method for buccal defect reconstruction.
    World Journal of Surgical Oncology 01/2013; 11(1):26. · 1.09 Impact Factor

Publication Stats

33 Citations
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38.57 Total Impact Points

Institutions

  • 2007–2013
    • China Medical University (PRC)
      • Department of Oral Maxillofacial and Plastic Surgery
      Shenyang, Liaoning, China
  • 2009
    • Center For Oral & Maxillofacial Surgery
      Georgia, United States
  • 2006
    • Dalian Municipal Central Hospital
      达连, Liaoning, China