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ABSTRACT: To investigate the value of computer aided navigation system (CANS) in the treatment of post traumatic maxillofacial deformation.
Fifty-four patients (M = 37, F = 17) were included in the study, including 31 cases of zygomatic fracture, 7 cases of pure orbital fracture, 11 cases of temporal mandibular joint ankylosis, 1 case of foreign body and 4 cases of defect reconstruction with custom implant. Data acquisition was done through CT scan, and DICOM data was transferred into workstation. Computer assisted design, including osteotomy, reposition, fibula flap design, orbital implant construction was performed using Surgicase CMF and Brain Lab Iplan system. The virtual design was transferred to Brain Lab navigation system, and the osteotomy, reduction, location of bone graft and custom implant were guided by navigation. Postoperative CT scan was required 48 - 72 hours after surgery. Preoperative and postoperative CT images were superimposed automatically in BrainLab Iplan system, and compared both in 3D objects and 2D slices.
All the cases achieved good results without serious complication. The error of important corresponding points in zygomatic fracture reduction, orbital reconstruction and defect reconstruction was 0.2 - 3.5 mm, 0.8 - 2.0 mm and 0.2 - 2.2 mm respectively.
Computer assisted design is of considerable value for the systematic and accurate planning for complicated post traumatic deformation. Virtual plan could be carried out accurately with the assistance of CANS.
Zhonghua kou qiang yi xue za zhi = Zhonghua kouqiang yixue zazhi = Chinese journal of stomatology 11/2012; 47(11):645-50.
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ABSTRACT: To evaluate the efficiency of navigation system for orbital wall reconstruction in unilateral orbital fractures.
Fifteen patients (7 male and 8 female) with unilateral orbital fracture underwent orbital reconstruction with the help of intraoperative navigation system. The average age was 34.3 ± 9.5 years. All patients underwent spiral CT scanning preoperatively, and the CT data was imported to the BrainLab navigation system (Germany, BrainLab company). The orbit of the intact side was mirrored to the opposite side as the reference for pre-operative planning. The titanium mesh was mounted on the resin template made by rapid prototyping machine based on the mirrored CT data. When the injury was limited, the hydroxyapatite sheet was used for the orbital wall reconstruction. During the operation, the real-time navigation helped to ensure precise placement. The re-establishing result was assessed based on the postoperative CT data with the following four variables: the volumetric difference between the bilateral orbit, the volume of the herniated soft tissue, the global projection and the discrepancy between the simulated and the achieved position of the reconstructed orbital wall. The reconstructive discrepancy was measured only in the titanium plate grafting cases.
There were no serious complications such as infection, graft rejection and optic nerve injury in any case. Preoperatively, the average degree of enophthalmos was (3.5 ± 1.6) mm, the average volumetric difference between the injured and the unaffected orbit was (4.5 ± 1.8) ml, and the average volume of the herniated orbital soft tissue was (2.1 ± 0.7) ml. Postoperatively, the three values were respectively reduced to (1.3 ± 0.6) mm, (1.8 ± 0.9) ml and (0.7 ± 0.3) ml. The discrepancy of the medial and inferior wall were (2.5 ± 0.6) mm and (2.1 ± 0.4) mm.
The intraoperative use of navigation system for the orbital wall reconstruction in unilateral orbital fractures can provide reliable accuracy and achieve satisfactory results.
Zhonghua kou qiang yi xue za zhi = Zhonghua kouqiang yixue zazhi = Chinese journal of stomatology 11/2012; 47(11):657-61.
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ABSTRACT: We sought to investigate the correlation between type of orbital fracture and occurrence of traumatic enophthalmos. The 119 patients with orbital fractures were divided into the enophthalmos group (71 cases) and the nonenophthalmos group (48 cases). The 2 groups were compared by location and type of orbital fracture based on observation of computed tomography scans. We found the incidence of medial wall fractures significantly higher in the enophthalmos group (76.06%) than in the nonenophthalmos group (22.92%, χ(2) = 32.63, P < 0.05). The incidence of combined medial-inferior wall fractures was also significantly higher in the enophthalmos group (52.93%) than in the nonenophthalmos group (12.5%, χ(2) = 23.21, P < 0.05). However, the incidence of lateral-inferior wall fractures was significantly lower in the enophthalmos group (36.62%) than in the other group (58.33%, χ(2) = 4.11, P < 0.05). In most cases of lateral-inferior orbital wall fracture in the enophthalmos group, the zygomatic complex was displaced toward the lateral-posterior direction. The combined medial-inferior wall fracture is likely the primary type of multiple wall fracture leading to traumatic enophthalmos. Enophthalmos caused by a combined lateral-inferior fracture may be correlated with lateral-posterior displacement of the zygomatic complex.
The Journal of craniofacial surgery 07/2012; 23(4):1050-3. · 0.81 Impact Factor
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ABSTRACT: To compare the efficacy of computer-navigated surgery and the 3-D skull models and guide plates for the treatment of unilateral delayed zygomatic fractures.
Eleven patients with unilateral delayed zygomatic fractures were treated by computer-navigated surgery (test group) and another 12 patients were treated by 3-D skull models and guide plates as the control group. Quality of reduction was assessed by examination of postoperative axial CT scans through zygomatic arch, the malar prominence and the width of zygomatic arch were measured in both groups.
The difference between bilateral malar prominence was (0.94 ± 0.73) mm in the test group and (1.88 ± 1.82) mm in the control group, there was no significant difference between the two groups (P > 0.05). The difference between bilateral width of zygomatic arch was (0.77 ± 0.51) mm in the test group, less than (3.00 ± 1.81) mm in the control group (P < 0.05). Excessive malar prominence was observed in 6 cases (6/11) in the test group and in 7 cases (7/12) in the control group, whereas malar depression was observed in 5 cases (5/11) in the test group and in 5 cases (5/12) in the control group. Overcorrection of the width of zygomatic arch was observed in 6 cases (6/11) in the test group and in 12 cases (12/12) in the control group, whereas under correction was observed in 5 cases (5/11) in the test group and in 0 cases (0/12) in the control group.
In the treatment of unilateral delayed zygomatic fractures, symmetry of malar prominence can be achieved by application of computer-navigated surgery or the 3-D skull models and guide plates. Symmetry of the width of zygomatic arch achieved with the computer-navigated surgery is better than that achieved with 3-D skull models and guide plates.
Zhonghua kou qiang yi xue za zhi = Zhonghua kouqiang yixue zazhi = Chinese journal of stomatology 07/2012; 47(7):414-8.
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ABSTRACT: To investigate the clinical feature, treatment, and prognosis of hospitalized patients with jaw osteoradionecrosis.
A total of 93 cases with jaw osteoradionecrosis treated between 2000 and 2010 was reviewed. Of the 93 cases, 79 cases were with mandible lesions, 13 cases with maxillary lesions, and 1 case with both mandible and maxillary lesions. Sixty-six cases received one course of radiotherapy, with the radiation doses of 34 - 90 Gy (mean 64.6 Gy). Twenty-two cases experienced tooth extraction or other operative procedures before exhibition of the clinical symptoms for osteoradionecrosis. The interval time between radiotherapy and the onset of osteoradionecrosis varied from 2 weeks to 32 years (mean 54 months).
Of 93 cases, 56 patients underwent radical resection of the pathologic bone and reconstruction with free tissue flaps, in whom 7 cases received the second surgery due to microvascular thrombosis in flap vessels, and flaps were survival by new vascular anastomosis in 3 cases, the failed flaps were removed and replaced successfully by non vascularized bone grafts in 2 cases, and the failed flaps removed and the defects were repaired with adjacent skin in other 2 cases. In the 56 cases, only one case was with disease recurrence and 53 cases with significant improvement in chewing and swallowing functions. Only 2 of 93 cases underwent resection of the pathologic bone and reconstruction with titanium plates, and thereafter they encountered titanium exposure. Scaling of osteoradionecrosis lesions was applied to 20 of 93 patients and 9 cases of them were with disease recurrence. Fifteen cases had resection of the effected mandible without reconstruction. Disease relapse was encountered in 2 of them, others had poor chewing and swallowing.
The mandible is more susceptible to osteoradionecrosis than maxilla. Radical resection with reconstruction by free tissue flap is recommended for the treatment of jaw osteoradionecrosis, and scaling and reconstruction only with titanium plate should be avoided because of high risks of titanium exposure and disease relapse.
Zhonghua er bi yan hou tou jing wai ke za zhi = Chinese journal of otorhinolaryngology head and neck surgery 06/2012; 47(6):458-61.
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ABSTRACT: To experimentally develop an animal model of traumatic temporomandibular joint ankylosis secondary to condylar fracture in small Tail Han sheep.
Four sheep were used to make sagittal fracture of condyles. The cartilage layer of articular surface was damaged and lateral half of articular disc was removed in the right side and conserved in the left side as a control. All animals were sacrificed at the end of 6 months postoperatively. CT observation and histological examination were carried out to evaluate the formation of ankylosed joints.
All of the animals showed a change of mixed ankylosis on the right sides. On the CT image, the joint space became narrow and the articular surfaces became irregular with high-density callus formation. Histological observation validated that the bone-like and the cartilage-like matrix scattered between the condyle and temporal fossa. The ankylosis bone bridge could be figured out in some slices.
This study has successfully simulated the formation of temporomandibular joint ankylosis resulting from condylar fractures. The established ankylosis model is allowed to duplicate at a high successful rate.
Beijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences 12/2011; 43(6):903-7.
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ABSTRACT: To assess the vascularization of the laterally based pericranial flap and the feasibility of bony channel on the orbital lateral wall for transplantation of the flap, and apply this flap to treat traumatic enophthalmos.
Two formalin preserved cadaver specimens were anatomized to observe the feasibility of pericranial flap transplantation through the bony channels on lateral orbital walls. Two fresh cadaver specimens were perfused with latex and ink respectively to observe the possible blood supply to laterally based pericranial flaps. Two patients with unilateral old orbital fracture were treated using this flap. The enophthalmos degrees were measured before and after operation to evaluate the effect of this therapy.
It was feasible to transplant the pericranial flap into orbit through the bony channel on lateral orbital wall, reaching the medial wall and orbital floor. Vascular perfusion did not reveal that the laterally based pericranial flap over the supra temporal line was vascularized by any axial vessel. The ink perfusion of one side showed that the middle temporal artery extended deeply under the deep temporal fascia, but didn't cross the supra temporal line. The subgaleal vascular plexus was observed obviously in the superficial layer of pericranial flap. The enophthalmos degrees of the two patients were respectively 5.35 mm and 6.86 mm prior to operation. They both showed desirable outcomes postoperation (<2 mm).
It is feasible to transfer the laterally based pericranial flap into orbit through the lateral orbital wall channel. The laterally based pericranial flap is possibly vascularized by the subgaleal vascular plexus. The primary treatment of traumatic enophthalmos using the laterally based pericranial flap is satisfactory.
Beijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences 10/2011; 43(5):761-5.
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ABSTRACT: To compare the clinical application of lateral arm flap and radial forearm flap in reconstruction after oral cancer ablation.
The clinical data of 21 cases with lateral arm flap and 104 cases with radial forearm flap between 2007 and 2009 were reviewed. The flap harvest time, flap survival rate, donor site morbidity and postoperative oral function were compared and analyzed.
The average flap harvest time of lateral arm flap and radial forearm flap were (46.4±7.6) min and (41.5±7.5) min (x±s) respectively. The flap survival rates of the two flaps were 90.5% (19/21) and 95.2% (99/104) respectively. There was no significant difference between the two flaps in the average flap harvest time and survival rate (P>0.05). The donor site of lateral arm flap could be primarily closed and radial nerve injury occurred in 2 patients. Skin graft was necessary for the donor site closure of radial forearm flap and conspicuous unattractive scar could be seen. All patients could have oral diet and no difficulty in speech intelligibility.
The lateral arm flap is relatively safe and reliable alterative to the radial forearm flap for the defects reconstruction after oral cancer ablation.
Zhonghua er bi yan hou tou jing wai ke za zhi = Chinese journal of otorhinolaryngology head and neck surgery 10/2011; 46(10):836-8.
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Zhonghua kou qiang yi xue za zhi = Zhonghua kouqiang yixue zazhi = Chinese journal of stomatology 08/2011; 46(8):470-2.
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ABSTRACT: To discuss the application of 3-D skull models and guide plates in treatment of unilateral orbitozygomatic deformity after fracture.
Each patient underwent CT scan and DICOM data was obtained preoperatively. Two 3-D resin skull models were produced by rapid prototyping technique. The first model was produced based on the patient's original data and the second was the reshaped model by mirroring the unaffected facial side to the traumatic side. The original model was used for measurement of the fracture displacement in three directions and model surgery. On the second model, one 2.0 mm miniplate (Synthes Inc) was bended along the orbital rim as the repositioning guide plate. During the operation, osteotomy and reduction of zygomatic and the periorbital fractures was guided by prepared repositioning guide plate, following by orbital wall reconstruction and bone grafting.
From March 2007 to February 2009, 7 cases (6 males and 1 female) were treated successfully with no infection or graft extrusion. One week after operation, the patient received CT examination again. The shape and location of zygomatic bone and arch was good. Three cases were followed up for 3 months. Among them, facial symmetry was achieved in 2 cases. Cicatricial contracture and temporal soft tissue atrophy occurred in one case.
Reliable therapeutic effect can be achieved by application of rapid prototyping technique and repositioning guide plate in the treatment of complicated posttraumatic orbitozygomatic deformity.
Zhonghua zheng xing wai ke za zhi = Zhonghua zhengxing waike zazhi = Chinese journal of plastic surgery 03/2011; 27(2):81-5.
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Xin Peng,
Chi Mao,
Guang yan Yu,
Chuan bin Guo,
Min xian Huang, Yi Zhang,
Lian Ma,
Xu liang Deng,
Ye Lin,
Da quan Ma,
Zhao qiang Meng,
Lei Zhang
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ABSTRACT: Maxillary defects resulting from tumor resection or trauma can cause severe functional and cosmetic deformities. Maxillary reconstruction has long been a challenge for oral maxillofacial surgeons. Functional maxillary reconstruction with vascularized composite bone flap and osseointegrated implants is one of the most important improvements in head and neck reconstructive surgery. Since 1999, our research group has performed a comprehensive research on functional maxillary reconstruction with free composite fibula flap. Clinical data of the patients with maxillary reconstruction using free fibula flap were analyzed to describe the indications and principles of perioperative period of this technique. The modified free fibula flexor-hallucis longus myofascial flap was introduced, which could overcome the disadvantages of traditional free composite fibula flap. The donor site morbidity, post-operative speech outcome, mastication function, and quality of life were evaluated objectively. The biomechanical effects of stress distribution on maxilla reconstructed by free fibula composite flap were analyzed by three-dimensional finite element analysis. These studies demonstrated maxillary defects can be reconstructed successfully using free fibula flaps. This procedure also allows dental implant or conventional denture rehabilitation, which can improve the patient's appearance and oral function and enhance the overall quality of life. The fibula free flap transfer has a high success rate and low perioperative complication rate, making it an ideal choice for maxillary defect reconstruction.
Beijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences 02/2011; 43(1):18-21.
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ABSTRACT: Computer-aided individually shape-adapted fabricated titanium mesh for the mirroring-reconstruction of the orbit is a promising method for the correction of post-traumatic enophthalmos. The purpose of this study was to evaluate the application of this technique and assess the treatment outcomes.
Twenty-one patients with delayed treatment of unilateral impure orbital fracture and post-traumatic enophthalmos were included in this study. Computed tomography-based mirroring-reconstruction images of the orbit were obtained for each individual to fabricate anatomically adaptive titanium mesh by computer-aided design and computer-aided manufacturing techniques. After exposing the areas of orbital defect and reducing the herniated soft tissue, the titanium mesh was inserted to reconstruct the internal orbit with a mean deep extension of 29.33 mm. Measurements were performed to assess the change in the degree of enophthalmos and orbital volume before and after surgery. Paired samples t test and Pearson correlation coefficient were employed for statistical analysis.
Follow-up examinations revealed that the degree of enophthalmos decreased to less than 2 mm in 11 patients, 2 to 4 mm in 9 patients, and remained greater than 7 mm in 1 patient. Statistical analysis revealed that post-traumatic enophthalmos in this series was 4.05 +/- 2.02 mm, which was associated with an orbital volume increment of 6.61 +/- 3.63 cm(3), with a regression formula of enophthalmos = 0.446 x orbital volume increment + 2.406. Orbital reconstruction effected a orbital volume decrease of 4.24 +/- 2.41 cm(3) and enophthalmos correction of 2.01 +/- 1.46 mm, the regression formula being enophthalmos = 0.586 x orbital volume decrease + 0.508. After surgery, the degree of unresolved enophthalmos was 2.03 +/- 1.52 mm, and the retained orbital volume expansion was 2.23 +/- 2.86 cm(3), and the regression formula was enophthalmos = 0.494 x orbital volume expansion + 1.415.
Application of the individual fabricated titanium mesh for orbital reconstruction reduced the trauma-induced orbital volume increment by 65% and corrected 50% of severe late enophthalmos. Additional augmentation of orbital contents was required for further correction. The related treatment parameters were suggested.
Journal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons 09/2010; 68(9):2070-5. · 1.58 Impact Factor
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ABSTRACT: A rare case of a male patient who suffered from noma with sequelae of ankylosis in bilateral temporomandibular joints for 52 years and a neoplasm in the right commissure of the lips for 1 year, was operated on to resolve the ankylosis, remove the neoplasm and reconstruct the soft tissue defect with a forearm flap through a one-stage operation. The neoplasm pathology was verrucous carcinoma.
The Chinese journal of dental research: the official journal of the Scientific Section of the Chinese Stomatological Association (CSA) 01/2010; 13(1):67-9.
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ABSTRACT: To preliminarily evaluate the method of using titanium condylar protheses in management of traumatic temporomandibular joint ankylosis.
Between August 2006 and April 2008, titanium condylar replacement was performed in 5 male patients. Preoperative CT datum of patient was obtained and a resin model was then produced and used as a reference to select a suitable titanium condyle for reconstruction of the joint. In the operation, the bony ankylosis was removed. According to the preoperation planning, the selected prosthesis was inserted and fixed to the distal mandibular segment. The results were assessed by means of examinations and measurements postoperatively and during follow-up.
The 5 patients received alloplastic replacement of 6 condyles. Three patients were under follow-up and follow-up time ranged from 8 months to 2 years and 6 months. The mean mouth opening was 30 mm. Two patients had good occlusion and one patient developed a slight open bite.
Prosthetic condylar replacement can provide a choice for management of traumatic temporomandibular joint ankylosis.
Zhonghua kou qiang yi xue za zhi = Zhonghua kouqiang yixue zazhi = Chinese journal of stomatology 12/2009; 44(12):717-21.
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ABSTRACT: To evaluate the accuracy of measurement of the globe proptosis by CT in patients with unilateral orbital fracture.
25 patients with unilateral orbital fracture were included. CT was performed before and after operation. The globe proptosis on the unaffected side was measured before and after operation by using Hertel exophthalmometer (HE), CT images with orbital lateral rim (OLR) and the optic nerve foramen (ONF) as reference points. The accuracy was evaluated comparably by statistical analyses.
The preoperative and postoperative average globe proptosis were (13.9 +/- 3.1) mm and (12.5 +/- 2.2) mm in HE group, (16.1 +/- 2.6) mm and (15.7 +/- 2.3) mm in the OLR group, (45.3 +/- 4.8) mm and (46 +/- 3.9) mm in the ONF group, showing a significant difference between the pre-and post-operative results in HE group, but not in OLR and ONF groups.
CT measurement with the orbital lateral rim as reference point is more reliable than Hertel exophthalmometer measurement for globe proptosis.
Zhonghua zheng xing wai ke za zhi = Zhonghua zhengxing waike zazhi = Chinese journal of plastic surgery 05/2009; 25(3):169-72.
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ABSTRACT: To investigate the efficacy of radioactive seeds for the treatment of recurrence malignant parotid gland tumors.
Thirty-three patients with recurrence malignant parotid gland tumor treated by radioactive seeds were retrospectively reviewed. Three patients received implanted radioactive seeds alone. Thirty patients underwent both tumor resection and radioactive seeds implanting. The patients were followed up for 1041 months.
All three patients receiving implanted radioactive seeds alone achieved CR Twenty-four patients treated by operation and radioactive seeds implanting had no local recurrence. The overall local control rate was 88%. The facial nerves were preserved in thirteen of fifteen patients without facial nerve palsy before treatment, and the facial nerve functioned well after operation. Four patients showed slight radiotherapeutic side effect.
Radioactive seeds implanting combined with operation or implanting radioactive seeds alone for the treatment of recurrent malignant parotid gland tumors could get good local control and treatment effects.
Zhonghua kou qiang yi xue za zhi = Zhonghua kouqiang yixue zazhi = Chinese journal of stomatology 02/2009; 44(1):2-4.
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ABSTRACT: To evaluate the application, indications and outcomes of free flaps for ora-maxillofacial traumatic defects reconstruction.
Twenty consecutive cases of ora-maxillofacial the traumatic defects reconstruction with free flaps were reviewed. All clinical data including causes of injuries, the type of defects, selection of free flaps, perioperative complications and the follow-up were analyzed.
All the cases underwent free flap reconstruction for ora-maxillofacial traumatic defects: 8 cases with soft tissue defects, 12 cases with soft and hard tissue defects. Fifteen patients received two-stage operation and 5 patients underwent primary reconstruction at the time of debridement or fracture reduction. Twenty free flaps were applied for the reconstruction, 11 cases with fibula flap, 1 case with iliac crest free flap, 7 cases with radial forearm flap and 1 case with scapula flap. No flap failure occurred. The successful rate of free flaps transfer was 100%.
The free flaps transfer is reliable and can reconstruct the ora-maxillofacial traumatic soft and hard tissue defects. Fibula and radial forearm free flap are the most common used flaps. Early aggressive surgery with free flaps transfer for traumatic defects can prevent the scar contracture and tissue displace, which can shorten the treatment period and improve the final outcome.
Zhonghua kou qiang yi xue za zhi = Zhonghua kouqiang yixue zazhi = Chinese journal of stomatology 12/2008; 43(11):650-2.
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ABSTRACT: The aim of this study was to develop and assess the computer-assisted fabricated individual titanium mesh technique applied for reconstruction of fractured orbital walls to correct post-traumatic enophthalmus and diplopia.
Twenty patients (12 males and 8 females) were included in this study. All of patients suffered from unilateral impure orbital fractures. Group A included 8 patients who were reconstructed for the fractured orbit with computer-assisted fabricated titanium mesh technique. Group B had 12 patients treated with traditional methods (titanium meshes in 2, autogenous bone grafts in 7 and Medpor implantation in 3). CT data of group A was input into a image software to rebuild a 3-D orbit and then mirror the unaffected side onto the affected side to replace the demolished orbit. A resin model of the reshaped orbit was then produced and was used to develop custom-fabricated titanium mesh for repair of the fractured orbital wall. The fabricated mesh was used in operation to reconstruct the orbital wall. Treatment was assessed in comparison with traditional way by means of clinical examinations and CT measurements.
The difference between pre-operative and post-operative enophthalmos: the mean value of group A was 2.6 mm, group B was 2.0 mm;the difference between the pre-operative and post-operative enlargement volume of traumatic orbit: the mean value of group A was 4.3 mL, group B was 3.7 mL; Index of Medial orbital wall of both groups was 100% and Index of inferior wall reconstruction of group A was 84.7%, group B was 53.3%; The mean depth of implants of group A was 31.2 mm, of group B was 28.3 mm; Improvement of diplopia of group A was 1.5 quadrants, that of group B was 1 quadrant. There were no infection, gaze restriction, or graft extrusion in all patients after operation.
Computer-assisted fabricated titanium mesh technique could provide more accurate orbital reconstruction and improve the correction of enophthalmus and diplopia.
Beijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences 03/2008; 40(1):88-91.
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ABSTRACT: Thyroglossal duct carcinoma is a rare malignant tumor which is usually diagnosed postoperatively. Clinical and pathological features of 3 cases of thyroglossal duct carcinoma were investigated and the optimal treatment protocol was proposed. The clinical presentation of thyroglossal duct carcinoma is very similar to that of its benign counterpart. Two cases were diagnosed as thyroglossal duct cyst prior to the operation, the remaining one as dermoid cyst. All three cases were diagnosed as papillary carcinoma of thyroid origin after microscopic examination. The characteristic histological hallmarks including: formation of papillary structure; nuclear morphological variations such as ground glass nuclei, pseudo-inclusions, intranuclear grooves and filaments; concentrically calcified structures termed psammoma bodies which is regarded as a strong indication of papillary carcinoma;positivity in immunohistological staining for thyroglobin. Sistrunk procedure of excision is the choice for treatment. A close follow-up is needed. In the presence of thyroid gland masses or cervical lymphadenopathy, thyroidectomy or neck dissection should be recommended.
Beijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences 03/2007; 39(1):83-6.
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Zhonghua kou qiang yi xue za zhi = Zhonghua kouqiang yixue zazhi = Chinese journal of stomatology 11/2006; 41(10):584-6.
