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PubMedDate not supplied

Aesthetic outcome of sliding island flap for reconstruction of cheek after tumour ablation.

BACKGROUND: Skin cancer is the most common malignancy in humans and the incidence continues to rise. Facial reconstruction after cutaneous tumour ablation is a challenging job and needs thorough knowledge of the anatomy and physiology of face skin, biomechanics of skin and muscles, design of local flaps and their blood supply. The objective of this study was to report the aesthetic results of sliding island flap on the cheek. METHODS: This study was carried in the department of Plastic and Reconstructive Surgery Postgraduate Medical Institute Hayatabad Medical Complex Peshawar from March 2001 to February 2004. Forty patients with age 50-70 years having Basal Cell Carcinoma on infraorbital and malar area of the cheek were taken for the study. Tumors were excised with safe margins and defects restored with sliding island flap. This flap is based on subcutaneous vertical pedicle that vascularizes the skin island through sub dermal plexus. Patients were regularly followed up with preoperative and postoperative photography. Final aesthetic results were analyzed after six months. RESULTS: Good symmetry of cheek was achieved. There was no noticeable scarring. Flap necrosis was not seen in any patient. Only one patient had mild ectropion of the lower eyelid (2.5%) that did not need any revisional surgery. CONCLUSIONS: Relatively bigger defects of the cheek can be easily covered with this flap with preservation of cosmesis and without any distortion in the symmetry of the face.

Aged↗
PubMed1985

The hamster cheek pouch--an experimental model to study postischemic macromolecular permeability.

In order to study permeability changes after local ischemia the cheek pouch of the hamster was everted for intravital microscopy. Macromolecular permeability was quantified as leakage of fluoroscein labelled dextran (Mw 70,000). Temporary ischemia with total circulatory arrest of the whole cheek pouch was obtained by a cuff mounted around the everted cheek pouch where it leaves the mouth of the hamster. At reperfusion after repeated ischemic periods of 5 min no leaks were seen. A prolongation of the ischemic period to 30 min resulted in a temporary increase in the number of postcapillary venular leaks. When the occlusion was repeated the response was significantly smaller. An occlusion period of 60 min gave no further increase in macromolecular permeability. Locally applied histamine was used to test the reactivity of the cheek pouch. It was concluded that the model is suited for studies of permeability increase after local ischemia.

Animals↗
PubMed1973

The hamster cheek pouch: an experimental model of corneal vascularization.

To gain insight into factors that might be responsible for the normal avascularity of the cornea and for its vascularization in certain pathologic states, an experimental model was designed in which corneal vascularization could be studied under controlled conditions in hamster cheek pouch chambers. Normal corneal tissue, as well as corneas that had been altered in a variety of ways (eg, boiled, autoclaved, freeze-thawed) were implanted into hamster cheek pouch chambers. The fate of the transplanted tissue was observed at regular intervals by direct visualization within the hamster cheek pouch at various magnifications and by light and electron microscopy. This report reviews observations on more than 300 such experiments. Normal and injured corneal autografts, allografts and xenografts and nonviable (autoclaved, boiled or freeze-thawed) corneas commonly became vascularized in the cheek pouch. When this occurred, a similar morphologic sequence of events preceded and accompanied the growth of blood vessels into the cornea. Vascular invasion was generally preceded by the formation of granulation tissue around the cornea. This was followed by a leukocytic, and frequently a fibroblastic, infiltration of the cornea. When cells did not invade the transplanted cornea, the cornea invariably remained avascular. In the present model, a swollen cornea was not a sufficient stimulus for corneal vascularization. The data suggest that under certain circumstances leukocytes may produce one or more factors which stimulate directional vascular growth. The findings are viewed in terms of current concepts on corneal vascularization.

Animals↗
PubMed1997

Lateral buccotomy for removal of a supernumerary cheek tooth in a horse.

A 3-year-old female Standardbred was admitted for evaluation of a firm swelling on the right side located rostral to the facial crest and a firm intraoral swelling located rostral to the erupted cheek teeth. Examination of skull radiographs revealed a supernumerary cheek tooth rostral to the erupted third premolar. The supernumerary tooth was removed via lateral buccotomy. The horse did not have complications after surgery and resumed racing. Lateral buccotomy should be considered for removal of rostrally located maxillary or mandibular cheek teeth. Supernumerary cheek teeth can be found in locations in the upper dental arcade, other than caudal to the last molar.

Animals↗
PubMed1996

Hexamethylene bisacetamide as a chemopreventive agent in hamster cheek pouch tumorigenesis.

The chemopreventive effect of oral and intraperitoneal (i.p.) administration of hexamethylene bisacetamide (HMBA) on 9,10-dimethyl-1,2-benzanthracene (DMBA)-induced tumour formation in hamster cheek pouches was investigated. Male Syrian hamsters were treated by painting both cheek pouches with a 0.5% solution of DMBA twice weekly for 11 weeks. In addition to DMBA application, Group 1 hamsters were given 1% HMBA continuously in the drinking water and Group 2 hamsters received i.p. injection of HMBA at a dose of 500 mg/kg three times per week during the experiment. Group 3 animals received DMBA application alone. Thirteen weeks after the start of the experiment, the numbers of cheek pouch tumours and tumour volume were significantly decreased by oral but not i.p. administration of HMBA. Low levels of HMBA were detected in the plasma of the hamsters which were given 1% HMBA in drinking water. These results indicate that oral administration of HMBA can act as a chemopreventive agent against hamster cheek pouch tumorigenesis.

9,10-Dimethyl-1,2-benzanthracene↗
PubMed1996

Autonomic and sensory innervation of cat molar gland and blood vessels in the lower lip, gingiva and cheek.

Innervation of the molar gland and blood vessels in the lower lip, gingiva and cheek mucous membrane was investigated in the cat with the aid of whole mount acetylthiocholinesterase (WATChE) histochemistry and retrograde neuronal tracing methods with horseradish peroxidase (HRP) and HRP-conjugated wheat germ agglutinin (WGA-HRP). The molar gland was found to be supplied from the buccal nerve and branches of the mylohyoid nerve on the basis of microdissection of WATChE-stained mandibular preparations under a dissecting microscope. The rostral half of the lower lip-gingiva was innervated by mental branches from the inferior alveolar nerve. The caudal half of the lower lip-gingiva and cheek mucous membrane were observed to be supplied from the buccal nerve. Following injections of HRP/WGA-HRP into the molar gland, lower lip-gingiva and cheek, many retrogradely labeled ganglion neurons were observed in the ipsilateral main and accessory otic ganglia, superior cervical ganglion and mandibular division of the trigeminal ganglion. In the pterygopalatine ganglion, a small number of positive neurons were found, but in a few cases in which the injected tracer was restricted to the lower lip-gingiva and anterior half of the molar gland, labeled neurons were not detected in the main ganglion nor in its accessory microganglia. These findings indicate that the cat molar gland receives a postganglionic parasympathetic supply from the otic ganglia, postganglionic sympathetic input from the superior cervical ganglion and sensory innervation from the trigeminal ganglion by way of the buccal nerve and mylohyoid nerve. Vessels in the rostral half of the lower lip-gingiva receive the same inputs from the inferior alveolar nerve, and vessels in the caudal half receive inputs from the buccal nerve. The vessels in the cheek mucous membrane receive dual parasympathetic supplies from the otic ganglia and the pterygopalatine ganglion by way of the buccal nerve.

Acetylcholinesterase↗
PubMed2000

Fluorescence pharmacokinetics of Lutetium Texaphyrin (PCI-0123, Lu-Tex) in the skin and in healthy and tumoral hamster cheek-pouch mucosa.

We have investigated the pharmacokinetics (PK) of Lutetium Texaphyrin (Lu-Tex), a second-generation photosensitizer, in the Syrian hamster cheek pouch early cancer model. Ten male hamsters, five with chemically induced early squamous cell cancer of the left cheek pouch, received an intracardiac injection of a 10 mg/ml Lu-Tex solution, resulting in a dose of 12 mg Lu-Tex per kg of bodyweight. The PK of the dye have been measured during the 24 h following the injection with an optical-fiber-based spectrofluorometer on the ventral skin, the healthy and the tumoral cheek-pouch mucosa. The Lu-Tex fluorescence is excited at 460 nm and detected around 740 nm. All the measurements yield very similar pharmacokinetic curves. The fluorescence intensity reaches a maximum between two and three hours after the injection and, at its maximum, it is consistently higher (up to 1.5 times) on the tumor than on the healthy mucosa. It remains smaller on the skin than on cheek-pouch mucosa. After 24 h, the Lu-Tex fluorescence is no longer detectable either on the skin, on the lesion or on the healthy mucosa. Moreover, Lu-Tex clearly displays a significant fluorescence selectivity between early carcinoma and healthy mucosa in this model. Furthermore, the inter-animal fluctuations of the fluorescence signal are small (+/-16% on the tumor-bearing mucosa). Eight-minute-long skin-irradiation tests have been performed 24 h after the injection of the Lu-Tex on the ventral skin of 16 additional animals with a solar simulator. No reaction is observed, either macroscopically or microscopically, which further demonstrates, as suggested by the fluorescence measurements, that this photosensitizer is significantly cleared from the skin after 24 h.

9,10-Dimethyl-1,2-benzanthracene↗
PubMed1999

Lower eyelid reconstruction with a cheek flap supported by fascia lata.

The use of a cheek rotation flap is a well-known method for reconstruction of a large defect of the lower eyelid. In this technique, a separate lining tissue supporting the cheek flap is required for full-thickness reconstruction. Previously, a chondromucosal graft or conchal cartilage has been used to support this flap. Recently, we have used a homologous or autologous fascia lata as support for the cheek flap instead of rigid tissues like cartilages. A fascia lata strip is fixed with tolerable tension to the medial canthal tendon and lateral orbital rim. The inner surface of the fascia and the cheek flap is lined with a buccal mucosa graft to decrease irritation of the conjunctiva and cornea. We present here seven patients in whom this procedure was used for lower eyelid reconstruction following resection of a malignant skin tumor. Based on follow-ups of 7 to 22 months, the functional and aesthetic results have been good in all cases. This procedure may be applicable for total or subtotal reconstruction of the lower eyelid.

Aged↗
PubMed2001

Reconstruction of total lower lip, labial commissure and palatomaxillary defect with composite island cheek flap.

Functional and cosmetic restoration of total lower lip, labial commissure, and palatomaxillary defects can be achieved by using multiform flaps. The possibility of reconstruction of these areas with composite island cheek flap is presented. The flap was used in three patients who were surgically treated between 1993 and 1998. In one female patient, total lower lip and chin defect was restored with a small contralateral platysma muscle cutaneous flap. The functional and cosmetic result was achieved with composite island cheek flap. In the other two cases, reconstruction was performed without another flap. Composite island cheek flap is supplied with bloody by the facial artery and vein, and contains mucous membrane, muscle and skin of the cheek. In two cases, the flap was formed by the anterior part of the buccal muscle, and in the case with the reconstruction of labial commissure, the greater and lesser zygomatic muscles with levator muscle of the angle of mouth were used. By freeing the blood vessels from the surrounding structures, isolation and transsection of minor vessel branches allowed straightening of the tortuous main vessels. With this technique, excellent functional and satisfactory cosmetic results were achieved in a single act, with minimal morbidity for labial commissure, and total lower lip or palatomaxillary defect reconstruction.

Aged↗
PubMed2001

Effect of jaw and cheek support on nutritional intake.

The purpose of this study was to determine the effect of jaw and cheek support on nutritional intake. A 32-month-old child who had experienced a brainstem stroke was spoon fed, with and without jaw and cheek support, in an ABAB single case fashion. Jaw and cheek support elicited an increased amount of solid food consumption by the participant. There was no difference, between control and intervention sessions, in the amount of solid food expelled onto the bib. Jaw and cheek support enabled a 32-month-old child with a brainstem stroke to consume more solid foods than without support.

Child, Preschool↗
PubMed1991

Comparison of the effects of four hyperplastic agents on hamster cheek pouch mucosa.

Hyperplasia in the hamster cheek pouch was examined using 4 different hyperplastic agents: oil of turpentine 50% v/v in liquid paraffin; vitamin A palmitate 10% w/v in liquid paraffin; 12-O-tetradeconyl-phorbol-13-acetate 16nM in acetone; and ethylphenylpropiolate 0.04mM in acetone. Acetone, paraffin and untreated control groups were also examined. Cheek pouches were painted 3 times a week for up to 4 weeks with each solution. Samples were removed and prepared for light microscopy 24 hours after 2 weeks of painting and 24 hours, 6, 12 and 18 weeks after 4 weeks of painting. Hyperplasia was produced by application of turpentine, vitamin A and TPA after 2 weeks of application. Further increases in epithelial width occurred after 4 weeks of painting in the turpentine and vitamin A groups but a decrease was seen in the TPA group. Six weeks (vitamin A and TPA groups) or 12 weeks (turpentine group) after the completion of treatment the epithelium had a normal histological appearance. No differences between the control or EPP treated cheek pouch mucosa could be detected. Turpentine and vitamin A can be used as models of reversible hyperplasia in the hamster cheek pouch.

Alkynes↗
PubMed1991

[Effect of natural panting frequency and cheek support on the plethysmographic determination of thoracic gas volume in patients with chronic obstructive pulmonary disease].

The authors studied the effects of natural panting frequency (NF) and the cheek support on the plethysmographic measurement of thoracic gas volume (TGV) in 8 normal subjects (non-smokers) and 46 patients with chronic obstructive pulmonary disease (COPD). The patients were divided into 2 groups according to the degree of airway obstruction (group I; specific airway conductance (SGaw) greater than 0.1 (n = 18), group II; SGaw less than 0.1 (n = 28)). TGV was measured with a pressure-type body plethysmograph (BP). NF was 2.00 +/- 0.43 Hz (mean +/- SD) in control subjects, 1.92 +/- 0.78 Hz in group I, and 1.39 +/- 0.59 Hz in group II, respectively, indicating lower NF in the patients with severe airway obstruction. In control subjects and group I, the differences between TGV at NF and at 0.5-1.0 Hz (TGVNF-TGV1.0) were -0.01 +/- 0.07L, and -0.06 +/- 0.16L, respectively, and cheek support did not alter the difference. On the other hand, in group II, the difference was slightly larger than other groups in spite of the lower NF, and this overestimation was abolished by cheek support (0.13 +/- 0.25L-----0.06 +/- 0.27L, p less than 0.05). These results suggest that, in patients with severe airway obstruction, TGVNF may be overestimated even if NF is relatively low. This overestimation may be mainly due to the extrathoracic airway compliance including the cheek.

Adult↗
PubMed1996

Pedicled temporoparietal galeal myofascial flap for orbital and cheek lining following radical maxillectomy.

Radical maxillectomy is indicated for stage III and IV antroethmoidal carcinoma. In those cases where the anterior bony wall of maxillary antrum or the anterior facial soft tissue is involved or a previous Caldwell-Luc antrostomy was performed, a generous amount of cheek soft tissue has to be resected with the surgical specimen in order to achieve tumour-free margins. In such cases survival of the cheek flap is in jeopardy. Following orbital exenteration the resultant defect requires covering to promote healing and to protect the underlying bone. Traditionally, a skin graft has been used to line the orbital defect and the cheek flap. The pedicled temporoparietal galeal myofascial flap offers well-vascularized, reliable, supple and plentiful tissue which can be used to line both the orbit and the cheek, thus covering both sites with one flap. Such a case is presented and the surgical anatomy and technique are described.

Adult↗
PubMed2000

Acid/pepsin promotion of carcinogenesis in the hamster cheek pouch.

OBJECTIVE: While clinical observation has suggested an association between gastroesophageal reflux and laryngeal carcinoma, the nature of this relationship has yet to be defined. The purpose of this study is to determine the carcinogenic potential of acid and pepsin mixtures in the hamster cheek pouch animal model. DESIGN: A blinded intervention study. SUBJECTS: One hundred male Syrian hamsters aged approximately 5 weeks. INTERVENTIONS: A control group of 20 hamsters received application of the carcinogen 9,10-dimethyl-1,2-henzanthracene (DMBA) to their cheek pouch mucosa. One experimental group (n = 20) received applications of DMBA plus hydrochloric acid, and another (n = 20) received DMBA plus an acid and pepsin solution. Latency to squamous cell tumor production, size of tumors, and numbers of tumors were compared among groups. RESULTS: Latency to tumor production and size of tumor were similar among groups, with both experimental and control groups developing tumors of comparable size after 12 weeks of chemical application. However, the number of tumors produced was significantly higher in the DMBA/acid and DMBA/acid/ pepsin groups than in the DMBA only group at 18 weeks, with 23, 27, and 10 tumors in these groups, respectively (P<.02). Likewise, a cumulative dysplasia score was different among groups at 18 weeks with the DMBA/acid and DMBA/acid/pepsin groups scoring higher degrees of dysplasia than the DMBA only group. CONCLUSION: These results suggest that application of acid and acid/pepsin mixtures may promote experimental carcinogenesis in the hamster cheek pouch.

Animals↗
PubMed1989

Anterior and posterior, but not cheek, intraoral cannulation procedures elevate serum corticosterone levels in neonatal rat pups.

Implantation of intraoral cannulas is a procedure that has been typically assumed to be relatively unstressful in neonatal rat pups. To test this assumption, endocrine responses to such implantations were compared with those of other standard procedures. In Experiment 1, corticosterone and growth hormone (GH) levels were assessed in 4-day-old rat pups placed in an incubator for 15 or 60 min following either: no treatment, subcutaneous (sc) injection of 0.9% NaCl, anterior or posterior intraoral cannulation, ice anesthesia or ether anesthesia. Corticosterone levels were elevated relative to nontreated controls 15 min after all treatments except sc injection. These levels remained elevated after 60 min in both cannulation groups and the ice anesthesia group. In Experiment 2, the ability of ether anesthesia to reduce the hormonal response to the cannulation procedures was assessed in addition to examining the hormonal response to intraoral cannulations through the cheek in 4-day-old rat pups. Ether did not attenuate the corticosterone response to either anterior or posterior cannulations. Pups subjected to the cheek cannulation procedure did not exhibit any significant alterations in serum corticosterone levels when compared with nontreated control pups. GH levels were found to differentiate less among the various procedures than corticosterone levels, with GH levels generally being low in all groups, including nontreated control animals. These data suggest that a cheek placement is less stressful than anterior and posterior placements and may provide a viable alternative in studies necessitating the implantation of cannula into the buccal cavity during the early postnatal period.

Anesthesia, General↗
PubMed1993

The hamster cheek pouch carcinogenesis model.

The Syrian golden hamster cheek pouch carcinogenesis model is probably the best-known animal system that closely compares to events involved in the development of premalignant and malignant human oral cancers. Furthermore, it is one of the most well-characterized models for squamous cell carcinomas (SCCs). However, stages of carcinogenesis (initiation, promotion, and progression) have not been well-defined in this system. Basic understanding of the mechanism(s) of carcinogenesis in this organ is instrumental for the development of new strategies for chemoprevention and early chemointervention. To understand the important early events that occur in the hamster cheek pouch carcinogenesis model, we compared it to the mouse skin model, where a number of critical events have been well characterized. We determined that approximately 60% of the hamster cheek pouch SCCs have a mutation in codon 61 of the Ha-ras gene. We also established a two-stage carcinogenesis protocol in this model using a single dose of dimethylbenz(alpha)anthracene (DMBA) and multiple doses of benzoyl peroxide for 45 weeks. Twenty-five percent of tumors developed with this protocol had the same mutation in codon 61 of the Ha-ras gene, confirming that this mutation, as in the mouse skin model, is initiation-related. We examined the sequential expression of hyperplasia, micronucleated cells, ornithine decarboxylase (ODC) activity, polyamine levels, transglutaminase I activity, epidermal growth factor receptor (EGF-R) levels, keratins, gamma-glutamyltranspeptidase (GGT), transforming growth factor-beta 1 (TGF-beta 1), leukoplakia, and carcinomas induced during carcinogenesis.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1989

Buccal drug absorption. II: In vitro diffusion across the hamster cheek pouch.

The in vitro diffusion of a series of substituted acetanilides across the hamster cheek pouch was studied. The keratinized epithelial layer of the cheek pouch appeared to provide the major barrier to diffusion of these compounds. Linear relationships were found for plots of log epithelial permeability (Pe) versus the log of the octanol-buffer partition coefficient (PCoct; r = 0.712), and log Pe versus the log of the isooctane-buffer partition coefficient (PCiso; r = 0.869). Comparison of the in vitro data with in vivo data obtained in humans using the buccal absorption test showed good correlation (r = 0.878) between Pe and percent buccal absorption in 5 min. These results suggest that diffusion across the hamster cheek pouch may have some utility in the prediction of human buccal absorption.

Acetanilides↗
PubMed1982

Local skin flaps in reconstruction following excision of basal cell carcinomas of the cheek and temple.

Twenty-seven male patients had been treated surgically for basal cell carcinomas of the temple and cheek. Eighteen tumors were classically nodular, seven cystic, and two cicatricial. A safety margin of 0.5--1.0 cm in nodular and cystic tumors, and 1.0--1.5 cm in cicatricial variety has proven satisfactory. Reconstruction has been achieved by local skin flap: Limberg rhomboid flap for the temple, cheek transposition flap for the anterior portion of the check, combined pre- and postauricular transposition flaps for the middle part of the cheek and advancement flap(s) with Bürow's triangles for tumours of the preauricular region. Principles and practical points of each flap have been discussed. The proposed safety margins have been enough to clear the lesions as proved by histopathological examination. Cosmetic result has been satisfactory, and there has been no recurrence over a period of 6 months to 3 years.

Basal Cell Carcinoma↗