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At least 163 records · Page 9Linked to original sources
PubMed2004

Dedifferentiated liposarcoma of the cheek.

Liposarcomas of the head and neck region are rare; only a few cases have been reported to arise in the cheek or buccal mucosa. Dedifferentiated liposarcoma has rarely been reported in the head and neck region and, to the best of our knowledge, this is the first reported case of dedifferentiated liposarcoma of the cheek. Dedifferentiated liposarcoma is a mixed histologic subtype defined by the association of an atypical lipomatous tumor or well-differentiated liposarcoma and a nonlipogenic sarcoma. The patient was a 61-year-old man who presented with a soft-tissue mass of the left cheek and a presumptive diagnosis of salivary neoplasm based on a fine needle aspiration. The tumor was excised and consisted histologically of an atypical lipomatous tumor/well-differentiated liposarcoma composed a well-differentiated lipomatous neoplasm with atypical cells and rare lipoblasts. The tumor recurred in the same location 5 months after surgery. The recurrent tumor was primarily composed of a nonlipogenic spindle sarcoma with focal rhabdomyoblastic differentiation associated with areas of an atypical lipomatous tumor/well-differentiated liposarcoma.

Biomarkers, Tumor↗
PubMed2001

Oral commissure reconstruction with split masseter muscle transposition and cheek skin flap.

Satisfactory reconstruction of the cheek involving the oral commissure is always challenging. A 64-year-old male patient underwent full-thickness repair of a cheek defect involving the oral commissure following excision of squamous cell carcinoma. Reconstruction was performed with a cheek skin flap combined with split masseter muscle transposition. This method was found to be useful for reconstructing the oral commissure with good functional and aesthetic results.

Carcinoma, Squamous Cell↗
PubMed1990

Modulatory effects of snuff, retinoic acid, and beta-carotene on DMBA-induced hamster cheek pouch carcinogenesis in relation to keratin expression.

The hamster cheek pouch (HCP) serves as an excellent model system not only for the studies on initiation and promotion but also for the modulation of experimental oral carcinogenesis. In our studies, HCPs treated with 7,12-dimethylbenz[a]anthracene (DMBA) showed both cheek pouch and stomach papillomas. Utilizing this model system, we tested and compared the modulatory effects of snuff, retinoic acid, and beta-carotene on the incidence of tumors and the keratin expression pattern. HCPs treated with snuff, either alone or in combination with DMBA, resulted in stomach papillomas. HCPs treated with snuff showed no cheek pouch tumors, and those treated with snuff and DMBA showed only 10-15% tumor incidence. Both beta-carotene and retinoic acid showed a total inhibition of DMBA-induced carcinogenesis in the HCP as well as in the stomach. The keratin expression pattern showed alterations depending on the experimental conditions.

9,10-Dimethyl-1,2-benzanthracene↗
PubMed1991

Cheek flaps for reconstruction of full-thickness lip defects.

Two patients with full-thickness defect of the lip reconstructed by a cheek flap are presented. The cheek flap was split into two flaps preserving subcutaneous vascular networks, one for external skin cover and the other for coverage of the oral lining. With this flap, an adequate intraoral vestibulum and easy denture-fitting could be maintained. Disadvantages of the flap described here are that whiskered men cannot use this flap for coverage of the oral lining, and that this cheek flap cannot be used for the reconstruction of full-thickness defects of the lower lip due to potential postoperative downward tendency, unless a simultaneous sling procedure or sphincter reconstruction is performed.

Aged↗
PubMed2003

Anchored flaps in post-Mohs reconstruction of the lower eyelid, cheek, and lateral canthus: avoiding eyelid distortion.

PURPOSE: To describe a system of post-Mohs reconstruction that addresses lower eyelid susceptibility to unopposed tractional, cicatricial, and gravitational forces. Large flaps are anchored to fixed tissue to avoid transmitting flap tension to the eyelids. METHODS: This is a retrospective, cohort study drawn from approximately 40 patients with post-Mohs defects of the nonmarginal lower eyelid, cheek, and lateral canthus. Surgical intervention involved horizontally oriented, relaxed skin tension line-designed advancement flaps, usually with eyelid margin stabilization. The use of anchoring sutures and any requirement for flap-graft combinations were based on defect size and the elasticity of adjacent tissues. RESULTS: Anchoring eyelid and cheek flaps to underlying periosteum permitted broad flap dissection and advancement without distortion, as the semimobile eyelid and canthi were protected from the resulting flap tension. Anticipated defect size limits for flap reconstruction often were exceeded. Defects too broad for flap reconstruction alone could be downsized, leaving a relatively small area for graft resurfacing. CONCLUSIONS: Anchored cheek flaps extend recognition of the continuity of the lower eyelid and midface to the primary reconstruction of tumor-free defects, and they address the relation by restoring deep attachments that minimize eyelid and canthal dystopia.

Basal Cell Carcinoma↗
PubMed1993

Inhibitory effect of the Ruscus extract and of the flavonoid hesperidine methylchalcone on increased microvascular permeability induced by various agents in the hamster cheek pouch.

The Ruscus extract and the flavonoid hesperidine methylchalcone (HMC) are used in treatment of venous insufficiency. In the present study, we used the hamster cheek pouch preparation and investigated the effects of these substances on increased microvascular permeability induced by bradykinin, histamine, and leukotriene B4 (LTB4) applied topically. Experiments were performed on male hamsters; 30 min after completion of the cheek pouch preparation, fluorescein-labeled dextran [molecular weight (mol wt) 150,000] was given intravenously (i.v.). Bradykinin, histamine, and LTB4 increased the number of fluorescent vascular leakage sites from postcapillary venules, evidence for an increase in macromolecular permeability, which was quantified in ultraviolet (UV)-light microscope as the number of leaky sites in the prepared area. Ruscus extract and HMC, given i.v., significantly inhibited the macromolecular permeability-increasing effect of bradykinin, LTB4, and histamine. Ruscus extract, applied topically, dose dependently inhibited the macromolecular permeability-increasing effect of histamine. Our results show that Ruscus extract and HMC have a protective effect against leakage of FITC-dextran in the cheek pouch after administration of various permeability-increasing substances, which further supports data previously reported on patients with venous insufficiency.

Animals↗
PubMed1995

Anterior SMAS plication for the treatment of prominent nasomandibular folds and restoration of normal cheek contour.

Prominent nasomandibular folds and cheek concavities are common sequelae of the aging process. The difficulty in achieving initial and long-lasting correction has been well documented. Anterior SMAS plication as an adjunct to subcutaneous rhytidectomy has proven to be an effective, straightforward method of flattening and rejuvinating the nasomandibular folds. Ptotic cheek fat is returned to the cheek hollow, and the end result is a more youthful, symmetrical flattening of the nasomandibular folds and jowls. The anterior SMAS is plicated vertically with a row of permanent sutures placed just lateral to the nasomandibular fold. Less tension is required on the skin flaps at closure, and this permits precise control of anterior SMAS vectors without the time, expense, and potential morbidity of more extensive dissections. The additional cost is that of two sutures and an extra 10 to 15 minutes of operative time. This technique has been performed on 226 patients of both sexes, and there have been no complications, including nerve injuries, infections, or dehiscences. The longest follow-up has been 2.2 years, and there have been no asymmetries, contour irregularities, or early recurrences.

Adult↗
PubMed2002

Three-dimensional endoscopic midface enhancement: a personal quest for the ideal cheek rejuvenation.

Standard face-lift techniques are excellent for the treatment of the jawline and neck. Treatment of the area between the lower eyelid and the corner of the mouth required the development of techniques in the intermediate lamella of the face. Alternative techniques of subperiosteal dissection by means of lower eyelid incisions were described with good aesthetic results but at the expense of increased morbidity and complications. All these techniques were also two-dimensional manipulations of the soft tissues of the face. The author presents a different approach that he believes is close to the ideal in terms of safety, morbidity, and complications. Although midface rejuvenation may be performed alone, it is more commonly done as a component of total facial rejuvenation. The midface is approached by means of a combination of a temporal slit incision and an upper oral sulcus incision; no eyelid access is used. Fifty percent of the midface dissection is performed under direct visualization, and 50 percent is performed under endoscopic control. Dissection of the temporal area is done under the temporoparietal fascia down to the zygomatic arch. The anterior two-thirds of the zygomatic arch periosteum is elevated along with a few millimeters of the intermediate temporal fascia and the fascia of the masseter muscle. The subperiosteal dissection of the zygoma and maxilla is completed with the medial extension of the dissection just medial to the infraorbital nerve. The orbital fat pads are released by means of intraoral route, and the lateral and middle fat pads are advanced over the orbital rim and fixed to the masseter tendon and the periosteum of the maxillary shelf at the intraoral incision. Three suspension points are typically used on the midface, each one with a different action. All are anchored to the temporal fascia proper. The vascularized Bichat's fat pad is mobilized and fixed with 4-0 polydioxanone sutures. This provides a volumetric cheek augmentation and improvement of the jowl. The inferior malar periosteum and fascia is used for malar imbrication with 4-0 polydioxanone sutures. This provides an anterior projection of the cheek and elevates the corner of the mouth. The suborbicularis oculi fat is used for en bloc vertical suspension of the cheek. This also improves the infraorbital V deformity. This technique has been used in close to 200 patients over the last 5 years. The complications have been minimal: two cases of temporary paresis of the levator of the upper lip, one case of paresis of the orbicularis oris (unilateral), one case of buccinator muscle dysfunction, and two moderate infections that were treated with simple drainage. The degree of facial edema has been minimal compared with the open or the transblepharoplasty approach. Typically, patients can return to work 2 weeks after surgery.The three-dimensional endoscopic midface enhancement provides a technique of midface remodeling that provides the missing dimension (volume) to the rejuvenation of the midface. This can be done with a minimal rate of complications, and the aesthetic results surpass by far the results of other midface techniques previously described by the author.

Adult↗
PubMed2002

Easy tissue expansion of prelaminated mucosa-lined flaps for cheek reconstruction in a canine model.

In head and neck reconstruction, there is sometimes the need for a skin flap lined with mucosa. The object of this study was to determine whether small pieces of mucosa grafted onto the undersurface of a skin flap can be expanded in a reasonable time to provide the material required to reconstruct a full-thickness cheek defect as a free flap. The study consisted of two phases: prelamination and expansion of the flap, and vascularized free-tissue transfer of the flap. Six adult mongrel dogs were used. First, a 5 x 10-cm flap based on the saphenous vessels was elevated on the lower leg, and then four 1 x 2-cm pieces of mucosa harvested from the tongue were grafted onto the undersurface of the flap. A tissue expander (5 x 10 cm) was then placed under the flap, and the incision was closed primarily. The expanders were initially filled with just enough normal saline to obliterate dead space immediately after surgery. The expansion was continued twice weekly for 3 weeks until sufficient expansion was obtained. Two of six flaps were followed for an additional 6 weeks after the 3-week expansion period to observe whether additional mucosa could be obtained. After measurement of the mucosal area, each flap was transferred as free flap to reconstruct an iatrogenic cheek defect. The increase of mucosal surface area was compared with the original graft, and differences were analyzed using the paired t test. All flaps were successfully expanded without any complications. Histologic evaluation revealed that grafted mucosa took well without evidence of graft necrosis, and the intergraft area was covered with histiocytes. Angiography revealed well-defined vascular structures covering the entire area of the flap. The new mucosal area (23.5 +/- 2.4 cm2) was significantly larger than the original mucosal graft (8.7 +/- 0.9 cm2) (p < 0.001). The net increase of the mucosal area was 172.9 +/- 32.4 percent. The increase of mucosal area in two flaps, following a 6-week consolidation period after 3 weeks of expansion, was only slightly greater (25.9 +/- 1.3 cm2) than those without the consolidation period (22.3 +/- 1.8 cm2). This increase of the mucosal area appears to be related to the amount of expansion, and not to the length of the consolidation period. The flaps were successfully transferred as free flaps to reconstruct the full-thickness cheek defects without major complications. Although a staged operation to allow flaps to mature is needed, the present procedure has the advantages of providing a mucosa-lined flap and allowing primary closure of the donor site. The authors conclude that expansion of this flap has great potential in reconstructive surgery.

Animals↗
PubMed1980

Growth of Sinclair swine melanoma in the hamster cheek pouch.

Specimens from seven Sinclair swine melanomas were transplanted to the cheek pouches of Syrian Golden hamsters. The specimens were taken from young swine and were derived from raised tumors that either were present at birth or developed after birth from flat melanocytic lesions as well as from apparently normal skin. All seven specimens grew in the hamster cheek pouch. One lesion, derived from a 3-day-old piglet, exhibited the most aggressive growth in the hamster and was successfully transferred to other hamster cheek pouches. These results confirm the malignancy of Sinclair swine melanoma and indicate that tumors of neonatal swine contain more malignant cells than those of older animals.

Animals↗
PubMed2004

Reconstruction of concomitant lip and cheek through-and-through defects with combined free flap and an advancement flap from the remaining lip.

Massive facial defects involving the oral sphincter are challenging to the reconstructive surgeon. This study presents the authors' approach to simultaneous reconstruction of complex defects with an advancement flap from the remaining lip and free flaps. From January of 1997 to December of 2001, 22 patients were studied following ablative oral cancer surgery. Their ages ranged from 32 to 66 years. Nineteen patients had buccal cancer, two patients had tongue cancer, and one patient had lip cancer. In all cases, the disease was advanced squamous cell carcinoma. Nine patients underwent composite resection of tumor with segmental mandibulectomy, and seven patients underwent marginal mandibulectomy. Cheek defects ranged from 15 x 12 cm to 4 x 3 cm, and intraoral defects ranged from 14 x 8 cm to 5 x 4 cm in size. One third of the lower lip was excised in nine patients, both the upper and lower lips were excised in 10 patients, and only commissure defects were excised in three patients. An advancement flap from the remaining upper lip was used for reconstruction of the oral commissure and oral sphincter. Then, the composite through-and-through defect of the cheek was reconstructed with radial forearm flaps in 13 patients, fibula osteocutaneous flaps in five patients, double flaps in three patients, and an anterolateral thigh flap in one patient. The free flap survival rate was 96 percent, and only one flap failed. With regard to complications, there were two patients with cheek hematoma, six patients with orocutaneous fistula or neck infection, and one patient with osteomyelitis of the mandible. All but one patient had adequate oral competence. All patients had an adequate oral stoma and could eat a regular or soft diet; two patients could eat only a liquid diet. For moderate lip defects, immediate reconstruction of complex defects took place using an advancement flap from the remaining lip to obtain a normal and functional oral sphincter; the free flap can be used to reconstruct through-and-through defects. This simple procedure can provide patients with a useful oral stoma and acceptable cosmesis.

Adult↗
PubMed2006

Combined approach for facial contour restoration: treatment of malar and cheek areas during rhytidectomy.

BACKGROUND: One of the main objectives in facial lifting is to achieve an adequate facial contour, to enhance facial characteristics. Sometimes, facial areas are more or less accentuated, resulting in an unbalanced or inharmonious facial contour; this can be resolved in the context of a face lift. In the middle third of the face, two anatomical regions define the facial silhouette: the malar contour, with its bone support and superficial structures and, at the cheek level, intimately associated with the mastication system and the facial nerve, the buccal fat pad or Bichat fat pad. METHODS: The authors describe their experience since 1998 using the double approach to malar atrophy and buccal fat pad hypertrophy in 194 patients with facial aging signs undergoing a face lift. All patients were offered a face lift with partial resection of the fat pad through facial incisions and a stronger malar projection using an inverse superficial musculoaponeurotic system flap. RESULTS: The main complications observed regarding this surgical technique, in order of appearance, were light asymmetry, caused by a persistent hematoma or swelling; paresthesia of the buccal and zygomatic branches, which resolved spontaneously; and a light sinking of the cheek caused by excessive resection. One patient underwent correction with a fat injection. CONCLUSIONS: The superior superficial musculoaponeurotic system flap and buccal fat pad resection provided excellent aesthetic results for a more harmonic and proportioned facial contour during rhytidectomy. Particularly in patients with round faces, the authors were able to obtain permanent malar symmetry and projection in addition to diminishing the cheek fullness.

Adipose Tissue↗
PubMed1977

Comparison of arteriolar blood flow in the hamster cheek pouch at two different oxygen tensions.

Red cell velocity and diameter were measured in arterioles of the hamster cheek pouch microvasculature. The cheek pouch tissue was exposed to two different oxygen tensions, PO2 less than 30 mmHg and PO2 greater than 150 mmHg. Blood flow was calculated from velocity and diameter measurements and was found to be significantly reduced (44%) when cheek pouch was exposed to room oxygen superfusant. This reduction was the combined result of a significant decrease in both diameter (17%) and red cell velocity (17%) as compared to the measurements during the initial low oxygen period.

Animals↗
PubMed2006

Serum, cheek cell and breast milk fatty acid compositions in infants with atopic and non-atopic eczema.

BACKGROUND: The major theory implicating diet with allergic diseases is associated with altered food consumption and subsequent changes in fatty acid composition. OBJECTIVE: To investigate fatty acid compositions among infants with atopic and non-atopic eczema and healthy infants and to evaluate the expediency of non-invasive cheek cell phospholipid fatty acid composition as a marker in patients with eczema. METHODS: Diagnosis of eczema in infants was confirmed clinically and by positive (atopic eczema, n=6) or negative (non-atopic eczema, n=6) skin prick testing in comparison with controls (n=19). The fatty acid compositions of infant cheek cell and serum phospholipids and breast milk total lipids were analysed by gas chromatography. RESULTS: The distinction between atopic and non-atopic eczema was manifested in cheek cell phospholipids as linoleic acid (14.69 (13.67-15.53)% of total fatty acids; the median (interquartile range)), the sum of n-6 fatty acids (19.94 (19.06-20.53)%) and the sum of polyunsaturated fatty acids (22.70 (21.31-23.28)%) were higher in infants with atopic eczema compared with non-atopic eczema (12.69 (10.87-13.93); 17.72 (15.63-18.91) and 19.90 (17.64-21.06), respectively; P<0.05) and controls (12.50 (12.16-13.42); 18.19 (17.43-18.70) and 20.32 (19.32-21.03), respectively; P<0.05). Serum phospholipid gamma-linolenic acid was lower in both atopic and non-atopic eczema compared with controls (P<0.05) and additionally eicosapentaenoic acid was higher in atopic eczema compared with controls (P<0.05). CONCLUSION: These preliminary results suggest differences in fatty acid compositions between the two types of eczema, calling for further evaluation in a larger setting. The two types of eczema may be regulated by different immunological processes, and fatty acids may have a more profound role in the atopic type.

Case-Control Studies↗
PubMed1993

A histological morphometric study of nuclear size in benign and malignant neoplasms of the human cheek.

This report describes the application of simple morphometric methods to generate quantitative data on nuclear size from tissue sections of normal, benign and malignant oral epithelium of the cheek. Measurements of nuclear areas of basal and spinous cells from cheek mucosa were made on haematoxylin and eosin-stained sections using a Zeiss VIDAS image analyser. The lesions examined comprised benign squamous cell papillomas and islands of cells from invasive squamous cell carcinomas. Normal control epithelium was obtained from the biopsy margins of non-neoplastic lesions. The nuclear areas (AN) were obtained by direct measurement whereas the nuclear diameters (DN) were determined automatically. In both basal and spinous strata, values for both these nuclear parameters were lowest in normal tissue and increased progressively through benign papillomas, with the highest values being found invariably in carcinomas. Statistically significant differences were detected between both normal and carcinoma and between papilloma and carcinoma. The morphometric parameters AN and DN are of value in distinguishing benign from malignant lesions of the human cheek.

Carcinoma, Squamous Cell↗
PubMed2004

Micronization enhances the protective effect of purified flavonoid fraction against postischaemic microvascular injury in the hamster cheek pouch.

1. The present study was designed to evaluate the effect of micronization on the protective effect of the purified flavonoid fraction (MPFF) on increases in macromolecular permeability induced by ischaemia-reperfusion in the hamster cheek pouch microcirculation. 2. Male hamsters (Mesocricetus auratus) were treated orally, twice a day, with vehicle (lactose), MPFF and non-micronized purified flavonoid fraction (PFF) at 5, 20, 80 and 320 mg/kg per day for 10 consecutive days. On the 11th day, cheek pouches of anaesthetized animals were prepared for intravital microscopy. 3. Local ischaemia was obtained by clamping the neck of the everted pouch and the increase in microvascular permeability was quantified as leakage (leaks) of intravenously injected fluorescein isothiocyanate-labelled dextran (FITC-dextran 150; MW = 150 000). 4. Reperfusion, after 30 min ischaemia, resulted in an immediate but reversible increase in post-capillary leakage. The MPFF induced a significant dose-related reduction in the increased permeability, with 83.4% inhibition compared with control at 320 mg/kg per day (19.2 +/- 1.9 vs 115.7 +/- 4.1 leaks/cm2; P < 0.0001). Non-micronized PFF was significantly less effective: only 47.9% inhibition compared with control was observed at 320 mg/kg per day (60.3 +/- 1.0 vs 115.7 +/- 4.1 leaks/cm2; P < 0.0001) and there was no dose-effect relationship. 5. In conclusion, micronization significantly enhances the protective effects of the purified flavonoid fraction on reperfusion injury in the hamster cheek pouch. This improvement is likely to be related to the better absorption of the micronized formulation, which could explain the superior clinical efficacy shown in previous studies.

Administration, Oral↗
PubMed2004

The use of the melolabial Burow's graft in the reconstruction of combination nasal sidewall-cheek defects.

BACKGROUND: Combination defects involving both the nasal sidewall or ala and cheek can be challenging to reconstruct. METHODS: Patients with skin cancers involving the nasal sidewall or ala and medial cheek treated with Mohs micrographic surgery were reconstructed using a cheek advancement flap in combination with a melolabial Burow's graft. RESULTS: This technique provides a simple, reproducible, and cosmetically excellent method of repairing these defects. CONCLUSION: The use of this repair provides superb tissue matches and maintains natural aesthetic subunits, yielding an excellent result with minimal morbidity.

Cheek↗
PubMed2005

Staged cheek-to-nose and auricular interpolation flaps.

BACKGROUND: Staged interpolation flaps are priceless options in skin cancer reconstruction. Their value lies in their flexibility, reach, reliability, and ability to repair distant, complex facial defects. Familiar interpolation flaps to dermatologic surgeons include the paramedian forehead flap, cheek-to-nose interpolation flaps, and auricular staged flaps. OBJECTIVE: In this special reconstructive issue, the paramedian forehead flap is discussed separately. This article highlights the cheek-to-nose and auricular interpolation flaps as applied to skin cancer defects. Design considerations, anatomic basis, execution, and the distinctions of each repair are presented. MATERIALS AND METHODS: Patients with facial defects from Mohs micrographic surgery serve to illustrate the surgical techniques of each repair. RESULTS: With meticulous planning and thoughtful execution, cheek-to-nose and auricular staged flaps are capable of restoring both function and cosmesis. Several surgical stages are necessary, and an adequate supporting infrastructure is essential for an optimal outcome. CONCLUSION: Skin cancer patients with complex facial wounds from Mohs micrographic surgery may be assured of the highest possible cure rate. Further, their esthetic and functional reconstructive goals may be achieved with staged flaps for the nose and ear.

Cheek↗