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Methods: Retrospect ive analysis of 47 patients of oral tongue squamous cell carcinoma treated surgically and pathologica lly staged as T2N0 with clear margins. The study period was from March 2004 to March 2011. Treatment outcome was evaluate d in terms of was locoregio nal recurre nce, disease free survival and overall survival. Kaplan Meir survival curves were used for the analysis. The mean follow up period was 28.3 months.Results: Recurrences occurred in 13 out of 47 patients (27.7%). At 5 years the overall survival is 80.5% and disease free survival is 53.9%. Univariate analysis revealed two significant prognost ic predictors for disease free survival: perineural invasion (PNI, p = 0.037) and lymphov ascular invasion (LVI, p = 0.05). This two factors did not have an effect on overall survival (p = 0.717). Conclusion:In oral tongue cancer (pT2N0), PNI and LVI significantly increased the recurre nce rate without an impact on surviva l. Prospect ive studies with large patient numbers are needed to evaluate this further and to see if adjuvant therapeuti c strategies need to be changed .

Surgical treatment for patients with actinomycosis with head and neck reconstruction should be considered as a reliable treatment option with a good long‐term effect.

45Summary Introduction. In occlusive diseases of carotid arteries may be involved salivary glands which play important role in oral and general homeostasis. Aim of the study. The purpose of this study was histomorphological evaluation of rabbit's salivary glands after regional reduction af arterial circulation and reconstruction of ligated common carotid arteries comparing with normal histological sight. Materials and methods. The experiments were authorized by the Animal Ethics Committee of the Latvian Food and Veterinary Service. 20 male Californian rabbits weighing approximately 3 kg were used. Under intravenous general anesthesia and local anesthesia the ligature of a. carotis communis dextra was done. After 28 days 10 rabbits were sacrificed and samples were taken from all major salivary glands and histological measured acinar dimensions and acinar epithelial cell. For rest 10 rabbits under the general anesthesia were performed revascularization of a. carotis communis dextra. After 28 days the rabbits were sacrificed with intrapulmonal injection of T61. The acini dimensions and acinar epithelial cell diameter in microns in all glands were measured except buccal glands were measured. Results. In ischemic conditions all glands react with decrease of acinar epithelial cell diameter and also diametr of functional unit of salivary gland.After revascularisation reestablishment of acini and secretory epithelial cells was observed. Conclusions. Rabbit's salivary glands have potential to recovery in diminished after ligation of ipsilateral common carotid artery size of acini and secretory epithelium after 4 week ischemia if the blood supply is reestabilished.

Radial forearm flap is a gold standard for oral soft tissue defect reconstruction after tumour ablative surgery of oral cancer in advanced stages. The main disadvantage of this flap is donor site morbidity. The goal of our study was to show versatility of lateral arm flap in 34 cases with different oral defects that were reconstructed after tumour ablation, and to analyse complications and donor site morbidity. Thirty-four patients with advanced stage oral cancer (T3 and T4) underwent tumour ablation with or without suspicious lymph node removal and with immediate reconstruction of oral defect with lateral arm flap. Analysis of complications and donor sites morbidity was carried out. The Michigan Hand Outcome Questionnaire was used to evaluate functional and esthetical donor site outcome during at least one year follow up. Thirty-one patients had successful free flap surgery with uneventful post-surgery period. Flap loss due to vascularity problems was in one case (2.9%). The flap success rate was 97.1%. The donor site was closed primarily in all cases and healed uneventfully. The Michigan Hand Outcome Score was average 94.30%. The lateral arm is an excellent choice for oral reconstruction after ablative tumour surgery. It is versatile, safe and reliable for oral reconstruction with very good functional and aesthetical donor site outcome.

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Introduction: The posterior interosseous artery flap (PIAF) has been used for many years for a successful coverage of the defects of dorsal aspect of the hand. Recently a concern was raised regarding donor site morbidity, as skin grafting has poor functional and aesthetic outcomes. We present a case report with an alternative technique for the donor site closure with radial artery perforator propeller flap. So far, we have used this technique in 4 cases. Case report: A 50 years old male was hospitalized due to a crush injury to the right hand. Examination revealed fractures of 4 th and 5 th metacarpal bone, crashed intrinsic muscles, rupture of extensor tendons and 5x7 centimeters soft tissue defect. Bone fixation was done, tendons were sutured primarily. For the hand's soft tissue defect a PIAF was used. To cover the defect on the donor site and to avoid skin grafting a perforator propeller flap was raised. The flap was based on a single perforator from the radial artery. No healing problems occurred. Conclusions: Perforator based on radial artery at dorsoradial aspect of forearm, could be used as propeller flap for soft tissue covering after PIAF. By covering the donor site with a perforator flap skin grafting is avoided, faster healing, good skin color and texture match is achieved.

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