The aim of this retrospective study, conducted by the Department of Otolaryngology, Chiang Mai University, Thailand, is to understand the clinical characteristics of patients with deep neck infection (DNI), especially in immunocompromised hosts, as well as to analyze the factors that influence multiple spaces' involvement and complications. The data collected (January 2004-July 2009) from 177 patients with DNI, excluding peritonsillar abscess, were reviewed, including demography, clinical presentation, etiology, involved fascial spaces, bacteriology, treatment, and complications. SPSS (15.0) was used to analyze the data. A p value of <0.05 was considered statistically significant. Among 177 DNI patients, there were 30 diabetic and 4 HIV infected patients, who were considered immunocompromised. Furthermore, two characteristics (complications and the Hb level) were statistically significant (p value <0.05) in the immunocompromised and immunocompetent groups. The 87 patients who presented with multiple space involvement were predicted by the level of white blood cell count (<5,000 or >12,000/μl) (OR 2.62; 95% CI 1.38-4.96) in univariate analysis. Complications were affected by both host immunity and abnormal Hb level (<10 or >15 g/dl), in univariate analysis, but Hb level was the only risk factor (OR 4.46; 95% CI 1.81-10.99) in multivariate analysis. Comorbidities such as diabetes mellitus and HIV infection required certain clinical assessment because of potential complications. In addition, blood tests (WBC and Hb levels) are the most important investigations necessary in patients suspected of having multiple space involvement and complications.

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To determine predictive factors which affect local and regional recurrence of T1-2N0-1M0 oral tongue carcinoma (OTC). Records of 42 patients with T1-2N0-1 M0 OTC were reviewed. The clinical characteristics, histopathological data, disease recurrence and survival rate were analyzed. Descriptive statistics and Kaplan-Meier survival analysis were used. The median follow up was 38 months. The 2-year overall survival and disease-free survival rates were 85.7 and 55.6 % respectively. At the 2 year analysis, there were surgical margin\5 mm (p value = 0.01), tumor thickness [7 mm (p value = 0.03), perivascular and perilymphatic invasion (p value = 0.01) affected on local recurrence and perivascular and perilymphatic invasion were also predictors for regional recurrence (p value = 0.04). The surgical margin status, tumor thickness, perivascular and perilymphatic invasion represented significant predictive factors for local recurrent OTC. Postoperative adjuvant therapy should be considered in these groups.

Objective: Temporalis myofascial flap is a good option for the reconstruction of maxillofacial, oral cavity, and parotid defect. Method: A total of 28 patients with postoperative defects located in the lower two thirds of the face and oral cavity in Chiang Mai University Hospital were included in this study. Results: Sixteen patients had nasal cavity and maxillary sinus cancer, 6 patients had oral cavity and oropharyngeal cancer, 3 patients had parotid cancer, 1 patient had cementifying fibroma, 1 patient had facial palsy, and 1 patient had osteoradionecrosis of the mandible. Temporalis muscle flap provided profuse well-vascularized tissue for the obliteration of orbital exenteration and totalor partial maxillectomy cavities and coverage of the surface of sinonasal and oropharyngeal defects. Conclusion: Oral and nasal spaces were separated successfully in all patients. Temporalis muscle flap is a very reliable technique with low complication rates and few donor site problems. This safe and technically simple flap can be preferred for the reconstruction of maxilla-facial defects after ablative tumor surgery, especially in older and debilitated patients.