Objectives:The submental flap provides an alternative technique in orofacial reconstruction, especially in situations where free flap services are not available. The objective of this study is to demonstrate the oncological safety and benefits of this flap in oral cavity reconstruction in a tertiary care cancer hospital.Materials and Methods:A total of 27 patients with oral cavity cancers, which underwent submental flap reconstruction from 2015 to 2017 at Shaukat Khanum Cancer Memorial Hospital, were included in the study. We have retrospectively reviewed records of these patients.Results:There were 25 male and 2 female patients with age ranging from 21 to 73 years. Most common primary tumor sites were buccal mucosa (13), tongue (7), and lower alveolus (7). All patients underwent ipsilateral selective neck dissection after flap was harvested. Complete flap loss was observed in three, whereas one patient had flap dehiscence that subsequently healed. Mean follow-up was 11 months. There were four regional recurrences but no local recurrence. On the last follow-up (minimum 6 months), 15 patients were alive without any disease, 4 were alive with disease, and 3 had died.Conclusion:Submental flap is a satisfactory option for oral cavity reconstruction. However, preoperative selection of clinically neck node-negative patient is extremely important as it has potential risk of occult metastasis.

The technology of 3D bioprinting has gained significant interest in biomedical engineering, regenerative medicine, and the pharmaceutical industry. Providing a new scope in tissue and organ printing, 3D bioprinters are becoming commercialized for biological processes. However, the current technology is costly, ranging from USD$9,000-$30,000 and is limited to customized extrusion methods. Multiple microfluidic pump systems for bioink extrusion are commercially available at USD$30,000. Additionally, the use of Cartesian systems for 3D printing restricts the user to three axes of movement and makes multi-material modeling a challenge. Consequently, it was proposed to design a cost effective robotic 3D bioprinting system, compatible with peptide bioinks which were developed at KAUST Laboratory for Nanomedicine. The components of the system included a programmable robotic arm, an extruder for bioprinting, and multiple microfluidic pumps. The extruder was designed using a coaxial nozzle made of three inlets and one outlet. The programmable microfluidic pumps transported the peptide bioink, phosphate buffer saline (PBS) and human skin fibroblast cells (in cell culture media solution) through the nozzle to extrude a peptide nanogel thread. Model cell structures were printed and monitored for a period of two weeks and subsequently found to be alive and healthy. The system was kept well under a budget of USD$3,500. Future modifications of the current system will include adding a custom bioprinting arm to allow multi-material printing which can fully integrate and synchronize between the pumps and the robotic arm. This system will allow the production of a more advanced robotic arm-based 3D bioprinting system in the future.

Irfan et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

IntroductionDevelopment of laryngeal cancer is multifactorial, and management is surrounded with controversies. Recent reports suggest a decline in the survival of these patients. We conducted a study to analyze the clinicopathological parameters and compute the outcomes in terms of survival in patients with laryngeal cancer treated at our institution.MethodsElectronic charts of 515 patients with Laryngeal cancer treated at our Hospital and Research Center from 2004 to 2014 were retrospectively reviewed.ResultsMedian age was 62 years. Male: female ratio 91%: 9%. Sixty-two percent were smokers. Histologically, all were squamous cell carcinoma. Most common subsite was glottis (88%). Treatment was non-surgical in 92% and surgical in 8%. The five-year overall survival (OS), disease-specific survival (DSS), disease-free survival (DFS) and locoregional control (LRC) were 67%, 74%, 59% and 70%, respectively. OS, DSS, DFS and LRC for early stage (I-II) and advance stage (III-IV) were 81 and 54%, 86 and 63%, 75 and 45%, and 83 and 57%, respectively. Twenty-two percent recurred locally. Of these failures, 19% were inoperable, 36% were surgically salvaged and 34% refused laryngectomy.ConclusionsOur survival rates are comparable with published data. The high refusal rate for salvage total laryngectomy is concerning and needs further study to evaluate the reasons.