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Oroantral fistulas (OAF), which develop as a result of maxillary sinus infection caused by oroantral communication, are sometimes intractable. We present a case of closure with a facial artery musculomucosal flap (FAMM flap) for intractable OAF. A 73-year-old man presenting with an OAF and rhinorrhea was referred to our department. Twenty-eight years earlier, he had undergone bilateral radical surgery for maxillary sinusitis, and six years earlier, he underwent extraction of his right maxillary first and second molars. Six months after the dental extractions, he developed maxillary sinusitis secondary to oroantral communication. Four years after the dental extractions, he underwent endoscopic sinus surgery with closure of the OAF with a rotational pedicled palatal flap, but the OAF recurred. To treat the OAF recurrence, we used a FAMM flap. His postoperative course was good, with no OAF recurrence 6 years after surgery. FAMM flaps are useful to close intractable OAFs.

The purpose of this study was to determine the detailed background of cases of oral squamous cell carcinoma (OSCC) with microscopic extracapsular spread (ECS) in the cervical lymph nodes. The cases of 78 patients with primary OSCC, who attended hospital from October 2007 to July 2011 and underwent resection of the primary tumour with neck dissection, were reviewed. The subjects were classified into three categories: pN0, pN+/ECS-, and pN+/ECS+; the outcomes of pN+/ECS+ patients were compared in detail with those of the other categories. Thirty-one cases (39.7%) were pN0, 25 cases (32.1%) were pN+/ECS-, and 22 cases (28.2%) were pN+/ECS+. The 3-year overall survival rate was 82.1% in pN0, 74.1% in pN+/ECS-, and 39.8% in pN+/ECS+ (pN0 vs. pN+/ECS+, P=0.0004; pN+/ECS- vs. pN+/ECS+, P=0.0086). The 3-year disease-specific survival rate was 96.2% in pN0, 77.2% in pN+/ECS-, and 39.8% in pN+/ECS+ (pN0 vs. pN+/ECS+, P