There are several methods of assessing dysphagia, but methods of assessing swallowing function in patients with oral cancer are not well standardized. Therefore, evaluation methods might differ across hospitals, possibly resulting in treatment-induced symptoms not being accurately reflected in the evaluation.
The Mann Assessment of Swallowing Ability-Cancer （MASA-C） is a screening tool used for patients with head and neck cancers undergoing radiation monotherapy or chemoradiotherapy. It comprises 24 items to assess the severity of dysphagia and the risk of aspiration.
This study evaluated the usefulness of the MASA-C tool postoperatively in patients with oral cancer. MASA-C scores were compared with evaluations performed using existing examination methods, such as video fluoroscopy and the Functional Oral Intake Scale（FOIS）.
The optimal MASA-C cut-off value for diagnosing aspiration was 150 points, with a sensitivity of 0.89, specificity of 0.80, and an area under the curve of 0.85. A significant correlation was observed between the FOIS and MASA-C（r＝0.624, P＝0.001）.
MASA-C is a useful screening tool for the evaluation of swallowing function after oral cancer surgery.

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Neutrophil-to-lymphocyte ratio （NLR）, platelet-to-lymphocyte ratio （PLR）, lymphocyte-to-monocyte ratio （LMR） and progressive nutrition index（PNI） are known as inflammation based prognostic scores（IBPS）, and have been reported as prognostic indicators for various cancers. We studied 101 patients who underwent curative surgery for oral squamous cell carcinoma in the Department of Dentistry and Oral Surgery, Hirosaki University Hospital between January 2008 and December 2016. IBPS was calculated from peripheral blood before surgery and at the time of recurrence or metastasis. The optimal cut-off point of IBPS was determined on the basis of a time-dependent receiver operating characteristics curve for disease-free survival. The optimal cut-off point of NLR was 2.649, LMR was 5.379, PLR was 154.317 and PNI was 50.703. The high NLR group had a significantly lower survival rate than the low NLR group. Univariate analysis using a COX proportional-hazards model showed that NLR and presence or absence of reconstruction were significantly associated with poor outcomes. Multivariate analysis showed that NLR remained as a risk factor for disease-free survival.
In the recurrence or metastasis group, a comparison of IBPS between pretreatment and the time of recurrence or metastasis was performed. In the case of recurrence or metastasis a significant reduction of PNI was observed. Thus, we suggest that pretreatment NLR was an important predictive factor for the prognosis of recurrence or metastasis, and PNI was the same during follow-up.

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Submental island flap （SIF） was first reported by Dr. Martin in 1993 as an axial-patterned flap in head and neck reconstruction. Blood supply of the SIF is provided by the submental artery, which is a well-defined branch of the facial artery. We surgically treated seven patients with oral cancer using SIF to reconstruct the defects between October 2017 and July 2018. These patients met the following criteria that are generally considered to be indications of SIF: no neck metastasis and small to medium-sized defects. In addition, SIF may be used for elderly patients and patients with comorbidities who require reduced operative burdens. Although partial necrosis of the flap was observed in two of the seven patients, all patients remained symptom-free of recurrence and metastasis at follow-up 14 to 23 months later.

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Polymorphous adenocarcinoma （PAC） is a rare malignant salivary gland tumor arising most commonly in the palate. It is characterized by cytologic uniformity but morphologically variable growth pattern. We report a case of PAC arising in the upper lip. A 69-year-old man was referred to our hospital due to a tumor in the right side of the buccal mucosa. Clinical examination showed a 9×9 mm painless and well-demarcated swelling of the buccal mucosa without mucosal ulceration. MRI revealed a well-defined mass in the right side of the buccal mucosa, of moderate intensity on T1 weighted images and high intensity on T2 weighted images. The tumor was surgically removed under general anesthesia. Histological examination of the surgical specimen showed PAC. After the diagnosis of PAC, an additional surgical excision with a 5-mm wide margin from the scar after the operation was performed as a second surgery. There has been no sign of recurrence or metastasis for 4 years postoperatively.

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