Reconstruction of oral defects using flaps following resection of oral cancer has become a standard approach for restoration of oral function. The purpose of this study was to investigate chronological changes in the volume of such flaps used for reconstruction and the factors affecting flap volume. We performed a retrospective analysis of 17 patients who had undergone oral cancer resection and reconstruction with flaps. Measurements were performed using data from computed tomography, and the flaps were selected semi-automatically using a computer-operated region-of-interest system. The data indicated that the change in total flap volume at 1 year after surgery was 30.6%, and that body weight loss was a risk factor for volume reduction. Our results suggested that flaps should be at least 30% larger than the defects they are intended to repair. However, as large flaps have the potential to cause upper airway obstruction, flap volume should be determined on an individual basis according to defect size and location.

An ectopic tonsil is defined as tonsillar tissue that develops in areas outside of the four major tonsil groups: the palatine, lingual, pharyngeal, and tubal tonsils. The occurrence of tonsillar tissue in the oral cavity in ectopic locations, its prevalence, and its developmental mechanisms that belong to its formation remain unclear. In this report, we describe a rare case of bilateral symmetric ectopic oral tonsillar tissue located at the ventral surface of the tongue along with two solitary cases arising from the floor of the mouth. The role of immune system and its aberrant response leading to ectopic deposits desires further studies. As an ectopic tonsil may simulate a benign soft tissue tumor, this case series highlights the importance of this entity in our clinical differential diagnosis of oral soft tissue masses.

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Adenoid cystic carcinoma (ACC) is one of the most common malignant salivary gland tumors, and is the major type of malignant tumor in the minor salivary glands. Among salivary gland tumors, the most frequent site of ACC is the palate, followed by the tongue, buccal mucosa, lip, and floor of the mouth. Among the malignant tumors originating from the minor salivary glands of the tongue, more than 85％ involve the base of the tongue. Further, ACC arising from the anterior third of the tongue, particularly from an anterior lingual salivary gland, is extremely rare. Herein, we report a case of ACC originating from the anterior lingual salivary gland. A 72yearold man presented with an elastic, immobile mass accompanied by pain on the left side of the tongue. Following incisional biopsy, the mass was diagnosed as ACC. Partial glossectomy was performed with sufficient safety margin. The anterior third of the tongue was resected along with the sublingual salivary gland, tissues of the oral floor and the genioglossus muscle. Histological examination revealed typical ACC with the predominant cribriform pattern. Although no tumor cells were detected in the margins, some tumor cells showed perineural invasion. At the 20month followup, no evidence of local recurrence, distant metastasis, or dysfunction was observed. However, ACC has a relentless clinical course and frequently a fatal outcome, owing to its invasive local growth and a high incidence of distant metastasis. Therefore, rigorous longterm followup is essential.Key words：Adenoid cystic carcinoma, anterior lingual salivary gland, minor salivary gland tumor Requests for reprints to : Dr.