LVSS use was found to be effective and proved to be efficient and safe, and may be useful in oral cancer surgery.

We have previously reported that the thoracolumbar posterior nerve root shows a tortuous epidural course, based on studies of human fetuses near term. For comparison with the cervical nerve, examinations were conducted using frontal, sagittal and horizontal sections of cervical vertebrae from 22 fetuses at 30-38 weeks of gestation. The cervical nerve root showed a short, straight and lateral course near the zygapophysial joint. Multiple rather than single bundles of the cervical posterior root seemed to account for the majority of sensory nerve fibers innervating the upper extremity. Fasciculation of rootlets was evident near the thoracolumbar spinal cord, whereas it was seen in the dural pocket at the nerve exit from the dural sac although both sites were subdural. As in the thoracolumbar region, the nerve sheath was continuous with the dura mater and independently surrounded each of the anterior and posterior roots. Radicular arteries were few in the cervical region. In 2 of the 22 fetuses (31 weeks and 33 weeks), there was a segmental, unilateral abnormality of nerve rootlet fasciculation where the dorsal root ganglion was located lateral or peripheral to the intervertebral region. Long nerve roots running inferiorly are a necessary adaptation to the delayed and marked growth of the thoracolumbar vertebral column. In children, the cervical nerve roots are likely to be affected by movement or dislocation of the vertebrae. The segmental abnormality of the cervical nerve root may be linked to rare variations in the brachial plexus.

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We evaluated 27 cases of salvage surgery for recurrent oral squamous cell carcinoma.The 1yOS was 75％ and 2yOS was 61％. Mean PFS was 10.9 months （2.6-61.3 m） .A pathological resection margin of positive or close, and the primary site in the tongue, oral floor and buccal mucosa were considered as poor prognostic factors. The primary site of re-recurrence in almost 88％ of cases was located in the posterior region or parapharyngeal space, so safe setting of the posterior margin and extended dissection of the parapharyngeal space should be considered.Key words： salvage surgery, head and neck cancer, oral cancer, microvascular anastomoses, free flap Requests for reprints to : Dr. Fushimi C.,