Head and neck reconstruction using ulnar forearm flaps has several advantages; however, it is still considered challenging because of the small venous diameter. Between January 2020 and September 2022, 24 patients underwent head and neck reconstruction using ulnar forearm flaps in Shimane University Hospital. The patients were 27-79 years old, and the postoperative follow-up period was 143-1126 days. The average diameter of the ulnar artery was 2.0 mm. Of the two accompanying veins, the larger vein had an average diameter of 1.2 mm, and the smaller vein had an average diameter of 1.0 mm. The cutaneous veins of the flap had an average diameter of 1.6 mm, consisting of 14 median antebrachial veins and five basilic veins, but they were absent in five cases. The ulnar vein was frequently anastomosed to the internal jugular vein in an end-to-side fashion. Overall, 18 out of 24 patients（75%）had two ulnar veins anastomosed to the internal jugular vein. Postoperatively, the flap survived completely in 23 cases, excluding one case where partial necrosis occurred. Anastomosing two ulnar veins to the internal jugular vein in an end-to-side fashion may be effective, and all possible venous anastomoses may be recommended to avoid flap compromise.

  The correction of jaw deformities usually requires orthognathic surgery, aimed at achieving good function and favorable esthetic aesthetic results. This study aimed to report on the efficacy of clockwise rotation of the maxillomandibular complex for correcting a protruding chin in skeletal class III malformations with a brachyfacial profile and positive overjet, using bimaxillary surgery. Two patients underwent clockwise rotation of the maxillomandibular complex through a surgical procedure consisting of a Le Fort I maxillary osteotomy and bilateral sagittal split ramus osteotomy (BSSO). The first patient was a 29-year-old male who received this orthognathic surgery without prior orthodontic treatment. Two L-shaped absorbent plates were used for Le Fort I osteotomy fixation, and titanium wires were used for BSSO loose fixation. The second patient was a 23-year-old female who underwent preoperative orthodontic treatment followed by orthognathic surgery and postoperative orthodontic treatment. Two L-shaped titanium plates were used for Le Fort I osteotomy fixation, and two I-shaped titanium plates were used for BSSO fixation. Additionally, the patient underwent bilateral mandibular angle osteotomies to reduce the prominent angle. Clockwise rotation of the maxillomandibular complex provided satisfying facial esthetic results, with a mesofacial profile and normal chin.

  A flat occiput is a type of positional cranial deformity that is known to be caused by sleeping on one's back during infancy. Such cranial deformity can sometimes cause emotional distress of the patient. In such cases, cranioplasty can improve the patient's quality of life, and benefits from a psychological and social standpoint may be noted.
  However, there are few reports on treatment for a flat occiput. In this study, we report two adult patients with a flat occiput who underwent bone grafting using custom-made artificial bone to improve the appearance of the flattened occipital region. In both cases, we were able to achieve satisfactory tissue augmentation. In order to ensure safe wound closure, in one case we used a bipedicle flap and skin graft, and in the other case, a tissue expander was inserted prior to artificial bone grafting in order to stretch the scalp. Although each method has its advantages and disadvantages, by understanding the characteristics of each one, both may enable the procedure to be performed safely and effectively.

  Background: Dermoid cysts (DCs) reportedly occur at the suture line of the skull. We report a case of DC arising from the sphenofrontal suture, and provide a summary of DCs from the sphenofrontal suture on cranial invasion reported in the literature.
  Case: The patient was a two year old boy. His tumor was located at the sphenofrontal suture and invaded the bone of the skull, and was surgically removed. We performed CT and MRI. They showed DC from the subcutaneous layer to full thickness of the bone. Recurrence occurred, and so a second operation was performed.
  Consideration: We summarized DCs from the sphenofrontal suture reported in the world, their degree of bone invasion, and evaluation methods. DCs from the sphenofrontal suture are rare, and relatively frequently invade bones. Therefore, we prefer to perform CT or MRI for preoperative diagnosis.
  Conclusion: DCs from the sphenofrontal suture are rare. Their preoperative evaluations are important because they are prone to invade bones.