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Sherif Idris, Alex M Mlynarek, Khalid Ansari, Jeffrey R Harris, Nabil Rizk, David Cote, Daniel A O'Connell, Heather Allen, Peter Dziegielewski, Hadi Seikaly
BACKGROUND: Defects following resection of tumors in the head and neck region are complex; more detailed and defect-specific reconstruction would likely result in better functional and cosmetic outcomes. The objectives of our study were: 1) to improve the understanding of the two- and three-dimensional nature of oral cavity and oropharyngeal defects following oncological resection and 2) to assess the geometric dimensions and the shapes of fasciocutaneous free flaps and locoregional tissue flaps required for reconstruction of these defects...
April 24, 2018: Journal of Otolaryngology—Head & Neck Surgery
Peter S Vosler, Mario Orsini, Danny J Enepekides, Kevin M Higgins
BACKGROUND: The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) universal surgical risk calculator is an online tool intended to improve the informed consent process and surgical decision-making. The risk calculator uses a database of information from 585 hospitals to predict a patient's risk of developing specific postoperative outcomes. METHODS: Patient records at a major Canadian tertiary care referral center between July 2015 and March 2017 were reviewed for surgical cases including one of six major head and neck oncologic surgeries: total thyroidectomy, total laryngectomy, hemiglossectomy, partial glossectomy, laryngopharyngectomy, and composite resection...
March 22, 2018: Journal of Otolaryngology—Head & Neck Surgery
Nootan Kumar Shukla, S V Suryanarayana Deo, Pankaj Kumar Garg, N M L Manjunath, Suman Bhaskar, V Sreenivas
The aim of the present study was to provide insight into various demographic, clinical, and management profile of Indian patients with oral tongue squamous cell cancer (OTSCC). All the OTSCC patients who had undergone surgical treatment during 1995 to 2010 at a tertiary care center in North India were considered for the present study. The details of the patients were retrieved from a prospectively maintained computerized database. A total of 124 patients were included in the present study. Mean age of the patients was 50...
March 2018: Indian Journal of Surgical Oncology
Khoi Anh Nguyen, Truong Xuan Bui, Hue Van Nguyen, Richard O Wein
OBJECTIVE: The purposes of the study was to evaluate for the functional improvement of outcomes of patients undergoing surgical management for tongue cancer at varying periods after surgery. DESIGN: Case series with intervention. PARTICIPANTS: Thirty consecutive patients, from 2011 to 2015, with carcinoma of the tongue undergoing surgical resection and reconstruction with a radial forearm free flap. MAIN MEASURES: The Speech Intelligibility Test (SIT) is used for objective evaluation of speech function...
May 2018: American Journal of Otolaryngology
Andrés M Bur, Ernest D Gomez, Jason G Newman, Gregory S Weinstein, Bert W O'Malley, Christopher H Rassekh, Katherine J Kuchenbecker
OBJECTIVES/HYPOTHESIS: To develop and evaluate a high-fidelity training simulator for transoral robotic posterior hemiglossectomy. STUDY DESIGN: Prospective observational study. METHODS: We constructed a transoral robotic surgery (TORS) simulator using porcine tongue in a modified airway mannequin. Twenty-nine surgeons performed transoral robotic posterior hemiglossectomy on the simulator. The 20 resident subjects completed six trials each, and the five fellows and four attending surgeons completed two trials each...
December 2017: Laryngoscope
Maggie A Kuhn, Amanda B Black, M Tausif Siddiqui, Jan A Nolta, Peter C Belafsky
OBJECTIVES/HYPOTHESIS: Dysphagia is common and costly. Treatments are limited and innovative therapies are required. The tongue is essential for safe, effective swallowing and is a natural target for regenerative therapy. Muscle-derived stem cells (MDSCs) hold potential to restore dynamic function, and their application in the damaged tongue is appealing. We examined the safety and efficacy of human MDSC implantation into a novel mouse tongue model. STUDY DESIGN: Animal study...
October 2017: Laryngoscope
Sapna Annaji Nikhar, Ashima Sharma, Mahesh Ramdaspally, Ramachandran Gopinath
OBJECTIVE: Oral cancer patients have a potentially difficult airway, but if managed properly during the perioperative period, morbidity and mortality can be reduced or avoided. METHODS: The medical records of 156 patients who were operated for oral cancers were reviewed for airway management during the perioperative period. RESULTS: The surgical procedures ranged from excisions, wide local excisions with split skin graftings, hemiglossectomies and radical neck nodes dissections to pectoralis major myocutaneous or free fibular flaps...
April 2017: Turkish Journal of Anaesthesiology and Reanimation
Takenori Ogawa, Ryo Ishii, Daiki Ozawa, Takeshi Rikiishi, Hajime Usubuchi, Mika Watanabe, Yoshimichi Imai, Kenichi Sato, Masatoshi Saito, Yoji Sasahara, Tadashi Matsuda, Shigeo Kure, Yukio Katori
Here we present an extremely rare case of giant infantile hemangiopericytoma (HPC) of the tongue diagnosed prenatally by fetal ultrasonography and MR imaging. Due to airway stenosis, the patient was delivered by the ex utero intrapartum treatment (EXIT) procedure at 36 weeks of pregnancy. Initial diagnosis was infantile hemangioma based on physical examination, diagnostic imaging and the high incidence of hemangioma. The tumor was resistant to conservative treatments. Due to severe tumor hemorrhage, the nutrient vessel was embolized by endovascular treatment on the 73th day after birth...
February 2018: Auris, Nasus, Larynx
Ying-Sheng Lin, Wen-Chung Liu, Yaoh-Shiang Lin, Lee-Wei Chen, Kuo-Chung Yang
Background For large tongue defects, reconstructive surgeons have devised a variety of feasible options, such as radial forearm free flap and anterolateral thigh (ALT) flap. In our institution, peroneal flap has been the workhorse flap for the soft tissue defect in head and neck reconstruction. We present our experience using peroneal flap in tongue reconstruction. Patients and Methods The study included 47 patients who had undergone tongue reconstructions with peroneal flaps after tumor resection. The size and location of the defect after tumor resection determined whether the peroneal flaps could be harvested as pure septocutaneous flaps to solely reconstruct the neotongue or to carry an additional muscle bulk to fill the adjacent defect...
July 2017: Journal of Reconstructive Microsurgery
Ricardo Fernández-Riera, Shao-Yu Hung, Jerry Chih-Wei Wu, Chung-Kan Tsao
BACKGROUND: Free profunda artery perforator (PAP) flap has recently been brought back for head and neck reconstruction. During the course of 1 year, we performed this procedure for reconstruction of partial glossectomy defects with excellent results. METHODS: From January through December 2015, 21 patients underwent partial glossectomy reconstruction with PAP flaps. Demographics, surgical technique, anatomic variations, success rates, complications, and characteristics are described...
April 2017: Head & Neck
Valentino Valentini, Andrea Cassoni, Valentina Terenzi, Gianmarco Prucher, Oriana Rajabtork Zadeh, Sandro Bosco, Evaristo Belli
AIM: Free and pedicled flap are methods of choice for reconstruction of post-surgical defects consequent to oral squamous cell carcinomas (SCCs), and missing intraoral mucosa is commonly reconstructed by the cutaneous component of the flap to guarantee an epithelial lining. Even if rare, cases of second tumors arising in the skin flap have been described. We present our experience reporting a clinical case. CASE REPORT: A squamous cell carcinoma arose on a forearm free flap 21 years after hemiglossectomy in a 72 years old woman...
February 4, 2016: Annali Italiani di Chirurgia
Natalie L Pease, Andrew Davies, William A Townley
BACKGROUND: The medial sural artery perforator (MSAP) flap is becoming a popular strategy for reconstructing intraoral defects. We present a case in which no MSAPs were present, however, a perforator-based calf flap was successfully raised on the sural artery and used for tongue reconstruction. A corresponding anatomic study was undertaken to establish if this finding was reproducible. METHODS: A 58-year-old woman underwent left hemiglossectomy for a squamous cell carcinoma of the tongue...
July 2016: Head & Neck
Douglas B Chepeha, Matthew E Spector, Steven B Chinn, Keith A Casper, Eric J P Chanowski, Jeffrey S Moyer, Robert Morrison, Emily Carvill, Teresa H Lyden
BACKGROUND: The purpose of this study was to model >12 month speech and the oral phase of swallowing outcomes with the reconstructive metrics of tongue elevation and protrusion in patients reconstructed with the rectangle tongue template for a hemiglossectomy defect. METHODS: We conducted a study using 40 surviving patients (23 men, 17 women) treated between 2000 and 2012. Statistically significant correlations of elevation and protrusion with functional outcomes were modeled with receiver operator characteristic (ROC) curves to understand the performance and reliability of the rectangle tongue reconstruction...
July 2016: Head & Neck
Chunyue Ma, Zhuowei Tian, Evagelos Kalfarentzos, Yixin Zhang, Zhiyuan Zhang, Din Lam, Chenping Zhang, Yue He
OBJECTIVES: With microvascular reconstruction, different perforator flaps have been introduced for the treatment of head and neck defects. In light of this, the superficial circumflex iliac artery perforator (SCIP) flap was assessed for reconstruction after partial and hemiglossectomy. STUDY DESIGN: A total number of nine patients who received SCIP flap reconstruction for tongue defects were included in this study. Details on clinical features were collected, and postoperative functions and esthetic results were analyzed...
April 2016: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Xiangru Li, Qiang Sun, Shu Guo
Our goal was to evaluate the functional outcomes following radial forearm free-flap reconstruction with a focus on radiotherapy. A 2-year prospective study was performed. A total of 47 patients were enrolled finally. They were asked to complete the swallowing, chewing, speech domains of the University of Washington Quality of Life questionnaire preoperatively and at 2 years postoperatively. Swallowing capacity was apparently affected after surgery, but no patients reported there was chokes cough during eating, the mean score was 51...
March 2016: Journal of Craniofacial Surgery
L Wang, K Liu, Z Shao, Z-J Shang
The aim of this study was to evaluate tongue function in patients with oral cancer treated surgically and reconstructed with anterolateral thigh free flaps (ALTFs). Patients (N=238) underwent primary reconstruction after hemiglossectomy between September 2012 and October 2014. Patients were divided into two groups according to the flap design: 'individual design' (ABC flap) and 'common design'. Patients were followed postoperatively and assessed after 6 months for the following functional outcomes: speech, deglutition, tongue mobility, and donor site morbidity...
June 2016: International Journal of Oral and Maxillofacial Surgery
Mingxing Lu, Guowen Sun, Qingang Hu, Enyi Tang, Yujia Wang
BACKGROUND: To compare free thin anterolateral thigh (ALT) flap with free radial forearm (FRF) flap in the reconstruction of hemiglossectomy defects, and to introduce our methods and experience in the tongue reconstruction with free thin ALT flap. MATERIAL AND METHODS: The clinicopathologic data of 46 tongue carcinoma cases hospitalized from December 2009 to April 2014 were obtained from Nangjing Stomatological Hospital, Medical School of Nanjing University. All the subjects were evaluated for the articulation and the swallowing function 3 months after the surgery...
November 1, 2015: Medicina Oral, Patología Oral y Cirugía Bucal
Senlin Zhang, Wei Chen, Gang Cao, Zhen Dong
This study investigated the tongue function and donor-site morbidity of patients with malignant tumors who had undergone immediate flap reconstruction surgery. Twenty-seven patients who had undergone immediate reconstruction after hemiglossectomy were observed. Twelve patients were reconstructed using the pedicled supraclavicular artery island flap (PSAIF) and 15 patients using the free radial forearm flap (FRFF). Flap survival, speech and swallowing function, and donor-site morbidity at the 6-month follow-up were evaluated...
September 2015: Journal of Craniofacial Surgery
Jelena V Jeremić, Živorad S Nikolić
INTRODUCTION: The radial forearm free flap has an important role in reconstruction of the oncologic defects in the region of head and neck. OBJECTIVE: The aim was to present and evaluate clinical experience and results in the radial forearm free transfer for intraoral reconstructions after resections due to malignancies. METHODS: This article illustrates the versatility and reliability of forearm single donor site in 21 patients with a variety of intraoral oncologic defects who underwent immediate (19 patients, 90...
May 2015: Srpski Arhiv za Celokupno Lekarstvo
Martijn Baas, Liron S Duraku, Eveline M L Corten, Marc A M Mureau
BACKGROUND: Tongue reconstruction after (hemi)glossectomy including sensory recovery is challenging. Although sensory recovery could improve functional outcome, no consensus on the need for reinnervation of the neo-tongue exists. Therefore, a systematic review was performed to determine if sensory reinnervation of free flaps in tongue reconstruction is better than no sensory reinnervation. The secondary study aim was to assess the effect of sensory reinnervation on overall functional outcome, such as speech and deglutition...
August 2015: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
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