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https://www.readbyqxmd.com/read/29146958/third-repeat-microvascular-reconstruction-in-head-and-neck-cancer-patients-aged-65-years-and-older-a-longitudinal-and-sequential-analysis
#1
Jonas Löfstrand, Kai-Ping Chang, Jennifer An-Jou Lin, Charles Yuen Yung Loh, Hsuan-Yu Chou, Huang-Kai Kao
Performing a sequential third free flap for reconstruction of a head and neck defect after cancer resection can be challenging, and the problem is further compounded in elderly patients. The outcomes in this clinical scenario are currently unknown and this study aims to compare the results in elderly patients with younger patients in a high-volume microsurgical unit. A retrospective review of 126 consecutive patients who had undergone three sequential free flap reconstructions after head and neck cancer was performed...
November 16, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29127127/abrikossoff-s-tumour-on-the-upper-limb-a-rare-presentation
#2
Carlos E Costa Almeida, Teresa Caroço, Marta Silva, Miguel Nico Albano
Abrikossoff's tumour or granular cell tumour is a rare entity. Most common locations are the head and neck, with only a few cases reported on the upper limbs. A 55-year-old man with a nodular lesion on the left arm resorted to surgery consultation. Nodule was firm, mobile, painless and non-ulcerated. Total excision using a Limberg flap procedure was performed. Following 3 months of follow-up, the patient is fine. Abrikossoff's tumour is frequently presented in the second to sixth decade of life as an ulcerated nodule with progressive growth...
November 9, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29124365/change-in-reimbursement-and-costs-in-german-oncological-head-and-neck-surgery-over-the-last-decade-ablative-tongue-cancer-surgery-and-reconstruction-with-split-thickness-skin-graft-vs-microvascular-radial-forearm-flap
#3
Sebastian Hoefert, Oliver Lotter
OBJECTIVES: Defects after ablative tongue cancer surgery can be reconstructed by split-thickness skin grafts or free microvascular flaps. The different surgical options may influence costs, reimbursement, and therefore possible profits. Our goal was to analyze the development of these parameters for different procedures in head and neck reconstruction in Germany over the last decade. MATERIALS AND METHODS: After tumor resection and neck dissection of tongue cancer, three different scenarios were chosen to calculate costs, reimbursement, length of stay (LoS), and profits...
November 9, 2017: Clinical Oral Investigations
https://www.readbyqxmd.com/read/29122486/trapezius-flaps-for-reconstruction-of-head-and-neck-defects-following-oncological-resection-a-systematic-review
#4
Conor M Sugrue, Grainne Rooney, Ryan M Sugrue
OBJECTIVE: Head and neck (H&N) reconstruction after cancer resection is challenging. Myocutaneous trapezius flaps provide an alternative reconstruction for patients not suitable for microvascular free tissue transfer. METHODS: A systematic review was performed on studies involving trapezius flaps for H&N reconstruction post oncological resection between the years 1985-2015. Data extracted included patient numbers and demographics, operative technique and complications...
October 10, 2017: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/29105818/simplified-profunda-artery-perforator-pap-flap-design-using-power-doppler-ultrasonography-pdu-a-prospective-study
#5
Andreas Kehrer, Ming-Yi Hsu, Yu-Ting Chen, Neil S Sachanandani, Chung-Kan Tsao
INTRODUCTION: Optimal design of PAP flaps requires precise perforator mapping. In a systematic review, Doppler ultrasonography demonstrated the highest sensitivity and positive predictive value (PPV). We present a prospective study of PAP flap design comparing PDU, handheld Doppler (HHD), and clinical findings. METHODS: From May to July 2016, 12 head and neck cancer patients receiving PAP flaps were examined with PDU and HHD. We used PDU to evaluate number, course, emergence point, peak systolic velocity (PSV), and arterial diameter of perforators...
November 4, 2017: Microsurgery
https://www.readbyqxmd.com/read/29073917/benefit-of-salvage-total-pharyngolaryngoesophagectomy-for-recurrent-locally-advanced-head-and-neck-cancer-after-radiotherapy
#6
Jie Liu, Ye Zhang, Zhengjiang Li, Shaoyan Liu, Huizheng Li, Zhengang Xu
BACKGROUND: The treatment modalities for recurrent locally advanced head and neck cancer failure after radiotherapy are limited with poor prognosis. Salvage supra-radical operation seems to be an option. It has not been established which patients will benefit from salvage total pharyngolaryngoesophagectomy. METHODS: We retrospectively reviewed 66 patients with previously irradiated recurrent T4 head and neck cancer who underwent salvage total pharyngolaryngoesophagectomy at our institution between January 2001 and June 2014...
October 26, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/29067796/risk-factors-of-and-treatments-for-pharyngocutaneous-fistula-occurring-after-oropharynx-and-hypopharynx-reconstruction
#7
Su Bin Do, Chul Hoon Chung, Yong Joon Chang, Byeong Jun Kim, Young Soo Rho
Background: A pharyngocutaneous fistula is a common and difficult-to-manage complication after head and neck reconstruction. It can lead to serious complications such as flap failure, carotid artery rupture, and pharyngeal stricture, and may require additional surgery. Previous radiotherapy, a low serum albumin level, and a higher T stage have been proposed as contributing factors. We aimed to clarify the risk factors for pharyngocutaneous fistula in patients who underwent flap reconstruction and to describe our experiences in treating pharyngocutaneous fistula...
October 25, 2017: Archives of Plastic Surgery
https://www.readbyqxmd.com/read/29032418/transoral-robotic-surgery-for-squamous-cell-carcinomas-of-the-posterior-pharyngeal-wall
#8
B Lallemant, S Moriniere, P Ceruse, M Lebalch, K Aubry, S Hans, G Dolivet, O Malard, Q Bonduelle, S Vergez
Posterior pharyngeal wall squamous cell carcinomas (SCCs) are rare and have an associated poor prognosis. Progress in transoral resection techniques, in particular, transoral robotic surgery (TORS), have renewed the role of surgery in their treatment. This article presents the oncological and functional results obtained by the French Group of Head and Neck Robotic Surgery for TORS for posterior pharyngeal wall SCC-curative surgery. This retrospective, multicentre study presents data collected between September 2009 and November 2013 for patients treated with TORS for posterior pharyngeal wall SCCs...
December 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/29024491/surgical-morbidity-and-mortality-in-patients-after-microvascular-reconstruction-for-head-and-neck-cancer
#9
Young-Hoon Joo, Kwang-Jae Cho, Jun-Ook Park, Sang-Yeon Kim, Min-Sik Kim
OBJECTIVES: The aim was to evaluate the importance of clinical factors in the prediction of postoperative complications in patients with microvascular reconstruction for head and neck squamous cell cancer (HNSCC). DESIGN: A retrospective review of case notes was performed. SETTING: Patients treated at a single institute. PARTICIPANTS: The present study included 259 patients with HNSCC treated with radical surgery and microvascular reconstruction between 1993 and 2014...
October 11, 2017: Clinical Otolaryngology
https://www.readbyqxmd.com/read/28984029/cervicopectoral-flap-as-an-adequate-decision-for-advanced-ameloblastic-carcinoma
#10
I Lozev, I Pidakev, J C Cardoso, U Wollina, G Tchernev
Management of advanced head and neck cancers are often complicated by challenging anatomy, complex reconstructions and long surgical procedures (1). The leading clinical manifestations of patients with ameloblastic carcinomas are large, often painless and rapidly growing mass, swelling, paresthesis, mucosal ulceration, bleeding and tooth mobility (2,3). The tumor may arise from preexistent cysts or develop de novo (2). This article is protected by copyright. All rights reserved.
October 6, 2017: Journal of the European Academy of Dermatology and Venereology: JEADV
https://www.readbyqxmd.com/read/28967346/impact-of-pre-operative-body-mass-index-in-head-and-neck-cancer-patients-undergoing-microvascular-reconstruction
#11
D-J Hyun, Y-H Joo, M-S Kim
OBJECTIVES: To analyse the relationship of pre-operative body mass index with surgical complications and oncological outcomes in patients undergoing microvascular reconstruction for head and neck squamous cell cancer. METHOD: A retrospective review was conducted of 259 patients who underwent microvascular free flap reconstruction after head and neck ablative surgery. RESULTS: Mean body mass index was 22.48 kg/m2. There were no correlations between body mass index and: flap failure (p = 0...
October 2, 2017: Journal of Laryngology and Otology
https://www.readbyqxmd.com/read/28963805/justification-of-routine-venous-thromboembolism-prophylaxis-in-head-and-neck-cancer-reconstructive-surgery
#12
Hui Shan Ong, Sandhya Gokavarapu, Laith Al-Qamachi, Min Yi Yin, Li Xin Su, Tong Ji, Chen Ping Zhang
BACKGROUND: Venous thromboembolism (VTE) is a preventable complication in which early ambulation is expected after head and neck surgery. Thus, the role of VTE prophylaxis is questionable and needs further assessment. The purpose of this study was to specify the relative contributing risk factors for patients who underwent head and neck cancer ablation with immediate reconstruction. METHODS: A retrospective analysis was conducted of consecutive head and neck cancer ablations with immediate reconstructions between 2008 and 2013...
September 30, 2017: Head & Neck
https://www.readbyqxmd.com/read/28961429/synchronous-reconstruction-of-a-total-mandibulectomy-defect-with-a-single-fibula-osteocutaneous-free-flap
#13
Ramzey Tursun, J Marshall Green, Daniel Winokur, Andre Ledoux
Osteoradionecrosis (ORN) is a well-known and usually late complication of radiation therapy in the treatment of head and neck cancer. Although the therapy can be life extending, it also produces tissue toxicity in ipsilateral and contralateral tissues in an acute and chronic fashion. In the most severe cases of ORN, such as the one presented in this report, bilateral disease results in the need for total mandibulectomy and creates a tremendous reconstructive challenge. The advent of microvascular surgery and free tissue transfer has caused an evolution of the management protocol for severe ORN cases...
September 8, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28937303/palliative-coverage-of-cranial-defect-following-failed-cranial-flap-for-advanced-squamous-cell-carcinoma-case-report
#14
Vyacheslav Makler, Jeffrey S Litt, N Scott Litofsky
INTRODUCTION: With advanced-stage head and neck cancers, patients may develop large and/or complex wounds despite multiple reconstruction attempts. Wound coverage may require novel approaches to palliate the patient. METHOD: We present the case of a 56-year-old female with advanced squamous cell carcinoma of the scalp and skull who required multiple surgical interventions. Despite our best reconstructive efforts, the patient subsequently developed scalp infection and sepsis, necessitating further debridement for source control...
September 22, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28910897/-the-application-of-microvascular-anastomotic-coupler-in-vascular-anastomosis-of-free-tissue-flap-for-reconstruction-of-defect-after-head-and-neck-cancer-resection
#15
Y J Zhang, Z H Wang, C H Li, J Chen
Objective: To investigate the application and operation skills in vein anastomosis by microvascular anastomotic coupler (MAC) in reconstruction of defects after head and neck cancer resection. Methods: From August 2015 to July 2016, in Department of Head and Neck Surgery, Sichuan Cancer Hosipital, 17 cases underwent the reconstruction of defects after head and neck cancer resection with free tissue flaps, including forearm flaps in 11 casess, anterolateral flaps in 4 casess and fibula flaps in 2 casess. Totally 17 MAC were used, including 14 MAC for end-to-end anastomosis and 3 MAC for end-to-side anastomosis...
September 7, 2017: Zhonghua Er Bi Yan Hou Tou Jing Wai Ke za Zhi, Chinese Journal of Otorhinolaryngology Head and Neck Surgery
https://www.readbyqxmd.com/read/28895181/simultaneous-double-free-radial-forearm-flaps-combined-with-coronoidectomy-and-myotomy-to-release-bilateral-severe-trismus-a-case-report
#16
Chieh Chou, Chien-Chang Chen, Chung-Sheng Lai, Sin-Daw Lin, Yur-Ren Kuo
Oral cancers associated with submucosal fibrosis-induced trismus are common. They may affect the patients' quality of life, cause nutritional deficits, and interfere with postoperative cancer surveillance. In such cases, locating desirable recipient vessels in the head and neck can be difficult. This report presents a 47-year-old man with severe trismus caused by recurrent head and neck cancer, who had received multiple free-flap reconstructions after cancer ablation. Reconstruction was successfully achieved for the bilateral defects and releasing the trismus by using simultaneous double free radial forearm flaps as a chained flow-through pattern with one residual recipient vessel combined with the bilateral myotomy of the medial pterygoid and masseter muscles, and coronoidectomy...
September 12, 2017: Microsurgery
https://www.readbyqxmd.com/read/28894667/dual-vascular-free-anterolateral-thigh-flap
#17
Toshiaki Numajiri, Daiki Morita, Shoko Tsujiko, Hiroko Nakamura, Yoshihiro Sowa, Akihito Arai, Matsui Masahiro, Hiroshi Nakano, Shigeru Hirano
BACKGROUND: The optimum number of microvascular anastomoses for safe free tissue transfer is controversial. Although the case for 2 venous anastomoses versus 1 anastomosis has been argued, the use of an additional arterial anastomosis has not been examined in detail. METHODS: Twelve patients who underwent 2 arterial anastomoses for a free flap transfer were identified retrospectively from the medical records of patients undergoing reconstruction for head and neck cancer...
August 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28880703/the-association-between-surgical-complications-and-the-possum-score-in-head-and-neck-reconstruction-a-retrospective-single-center-study
#18
Yohjiroh Makino, Katsuhiro Ishida, Keita Kishi, Hiroki Kodama, Takeshi Miyawaki
The Physiological and Operative Severity Score for the Enumeration of Mortality and Morbidity (POSSUM) is widely used to predict surgical complications affecting various organs. However, there are few reports about objective evaluation methods for head and neck surgery. In this study, we retrospectively examined the association between POSSUM score and actual surgical complications of head and neck reconstruction surgery. In total, 711 patients who underwent head and neck reconstruction after cancer extirpation between January 2007 and January 2015 were studied...
September 7, 2017: Journal of Plastic Surgery and Hand Surgery
https://www.readbyqxmd.com/read/28872500/simple-septocutaneous-free-flap-design-for-one-stage-reconstruction-of-pharyngocutaneous-and-orocutaneous-fistulae
#19
Soo Hyun Woo, Tae Hui Bae, Woo Seob Kim, Han Koo Kim
Reconstruction of pharyngocutaneous fistula (PCF) or orocutaneous fistula is always a challenging task. It has many causes and is especially related to radiation therapy after resection of head and neck cancers. There are many reports of surgical procedures for fistula repair. For example, 2-stage methods, methods of combining multiple flaps, and methods of using chimeric flaps have been reported. However, there is no established simple method as a treatment of choice. The authors describe 5 patients of head and neck fistulas and recommend a useful 1-stage reconstruction method using a double skin paddle free flap...
October 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28796101/use-of-the-ipsilateral-anteromedial-thigh-flap-for-immediate-rescue-of-nonviable-anterolateral-thigh-flaps-in-head-and-neck-cancer-reconstruction
#20
Hsu-Tang Cheng, Jin-Yi Tian, Yung-Chang Hsu, Hsin-Han Chen, Sophia Chia-Ning Chang
BACKGROUND: It is not always possible to use the anatomically variable free anterolateral thigh (ALT) flap for reconstructive surgery. An anteromedial thigh (AMT) flap serves as a good alternative, and shares the same vascular pedicle as the ALT flap. METHODS: Of 698 reconstructions performed in 2006 to 2013 following head and neck tumor ablation surgery, ALT flaps were used in 653 patients. Eighteen free AMT flaps were harvested to replace variant nonviable ALT flaps...
September 2017: Journal of Craniofacial Surgery
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