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https://www.readbyqxmd.com/read/29335032/-sit-and-tilt-preparation-for-subscapular-system-free-flaps
#1
J Mark, H Patwa, M S Costello, Y Patil
BACKGROUND: The ablation of advanced head and neck cancer often results in large three-dimensional defects that require free tissue transfer to optimally address functional and cosmetic issues. The subscapular system is a highly versatile donor site for flaps used for head and neck reconstruction. Traditional methods of harvesting subscapular flaps require repositioning and re-preparing, which significantly increases the operative time and prevents simultaneous harvesting of the flap...
January 16, 2018: Journal of Laryngology and Otology
https://www.readbyqxmd.com/read/29328540/case-of-late-onset-relapsing-surgical-site-infection-related-to-a-venous-coupler-placed-during-free-flap-reconstruction-for-major-head-and-neck-cancer
#2
Yin Ren, Daniel G Deschler, Dipti Sajed, Marlene L Durand
BACKGROUND: Venous coupling devices are widely used during reconstructive surgery involving microvascular anastomosis but have not served as foreign bodies in head and neck surgical site infections. METHODS: We conducted a case report. RESULTS: A patient underwent resection and free flap reconstruction for recurrent tongue squamous cell carcinoma. She developed a neck abscess due to Streptococcus intermedius 7 weeks postoperatively, days after starting chemoradiotherapy...
January 12, 2018: Head & Neck
https://www.readbyqxmd.com/read/29280859/outcome-analysis-of-free-flap-salvage-in-outpatients-presenting-with-microvascular-compromise
#3
Rene D Largo, Jesse C Selber, Patrick B Garvey, Edward I Chang, Matthew M Hanasono, Peirong Yu, Charles E Butler, Donald P Baumann
BACKGROUND: Extensive flap salvage attempts are routinely performed in patients with late-onset flap vascular crisis despite low flap survival rates. A knowledge gap exists in management of compromised free flaps in patients who present with perfusion-related complications after hospital discharge. METHODS: A retrospective review of 7443 free flaps used in 7128 cancer patients at a single institution from January of 2001 to March of 2015 was performed. RESULTS: Of 7443 free flap reconstructions, 856 patients (12 percent) were taken back to the operating room...
January 2018: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29249263/reconstructive-methods-in-mohs-micrographic-surgery-in-uruguay-a-bidirectional-descriptive-cohort-analysis
#4
J Navarrete, J Magliano, M Martínez, C Bazzano
BACKGROUND AND OBJECTIVES: The primary goal of Mohs micrographic surgery (MMS) is to completely excise a cancerous lesion and a wide range of reconstructive techniques of varying complexity are used to close the resulting wound. In this study, we performed a descriptive analysis of patients who underwent MMS, with a focus on wound closure methods. MATERIAL AND METHODS: We conducted a bidirectional descriptive cohort analysis of all MMS procedures performed by a single surgeon between November 2013 and April 2016...
December 14, 2017: Actas Dermo-sifiliográficas
https://www.readbyqxmd.com/read/29233698/ex-corpore-linguae-a-cohort-analysis-after-a-unique-surgical-technique-in-oral-cancer-resection
#5
Jan-Falco Wilbrand, Daniel Schmermund, Michael Knitschke, Philipp Streckbein, Christopher Kähling, Heiko Kerkmann, Heidrun Schaaf, Hans-Peter Howaldt, Sebastian Böttger
OBJECTIVE: Resection of posteriorly located oral squamous cell carcinomas (OSCCs) remains challenging for head and neck surgeons. However, several surgical techniques, such as lip and mandibular splitting, as well as submental "visor drop-down" of intraoral soft tissues, have been proposed for this purpose. Merrick et al. suggested that a pedicled genial drop-down surgical approach should be used to resect dorsally located OSCCs. Our study investigated patient outcomes following this surgical procedure, as no previous study has analyzed long-term follow-up data...
November 21, 2017: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/29224825/head-and-neck-free-flap-reconstruction-what-is-the-appropriate-post-operative-level-of-care
#6
Varun V Varadarajan, Hassan Arshad, Peter T Dziegielewski
Patients undergoing head and neck reconstruction require complex, multidisciplinary postoperative care which may include wound care, flap monitoring, tracheostomy management, and management of comorbid conditions. Historically, patients undergoing major resection of a head and neck or aerodigestive tract malignancy with regional or free flap reconstruction were routinely admitted to the ICU. Although head and neck cancer patients may have multiple medical comorbidities that may require postoperative critical care, the current trend in many institutions is to transfer stable and less medically complex patients to non-intensive care-level units with specialty trained nursing staff...
December 2017: Oral Oncology
https://www.readbyqxmd.com/read/29218279/non-metastatic-non-melanoma-skin-cancers-our-3-years-of-clinical-experiences
#7
Elif Sari
BACKGROUND: Nonmelanoma skin cancers (NMSC) constitute the largest group of skin cancers. In this study, NMSCs were analyzed retrospectively. METHODS: Between June 2013 and March 2017, demographics and comorbidities of patients underwent reconstructive surgery for NMSC; their risk factors, types, diameters, differentiation, localizations, follow-up times, treatment methods and complications were compared and statistically analyzed. RESULTS: Totally, 163 tumors [111 basal cell carcinoma and 52 cutaneous squamous cell carcinoma (cSCC)] were excized from 148 patients (63 females, 85 males)...
September 2017: World Journal of Plastic Surgery
https://www.readbyqxmd.com/read/29178168/core-information-set-for-informed-consent-to-surgery-for-oral-or-oropharyngeal-cancer-a-mixed-methods-study
#8
B G Main, A G K McNair, S Haworth, L Rooshenas, C W Hughes, P Tierney, J L Donovan, S J Thomas, J M Blazeby
OBJECTIVES: To develop a core information set for informed consent to surgery for oral/oropharyngeal surgery. A core information set is baseline information rated important by patients and surgeons, and is intended to improve patients' understanding of the intended procedure. DESIGN: A mixed methods study. Systematic reviews of scientific and written healthcare literature, qualitative interviews and observations, Delphi surveys, and group consensus meetings identified information domains of importance for consent...
November 27, 2017: Clinical Otolaryngology
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
#9
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
#10
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
#11
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
#12
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...
December 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
#13
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
#14
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
#15
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...
November 2017: Archives of Plastic Surgery
https://www.readbyqxmd.com/read/29032418/transoral-robotic-surgery-for-squamous-cell-carcinomas-of-the-posterior-pharyngeal-wall
#16
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
#17
Y-H Joo, K-J Cho, J-O Park, S-Y Kim, M-S 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: This 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
#18
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
#19
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...
November 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
#20
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...
December 2017: Head & Neck
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