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https://www.readbyqxmd.com/read/27898195/cost-effectiveness-of-microsurgical-reconstruction-for-head-and-neck-defects-after-oncologic-resection
#1
Lin Lin Gao, Marten Basta, Suhail K Kanchwala, Joseph M Serletti, David W Low, Liza C Wu
BACKGROUND: Microvascular free tissue transfer has become the main technique used for head and neck reconstruction. We assessed the cost-effectiveness of free flap reconstruction for head and neck defects after oncologic resection for squamous cell carcinoma (SCC). METHODS: We developed a Markov model of the cost, quality of life, survival, and incremental cost-effectiveness of reconstruction with free tissue transfer compared with locoregional flaps. Health state probabilities and quality of life scores were determined from literature...
November 29, 2016: Head & Neck
https://www.readbyqxmd.com/read/27880030/osseointegrated-implants-into-a-variety-of-composite-free-flaps-a-comparative-analysis
#2
Michael Burgess, Matthew Leung, Anthony Chellapah, Jonathan R Clark, Martin D Batstone
BACKGROUND: Significant oral function is often lost after surgical therapy for head and neck cancer. The use of osseointegrated implants for reconstruction in patients with head and neck surgery has shown to significantly improve the quality of life for these patients. Variable success rates range from 99% to 70%. METHODS: A retrospective audit of patient records was performed looking at cumulative survival of implants. Inclusion criteria were patients who were treated at 1 of 2 designated Australian Head and Neck Units and received oral osseointegrated implants...
November 23, 2016: Head & Neck
https://www.readbyqxmd.com/read/27879602/health-related-quality-of-life-following-reconstruction-for-common-head-and-neck-surgical-defects
#3
Wess A Cohen, Claudia R Albornoz, Peter G Cordeiro, Jennifer Cracchiolo, Elizabeth Encarnacion, Meghan Lee, Michele Cavalli, Snehal Patel, Andrea L Pusic, Evan Matros
BACKGROUND: Improved understanding and management of health-related quality of life represents one of the greatest unmet needs for patients with head and neck malignancies. The purpose of this study was to prospectively measure health-related quality of life associated with different anatomical (head and neck) surgical resections. METHODS: A prospective analysis of health-related quality of life was performed in patients undergoing surgical resection with flap reconstruction for stage II or III head and neck malignancies...
December 2016: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/27872534/use-of-combined-pmmc-and-nasolabial-flap-for-reconstruction-of-full-thickness-cheek-defect-involving-lip-commisure
#4
Mahendra I Katre, Sunil Deshmukh, Pramod Dhanajkar
Head neck cancer constitute significant cancer burden and among it carcinoma of oral cavity involving buccal mucosa is most common entity in India. Very often it involves lip commisure. Radical surgery along with radiotherapy still remains treatment of choice. Reconstruction of composite defect of oral cavity fallowing ablative surgery remains difficult task. Reconstruction of lip commisure defect after primary tumor excision is still a big challenge. Micro vascular technique primary repair is main modality of treatment which needs great surgical expertise in plastic surgery which is not possible in every institution...
December 2016: Indian Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27862538/free-thyroid-transfer-short-term-results-of-a-novel-procedure-to-prevent-post-radiation-hypothyroidism
#5
Jeffrey Harris, Brittany Barber, Hani Almarzouki, Rufus Scrimger, Jacques Romney, Daniel O'Connell, Mark Urken, Hadi Seikaly
BACKGROUND: The incidence of radiation-induced hypothyroidism (RIH) in patients with head and neck cancer is >50%. The purpose of this study was to assess the long-term efficacy of free thyroid transfer (FTT) for prevention of RIH in patients with head and neck cancer. METHODS: Hemithyroid dissection was completed in 10 patients with advanced head and neck cancer undergoing ablation, radial forearm free flap (RFFF) reconstruction, and postoperative radiotherapy (RT)...
November 15, 2016: Head & Neck
https://www.readbyqxmd.com/read/27861470/-mandibular-osteoradionecrosis-orn-as-a-side-effect-of-head-and-neck-cancer-treatment-factors-that-induce-it
#6
José Francisco Gallegos-Hernández, Alejandro Reyes-Vivanco, Héctor Arias-Ceballos, Gerardo Gabriel Minauro-Muñoz, Alma Lilia Ortiz-Maldonado, Daniel Israel García-Ruiz, Martín Hernández-Sanjuán
INTRODUCTION: Osteoradionecrosis of the mandible is a relatively common complication in patients with head and neck cancer undergoing radiotherapy or concomitant chemoradiotherapy, characterized by exposure of the mandibular bone either in the mouth or in the facial skin, with no improvement with conservative treatment for six months. The risk factors are radiotherapy in head and neck region, lack of dental prophylaxis before treatment and dental extraction. MATERIAL AND METHODS: Retrospective observational study analyzing incidence and etiologic factors of osteoradionecrosis in 250 patients undergoing radiotherapy or combined treatment of cervicofacial area between 2002 and 2010...
November 2016: Gaceta Médica de México
https://www.readbyqxmd.com/read/27773516/development-of-a-nomogram-for-predicting-the-probability-of-postoperative-delirium-in-patients-undergoing-free-flap-reconstruction-for-head-and-neck-cancer
#7
N Y Choi, E H Kim, C H Baek, I Sohn, S Yeon, M K Chung
PURPOSE: To develop nomogram for prediction of postoperative delirium (POD) in patients undergoing ablative and reconstruction surgery for head and neck cancer. METHODS: Total 341 patients were retrospectively analyzed, and clinical variables in preoperative, intraoperative and postoperative periods were compared between delirium group (n = 89) and non-delirium group (n = 252). Multivariate logistic regression, receiver operating characteristics curve, and area under the curve (AUC) were used to generate and test a nomogram, which performance was evaluated by 10-fold cross validation (CV) procedure...
October 14, 2016: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27765549/factors-influencing-postoperative-complications-in-reconstructive-microsurgery-for-head-and-neck-cancer
#8
Shih-Lun Lo, Yu-Hsiu Yen, Pi-Jung Lee, Charles Chih-Ho Liu, Chi-Ming Pu
PURPOSE: The present study aimed to analyze multiple variables and to determine the factors influencing postoperative complications in reconstructive microsurgeries for head and neck cancer. MATERIALS AND METHODS: This was a retrospective review of the medical records of patients with head and neck cancer who underwent free flap reconstruction after ablation surgery at the Cathay General Hospital (Taipei, Taiwan) from January 2010 to December 2014. Clinical and surgical procedure-related factors were retrieved from a database and analyzed...
September 23, 2016: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/27759740/goal-directed-fluid-management-in-free-flap-surgery-for-cancer-of-the-head-and-neck
#9
Sanna L Lahtinen, Janne H Liisanantti, Meri M Poukkanen, Päivi A Laurila
BACKGROUND: Goal-directed fluid management using stroke volume variation (SVV) analysis is not well studied in free flap reconstruction surgery in patients with head and neck cancer. METHODS: Patients operated due to cancer of the head and neck with free flap reconstruction during 2008-2010 and 2012-2014 in Oulu University Hospital were retrospectively evaluated to determine the impact of SVV-guided fluid management on perioperative fluid balance, postoperative complications and hospital length of stay (LOS)...
October 19, 2016: Minerva Anestesiologica
https://www.readbyqxmd.com/read/27756320/a-case-of-peritoneal-metastasis-during-treatment-for-hypopharyngeal-squamous-cell-carcinoma
#10
Takahiro Wakasaki, Hirofumi Omori, Shintaro Sueyoshi, Fumihide Rikimaru, Satoshi Toh, Kenichi Taguchi, Yuichiro Higaki, Masaru Morita, Muneyuki Masuda
BACKGROUND: Advanced head and neck squamous cell carcinomas frequently develop distant metastases to limited organs, including the lungs, bone, mediastinal lymph nodes, brain, and liver. Peritoneal carcinomatosis as an initial distant metastasis from hypopharyngeal squamous cell carcinoma is quite rare. CASE PRESENTATION: A 75-year-old man diagnosed with hypopharyngeal squamous cell carcinoma and his clinical stage was determined as T2N2cM0. Notably, the right retropharyngeal lymph node surrounded more than half of the right internal carotid artery...
October 18, 2016: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27737447/optimal-perioperative-care-in-major-head-and-neck-cancer-surgery-with-free-flap-reconstruction-a-consensus-review-and-recommendations-from-the-enhanced-recovery-after-surgery-society
#11
Joseph C Dort, D Gregory Farwell, Merran Findlay, Gerhard F Huber, Paul Kerr, Melissa A Shea-Budgell, Christian Simon, Jeffrey Uppington, David Zygun, Olle Ljungqvist, Jeffrey Harris
Importance: Head and neck cancers often require complex, labor-intensive surgeries, especially when free flap reconstruction is required. Enhanced recovery is important in this patient population but evidence-based protocols on perioperative care for this population are lacking. Objective: To provide a consensus-based protocol for optimal perioperative care of patients undergoing head and neck cancer surgery with free flap reconstruction. Evidence Review: Following endorsement by the Enhanced Recovery After Surgery (ERAS) Society to develop this protocol, a systematic review was conducted for each topic...
October 13, 2016: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/27717818/craniofacial-resection-and-reconstruction-in-patients-with-recurrent-cancer-involving-the-craniomaxillofacial-region
#12
Wei-Liang Chen, Zhao-Hui Yang, Zhi-Quan Huang, Song Fan, Da-Ming Zhang, You-Yuan Wang
PURPOSE: Head and neck tumors that involve the craniomaxillofacial region are classified as stage IVb disease and are clinically challenging. In this study, the outcomes of craniofacial resection and craniofacial reconstruction in patients with recurrent malignant tumors involving the craniomaxillofacial region were evaluated. PATIENTS AND METHODS: This retrospective observational study was conducted from January 2008 to August 2015. Data collected for each patient included age, gender, tumor site, initial treatment, craniofacial resection, reconstruction flaps and complications after craniofacial resection, adjuvant treatment, and reported outcomes of craniofacial resection and craniofacial reconstruction...
September 13, 2016: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/27693270/selection-of-recipient-vessels-for-free-flap-following-intra-arterial-chemoradiotherapy
#13
Keishi Kohyama, Ikuo Hyodo, Yasuhisa Hasegawa, Nobukazu Fuwa, Hisakazu Kato
OBJECTIVE: This study aims at selecting recipient vessels for free flap following intra-arterial chemoradiotherapy. At present, many centers combine intra-arterial chemotherapy and concomitant radiotherapy for treating head and neck cancer with favorable results. However, some patients develop recurrent, residual disease/complications after completing treatment protocols and thus require free-flap surgery. The feasibility of microsurgery following intra-arterial chemoradiotherapy remains unclear...
September 8, 2016: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/27648084/neither-high-dose-nor-low-dose-brachytherapy-increases-flap-morbidity-in-salvage-treatment-of-recurrent-head-and-neck-cancer
#14
Peter W Henderson, David I Kutler, Bhupesh Parashar, David M Otterburn, Marc A Cohen, Jason A Spector
PURPOSE: While brachytherapy is often used concurrently with flap reconstruction following surgical ablation for head and neck cancer, it remains unclear whether it increases morbidity in the particularly high risk subset of patients undergoing salvage treatment for recurrent head and neck cancer (RH&NC). MATERIAL AND METHODS: A retrospective chart review was undertaken that evaluated patients with RH&NC who underwent flap coverage after surgical re-resection and concomitant brachytherapy...
August 2016: Journal of Contemporary Brachytherapy
https://www.readbyqxmd.com/read/27639411/minimally-invasive-neck-dissection-and-free-flap-reconstruction-in-patients-with-cancer-of-the-head-and-neck
#15
D W K Hsu, A Sayan, P Ramchandani, V Ilankovan
We describe our experience of cervical lymphadenectomy with microvascular anastomoses involving levels I to V through a minimally-invasive neck dissection. We retrospectively studied 12 patients who had levels I to IV neck dissection with free flap reconstruction between July 2013 and April 2015 at Poole Hospital (male:female ratio 8:4, mean (range) age 66 (49 - 83) years). The mean (range) operating time was 7 (5 - 8) hours, and the total volume drained from the neck was 105 (60-300) ml. The mean (range) number of harvested lymph nodes was 26 (13-39) from levels I to III, and 33 (20-42) from levels I to IV...
September 14, 2016: British Journal of Oral & Maxillofacial Surgery
https://www.readbyqxmd.com/read/27610262/squamous-cell-cancer-arising-in-an-african-american-male-cheek-from-discoid-lupus-a-rare-case-and-review-of-the-literature
#16
Emanuel A Shapera, Paul D Kim
A 50-year-old African American male with Discoid Lupus Erythematosus (DLE) presented to the dermatology clinic for a rapidly enlarging left cheek mass. The mass failed to resolve with conservative measures. A biopsy revealed poorly differentiated Squamous Cell Carcinoma (SCC). He was referred to Head and Neck Surgery and successfully underwent a resection with free flap reconstruction. Postoperatively he did well. Squamous cell skin carcinomas arising from lesions of Discoid Lupus are rare and aggressive tumors with greater likelihood of metastases...
2016: Case Reports in Surgery
https://www.readbyqxmd.com/read/27601398/trismus-secondary-release-surgery-and-microsurgical-free-flap-reconstruction-after-surgical-treatment-of-head-and-neck-cancer
#17
REVIEW
Yang-Ming Chang, Nidal Farhan Al Deek, Fu-Chan Wei
This article addresses trismus following head and neck cancer ablation and free flap reconstruction whether or not radiotherapy has been utilized. The focus is to achieve durable and favorable outcomes and avoid untoward results. To aid surgeons in fulfilling these goals, key factors, including adequate release surgery, optimal free flap selection and reconstruction, long-lasting results, and the untoward outcomes specific to trismus release and reconstruction surgery and how to avoid them have been investigated and discussed based on the authors' experience in this surgery...
October 2016: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/27601394/liverpool-opinion-on-unfavorable-results-in-microsurgical-head-and-neck-reconstruction-lessons-learned
#18
REVIEW
James Brown, Andrew Schache, Chris Butterworth
This article annotates a philosophy toward achieving best results for the patient with head and neck cancer, in particular relating to oral, mandibular, and maxillary resection. At the same time are highlighted the pitfalls that, if not avoided, are likely to result in a poor outcome even with a successful flap transfer. There is a paucity of evidence to support clinical practice in head and neck reconstruction such that much of the discussion presented is opinion-based rather than evidence-based.
October 2016: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/27601393/henri-mondor-experience-with-microsurgical-head-and-neck-reconstruction-failure
#19
REVIEW
Romain Bosc, Jean-Paul Meningaud
Maxillofacial reconstruction surgery largely relies on the use of microsurgical free transfer techniques. Head and neck cancer surgery and ballistic injuries may lead to significant losses of multitissular substances. Even when the free transfer is successful and the microvascular critical phase is resolved, some functions or anatomic structures may not have been properly restored or have worsened. Any plastic surgery technique may be used to improve an unfavorable functional or aesthetic result after free flap reconstruction...
October 2016: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/27601390/management-of-unfavorable-outcomes-in-head-and-neck-free-flap-reconstruction-experience-based-lessons-from-the-md-anderson-cancer-center
#20
REVIEW
Edward I Chang, Matthew M Hanasono, Charles E Butler
Complex head and neck reconstruction often mandates free tissue transfer to achieve the most optimal outcomes. Unfortunately, such challenging cases are not without risks of complications, the most dreaded of which is loss of the free flap. Aside from loss of the free flap, there are several other potential complications that can result following head and neck reconstruction. Certain complications are avoided with careful planning, others require significant revisions and in certain cases another free flap...
October 2016: Clinics in Plastic Surgery
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