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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
#1
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
#2
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
#3
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
#4
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
#5
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...
September 1, 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
#6
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
https://www.readbyqxmd.com/read/28755704/it-takes-two-one-resects-one-reconstructs
#7
REVIEW
Shabnam Ghazizadeh, Edward C Kuan, Jon Mallen-St Clair, Elliot Abemayor, Quang Luu, Vishad Nabili, Maie A St John
Care of patients with advanced head and neck cancer is a multidisciplinary effort through all phases of care. Head and neck cancer surgery involves balancing oncologic control, functional preservation, and aesthetics. Given the advances in free tissue reconstruction, the majority of defects can be reconstructed using free tissue transfer flaps. A 2-team approach allows for early, continual communication and meticulous operative planning. Operations can be combined into a single effort. This approach maximizes efficiency and enables multidisciplinary collaboration for comprehensive surgical treatment...
August 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/28746932/morbidity-and-functional-outcomes-following-free-jejunal-flap-reconstruction-for-head-and-neck-cancer
#8
Song Ni, Yiming Zhu, Dong Qu, Jian Wang, Dezhi Li, Bin Zhang, Zhengang Xu, Shaoyan Liu
AIM: To evaluate the morbidity and fundamental functional outcomes (swallow and speech) after free jejunal flap (FJF) reconstruction following total pharyngolaryngo-esophagectomy (PLE) in China. METHODS: 18 patients with FJF reconstruction after total PLE were retrospectively reviewed. Scheduled barium swallow test was performed 7-10 days postoperatively. Rehabilitation of swallowing and speech for patients was assessed by the Performance Status Scale for Head and Neck Cancer Patients...
2017: ORL; Journal for Oto-rhino-laryngology and its related Specialties
https://www.readbyqxmd.com/read/28746288/using-a-second-free-fibula-osteocutaneous-flap-after-repeated-mandibulectomy-is-associated-with-a-low-complication-rate-and-acceptable-functional-outcomes
#9
Alexander F Mericli, Mark V Schaverien, Matthew M Hanasono, Peirong Yu, Rene D Largo, Mark T Villa, Greg Reece, Charles E Butler, Patrick B Garvey
BACKGROUND: A significant percentage of patients who undergo segmental mandibulectomy for head and neck cancer will develop a new or recurrent cancer or osteoradionecrosis, necessitating a second mandibulectomy and reconstruction. In this scenario, many surgeons are reluctant to perform a reconstruction with an osseous flap because of the presumed increased morbidity and complexity. The purpose of this study was to evaluate the safety and efficacy of performing a second free fibula flap reconstruction after repeated segmental mandibulectomy...
August 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28740764/multiple-free-flap-reconstructions-of-head-and-neck-defects-due-to-oral-cancer
#10
Yumi Mochizuki, Hiroyuki Harada, Hiroaki Shimamoto, Hirofumi Tomioka, Hideaki Hirai
OBJECTIVE: We studied complications following multiple free flap reconstructions in the head and neck. METHODS: In this cohort, 26 patients (14 men and 12 women) who underwent multiple microvascular free flap reconstructions were included in the study. The reasons for secondary reconstruction were recurrence of tumor (12 cases), necrosis of transferred skin and/or bone (6 cases), reconstruction plate fracture or exposure (4 cases), and others (4 cases). A third reconstruction in 4 cases and a fourth reconstruction in 1 case were performed...
June 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28736943/risk-factors-for-wound-complications-in-head-and-neck-reconstruction-773-free-jejunal-reconstruction-procedures-after-total-pharyngolaryngoesophagectomy
#11
Narushi Sugiyama, Soshi Takao, Etsuji Suzuki, Yoshihiro Kimata
BACKGROUND: Most studies that examined risk factors for wound complications after head and neck reconstruction analyzed various complications collectively. Moreover, they included a wide variety of resection areas and reconstruction materials. To overcome these limitations, both the resection area and reconstruction method were constrained in the present study. METHODS: Patients who underwent free jejunal graft reconstruction after pharyngolaryngoesophagectomy for hypopharyngeal cancer were enrolled...
October 2017: Head & Neck
https://www.readbyqxmd.com/read/28735639/free-flap-reconstruction-for-patients-aged-85-years-and-over-with-head-and-neck-cancer-clinical-considerations-for-comprehensive-care
#12
X F Chen, Y M Chen, S Gokavarapu, Q C Shen, T Ji
We aimed to identify and evaluate the clinical challenges involved in microvascular flap reconstructions of defects caused by resection of head and neck cancer among patients aged 85 and over. We designed a retrospective study of patients who were treated in the head and neck department of a tertiary referral centre from 2005 to 2015, and all patients aged 85 years and over who had reconstructions with microvascular flaps for head and neck cancer were entered into the study. A total of 24 patients fulfilled the criteria, of whom 15 were men and nine were women...
July 20, 2017: British Journal of Oral & Maxillofacial Surgery
https://www.readbyqxmd.com/read/28731497/the-effect-of-frailty-on-short-term-outcomes-after-head-and-neck-cancer-surgery
#13
Carrie L Nieman, Karen T Pitman, Anthony P Tufaro, David W Eisele, Kevin D Frick, Christine G Gourin
OBJECTIVE: To determine the relationship between frailty and comorbidity, in-hospital mortality, postoperative complications, length of hospital stay (LOS), and costs in head and neck cancer (HNCA) surgery. STUDY DESIGN: Cross-sectional analysis. METHODS: Discharge data from the Nationwide Inpatient Sample for 159,301 patients who underwent ablative surgery for a malignant oral cavity, laryngeal, hypopharyngeal, or oropharyngeal neoplasm in 2001 to 2010 was analyzed using cross-tabulations and multivariate regression modeling...
July 21, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28728327/non-melanocytic-skin-cancers-of-the-head-and-neck-a-clinical-study-in-jeju-province
#14
Jae Kyoung Kang, Byung Min Yun, Jung-Kook Song, Myoung Soo Shin
BACKGROUND: Jeju Island is geographically and socioeconomically distinct from the mainland of South Korea. Thus, the presentation and management of non-melanocytic skin cancers (NMSC) of the head and neck may differ from those in other regions of the country. We compared the clinical characteristics and treatment modalities of NMSC on Jeju Island with the findings of similar regional studies. METHODS: Patient data, including age, sex, diagnosis, tumor site, treatment, and recurrence, were obtained from the medical and pathology records of patients diagnosed with NMSC between January 2010 and June 2015...
July 2017: Archives of Plastic Surgery
https://www.readbyqxmd.com/read/28712070/flow-diverter-in-radiation-induced-skull-base-carotid-blowout-syndrome-do-not-write-it-off
#15
Gopinathan Anil, Junwei Zhang, Yew Kwang Ong, Francis Hui
Post-radiotherapy carotid blowout syndrome (CBS) of the skull base is a rare but often catastrophic complication of head and neck malignancies. The existing literature on the treatment of this condition with flow-diverting devices (FDD) is extremely limited and disappointing. We present a case of impending CBS in a patient previously irradiated for nasopharyngeal cancer that was successfully treated with use of multiple FDDs, adjunctive endonasal packing and delayed reinforcement with pedicled naso-septal flap, yielding an excellent outcome at 14-months follow-up...
July 16, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28709536/margin-analysis-has-free-tissue-transfer-improved-oncologic-outcomes-for-oral-squamous-cell-carcinoma
#16
REVIEW
Sean P Edwards
Microvascular reconstruction of ablative defects has become a mainstay of contemporary management of head and neck cancer patients. These techniques offer myriad tissue options that vary in character, volume, and components and have vastly improved the esthetic and functional outcomes achieved in this patient population. Although consensus exists regarding the reliability and functional and esthetic benefits of free tissue transfer, the same cannot be said for oncologic outcomes. The increase in resources required for the routine use of free tissue transfer has led to asking this question-Do vascularized free flaps allow for increased surgical margins and improvements in oncologic outcomes?...
August 2017: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/28708656/osteoradionecrosis-of-the-zygoma
#17
Zhuo-Jue Liu, Xue-Peng Xiong, Yi-Fang Zhao
Osteoradionecrosis occurs in 4.74% to 37.5% of patients following radiation therapy for head and neck cancer. Osteoradionecrosis mostly happens in the mandible but seldom occurs in other maxillofacial bones. Here, the authors reported a rare case of zygomatic osteoradionecrosis which occurred after maxillectomy and then radiotherapy because of maxillary myoepithelial carcinoma. After resection of zygoma sequestrum, the defect was repaired with forehead flap and healed uneventfully.
September 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28668299/head-neck-reconstruction-predictors-of-readmission
#18
Evan M Graboyes, Joseph Zenga, Brian Nussenbaum
Unplanned hospital readmission following head and neck cancer surgery is common and associated with significant negative consequences. Because of the vital role that microvascular free tissue transfer plays in the management of head and neck oncologic defects, its relationship to unplanned hospital readmission requires attention. In this review, the incidence of, risk factors for, and reasons for unplanned readmission in patients undergoing free flap reconstruction for head and neck cancer are analyzed. The role of free flap reconstruction as a separate risk factor for unplanned readmission in patients with head and neck cancer is described...
June 28, 2017: Oral Oncology
https://www.readbyqxmd.com/read/28581030/postoperative-anticoagulation-after-free-flap-reconstruction-for-head-and-neck-cancer-a-systematic-review
#19
REVIEW
Blair M Barton, Charles A Riley, John C Fitzpatrick, Christian P Hasney, Brian A Moore, Edward D McCoul
OBJECTIVE: Postoperative use of anticoagulation after free tissue transfer in head and neck ablative procedures is common practice, but a clear protocol has not been well established. The outcome measures including total flap failure, thrombosis, and hematoma formation for different anticoagulation regimens in free tissue transfer in the head and neck were reviewed. DATA SOURCES: PubMed, Ovid, and Cochrane databases were examined for patients who underwent free tissue transfer following head and neck ablative procedures...
June 5, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28570441/significance-of-the-lateral-thoracic-artery-in-pectoralis-major-musculocutaneous-flap-reconstruction-quantitative-assessment-of-blood-circulation-using-indocyanine-green-angiography
#20
Hidetaka Miyazaki, Kimihiro Igari, Toshifumi Kudo, Toshinori Iwai, Yoshitaka Wada, Yasuhiro Takahashi, Yoshinori Inoue, Shinichi Asamura
Free tissue transfer is the preferred reconstruction option in most major head and neck reconstructions. The pectoralis major muscle musculocutaneous (PMMC) flap is commonly used in salvage of necrotic free flaps and is the first choice for patients who are not candidates for free flaps. The lateral thoracic artery (LTA), which is thought to contribute to blood perfusion of the inferior and lateral mammary area, is not preserved in a conventionally harvested PMMC flap. With regard to blood supply, it has been suggested that the LTA should be preserved, in addition to the pectoral branch of the thoracoacromial artery, when a skin island is designed in the lower chest to attain a pedicle length sufficient for head and neck reconstruction...
May 31, 2017: Annals of Plastic Surgery
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