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Head and neck complications

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https://www.readbyqxmd.com/read/28449296/frailty-index-intensive-care-unit-complications-in-head-and-neck-oncologic-regional-and-free-flap-reconstruction
#1
Nicholas B Abt, Yanjun Xie, Sidharth V Puram, Jeremy D Richmon, Mark A Varvares
BACKGROUND: Head and neck extirpations requiring reconstruction are challenging surgeries with high postoperative complication risk. METHODS: Regional and free flap reconstructions of head and neck defects were collected from the 2006-2013 American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database. The modified frailty index was made of 15 variables, with increasing index scores indicative of frailer patients. Intensive care unit (ICU)-level complications were defined by Clavien-Dindo classification IV and analyzed with multivariable logistic regression...
April 27, 2017: Head & Neck
https://www.readbyqxmd.com/read/28448668/prognostic-indication-of-sarcopenia-for-wound-complication-after-total-laryngectomy
#2
Virginie Achim, Jasper Bash, Alia Mowery, Alexander R Guimaraes, Ryan Li, Josh Schindler, Mark Wax, Peter Andersen, Daniel Clayburgh
Importance: Postoperative wound complications after total laryngectomy (TL) increase hospital stay, costs, and delay adjuvant therapy when indicated. Recently, sarcopenia has been identified as a predictor of postoperative complications in patients undergoing major surgery but has not been assessed in head and neck surgery patients. Objective: To determine the incidence of sarcopenia in patients with squamous cell carcinoma (SCC) undergoing TL and evaluate its association with the development of postoperative wound complications...
April 27, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28448262/an-unusually-large-carbuncle-of-the-temporofacial-region-demonstrating-remarkable-post-debridement-wound-healing-process-a-case-report
#3
Humaid Ahmad, Sheeraz Shakoor Siddiqui
Skin carbuncles are debilitating skin infections commonly seen in elderly patients with diabetes. These infections develop when a cluster of adjacent furuncles coalesce to form one inflammatory mass. While they commonly occur on the nape of the neck and back, rarer sites involving the face and head have been noted. Management of these rare sites is urgent because of the potential intracranial complications and the surgical outcome is often unsatisfactory due to associated facial scarring. Intraoral drainage is advocated to avoid this; however, when the carbuncle involves a larger area, debridement from the exterior is necessary...
April 2017: Wounds: a Compendium of Clinical Research and Practice
https://www.readbyqxmd.com/read/28443189/intraoperative-dislocation-of-the-trial-bipolar-cup-into-the-pelvis-during-bipolar-hip-arthroplasty-a-case-report
#4
Takahito Miyake, Akio Kanda, Itaru Morohashi, Osamu Obayashi, Atsuhiko Mogami, Kazuo Kaneko
INTRODUCTION: Bipolar hip arthroplasty is a good option for treating femoral neck fractures, although some contraindications have been indicated. We report a case of intraoperative dislocation of the trial bipolar cup into the pelvis during bipolar hip arthroplasty. CASE PRESENTATION: A 74-year-old woman underwent bipolar hip arthroplasty for a femoral neck fracture (AO31-B2). She was placed in a lateral decubitus position, and a direct lateral approach was used...
June 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28441705/oral-complications-of-the-oromaxillofacial-area-radiotherapy
#5
Hakimeh Ahadian, Soghra Yassaei, Fathollah Bouzarjomehri, Mehrdad Ghaffari Targhi, Khatereh Kheirollahi
Background: The incidence of malignancies is on the rise in different communities, making them the second most important cause of mortality in developed countries. One of the treatment modalities for these malignancies, apart from surgery and chemotherapy, is radiotherapy which might in itself lead to some complications in the area receiving radiation. The present study was undertaken to evaluate the prevalence of oral complications in patients undergoing radiotherapy of the oromaxillofacial area in Shahid Ramazanzadeh Radiotherapy Center in Shahid Sadoughi University of Medical Sciences...
March 1, 2017: Asian Pacific Journal of Cancer Prevention: APJCP
https://www.readbyqxmd.com/read/28438396/the-versatile-use-of-revisited-de-epithelialization-concept-in-superficial-circumflex-iliac-and-anterolateral-thigh-perforator-free-flap-for-head-and-neck-reconstructions
#6
Jong Woo Choi, Young Chul Kim, Tae Suk Oh, Kyung S Koh, Woo Shik Jeong
BACKGROUND: Although the perforator free flap is now a standard choice for head and neck reconstruction, problems such as microvascular complications, insufficient volume support for the defect, and fistula formation occur. We revisited a de-epithelialized concept for superficial circumflex iliac artery and anterolateral thigh perforator free flap to overcome these problems. METHODS: We applied the de-epithelized perforator free flaps in 35 cases among 761 microsurgical head and neck reconstructions and investigated flap characteristics (length gain of pedicle, flap size, and volumetric analysis) and outcomes (flap failure, partial flap necrosis, hematoma, infection, and fistula)...
February 20, 2017: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/28437811/symptomatic-outcome-after-bone-only-suboccipital-decompression-in-adult-patients-with-chiari-type-i-malformations-in-the-absence-of-hydromyelia-or-hydrocephalus
#7
Nicolas Olmo Koechlin, Hazem J Abuhusain, Manuri Gunawardena, Tyler S Auschwitz, Charles Teo
Background Type I Chiari malformation presents without an associated hydromyelia in 30 to 70% of cases, yet there is no agreement regarding the optimal surgical treatment for these patients. We review our experience for treating symptomatic adult type I Chiari malformation without hydromyelia using a suboccipital bone decompression of the hindbrain and no duraplasty in 12 adult patients. Outcome was measured according to the Chicago Chiari Outcome Scale (CCOS). Results Nine of 12 patients were female; average age at surgery was 34...
April 24, 2017: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/28437267/reconstruction-of-pediatric-scalp-avulsion-injuries-after-dog-bites
#8
Zhi Yang Ng, Kyle R Eberlin, Tianyu Lin, Peter T Masiakos, Curtis L Cetrulo
Dog bite injuries are common and the head and neck is most frequently involved in pediatric patients. In severe cases, the combination of crushing, tearing, and puncturing can result in scalp avulsion. Currently, microsurgical replantation of the avulsed scalp remains the gold standard but may not always be possible. The authors present their treatment algorithm with 2 patient examples. In Patient 1, the scalp was deemed unsuitable for replantation due to extensive soft tissue injury; in Patient 2, the scalp was not available on presentation...
April 21, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28433204/-post-operative-visual-loss-after-cervical-laminectomy-in-prone-position
#9
Kumar Naren Chandra, Meghraj Kundan
Postoperative visual loss is a rare and devastating complication. The estimated incidence is 0.01-1% after non ocular surgery. It has been reported after spine, cardiac and head and neck surgeries. We report a patient who was operated for cervical laminectomy in prone position and complained of loss of vision in one eye postoperatively. He was thoroughly investigated after visual loss. The case was diagnosed as central retinal artery occlusion (CRAO) of the left eye. Here we consider the potential etiological factors causing this unilateral loss of vision and try to suggest strategies to reduce the incidence of the complication in spinal surgery...
April 19, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28431804/prognostic-value-of-dynamic-mri-positive-enhancement-integral-color-mapping-in-osteosynthesis-of-undisplaced-femoral-neck-fractures
#10
Masatoshi Morimoto, Yoshinori Takahashi, Takahiro Kubo, Kosuke Sugiura, Yasuaki Tamaki, Shunichi Toki, Katsuyoshi Suganuma, Kazumasa Inoue, Keisuke Adachi, Takashi Chikawa, Koichi Sairyo, Akihiro Nagamachi
AIMS: The common treatment for an undisplaced femoral neck fracture is osteosynthesis. Two major complications of osteosynthesis are non-union and late collapse of the femoral head. We speculated that femoral head perfusion is one of the most important factors that affect the outcome of osteosynthesis after femoral neck fracture. We have preoperatively estimated femoral head perfusion by dynamic MRI positive enhancement integral color mapping (PEICM). The purpose of this study was to evaluate the outcomes of undisplaced femoral neck fractures based on PEICM...
April 18, 2017: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/28430990/three-dimensional-dose-prediction-and-validation-with-the-radiobiological-gamma-index-based-on-a-relative-seriality-model-for-head-and-neck-imrt
#11
Noriaki Hamatani, Iori Sumida, Yutaka Takahashi, Michio Oda, Yuji Seo, Fumiaki Isohashi, Keisuke Tamari, Kazuhiko Ogawa
This study proposes a quality assurance (QA) method incorporating radiobiological factors based on the QUANTEC-determined tumor control probability and the normal tissue complication probability (NTCP) of head-and-neck intensity-modulated radiation therapy (HN-IMRT). Per-beam measurements were conducted for 20 cases using a 2D detector array. Three-dimensional predicted dose distributions within targets and organs at risk were reconstructed based on the per-beam QA results derived from differences between planned and measured doses...
April 19, 2017: Journal of Radiation Research
https://www.readbyqxmd.com/read/28423034/elevated-frequencies-of-cd8-t-cells-expressing-pd-1-ctla-4-and-tim-3-within-tumour-from-perineural-squamous-cell-carcinoma-patients
#12
Richard Linedale, Campbell Schmidt, Brigid T King, Annabelle G Ganko, Fiona Simpson, Benedict J Panizza, Graham R Leggatt
Perineural spread of tumour cells along cranial nerves is a severe complication of primary cutaneous squamous cell carcinomas of the head and neck region. While surgical excision of the tumour is the treatment of choice, removal of all the tumour is often complicated by the neural location and recurrence is frequent. Non-invasive immune treatments such as checkpoint inhibitor blockade may be useful in this set of tumours although little is understood about the immune response to perineural spread of squamous cell carcinomas...
2017: PloS One
https://www.readbyqxmd.com/read/28417663/is-neck-dissection-associated-with-an-increased-risk-of-postoperative-stroke
#13
John D Cramer, Urjeet A Patel, Matthew B Maas, Sandeep Samant, Stephanie Shintani Smith
Objective Prior studies have reported widely disparate rates of postoperative stroke, with conflicting analyses of whether neck dissection is an independent risk factor. Study Design Cohort study. Setting American College of Surgeons National Surgical Quality Improvement Program from 2005 to 2013. Subjects and Methods We compared the 30-day rate of postoperative stroke between patients undergoing complete or modified radical neck dissection and a control cohort composed of those undergoing resections in the oral cavity, oropharynx, larynx, or hypopharynx without neck dissection...
April 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28416826/-surgical-technique-and-early-clinical-outcomes-of-direct-anterior-approach-to-total-hip-arthroplasty
#14
M Lv, J Q Zhang, X S Wang, Y Huang, W Li, C Y Zhang
OBJECTIVE: To describe the surgical technique of direct anterior approach to total hip arthroplasty and to report the early clinical outcomes. METHODS: A series of 100 consecutive, unselected patients who had 116 primary total hip arthroplasty surgeries (16 bilateral) done through direct anterior approach from March 11 2015 to June 21 2016 was reviewed. There were 50 male patients and 50 female patients. The average patient age was 51 years, and the average body mass index was 24...
April 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/28415025/unusual-combination-of-femoral-head-dislocation-associated-acetabular-fracture-with-multipart-femoral-fractures-case-report
#15
Erdal Uzun, Ali Eray Günay, İbrahim Karaman, Abdülhamit Mısır, Turan Bilge Kızkapan, Mustafa Özçamdallı
INTRODUCTION: Traumatic hip dislocation associated with femur intertrocanteric fracture is a rare and severe injury and it frequently occurs following a high energy trauma, Associated acetabular fractures with this injury are even more rare and potentially cause devastating consequences including avascular necrosis of the femoral head and subsequent early secondary osteoarthritis of the hip joint. PRESENTATION OF CASE: In this case report, we present a 20year old polytraumatized patient with traumatic hip dislocation associated with ipsilateral acetabulum fracture and simultaneous fractures of the ipsilateral femur...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28412985/active-surveillance-management-of-head-and-neck-paragangliomas-case-series-and-review-of-the-literature
#16
L Harrison, R Corbridge
BACKGROUND: Head and neck paragangliomas are rare. They are usually slow-growing, benign, non-catecholamine secreting tumours, traditionally treated with surgical excision. Complications of surgical excision include lower cranial nerve palsies, stroke and death. METHOD: A retrospective case note analysis was conducted of patients with head and neck paragangliomas treated with a watch-and-scan policy from March 2003 to September 2015, and the relevant literature was reviewed...
April 17, 2017: Journal of Laryngology and Otology
https://www.readbyqxmd.com/read/28412686/analysis-of-application-of-docetaxel-combined-therapy-scheme-in-treating-advanced-head-and-neck-neoplasm
#17
Lei Nie, Yizhi Liu
Docetaxel is a semi-synthetic taxoid anti-cancer drug, which can basically freeze intracellular skeleton that is composed of microtubules, so as to inhibit cell division. Under normal condition, Docetaxel can make microtubule in a cell cycle follow the rule of first polymerization and then depolymerization. Moreover, docetaxel can further promote the microtubule polymerization while inhibiting cell depolymerization, so as to prevent cells division, lead to cancer cells death, and improve the therapeutic efficiency of tumor and cancer...
November 2016: Pakistan Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/28411387/prophylactic-dissection-of-level-v-in-primary-mucosal-scc-in-the-clinically-n-positive-neck-a-systematic-review
#18
REVIEW
Timothy McLean, Stephen J Kerr, Charles E B Giddings
OBJECTIVE: To review the evidence for level V dissection in the management of previously untreated mucosal squamous cell carcinoma (SCC) of the head and neck presenting with nodal metastasis when level V is clinically uninvolved. DATA SOURCE: The Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) were used to conduct a systematic review of the current literature, including all English language articles published after 1990. A literature search was performed on November 29, 2015, of Medline, EMBASE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and the Cochrane Library...
April 14, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28409743/pet-neck-a-multicentre-randomised-phase-iii-non-inferiority-trial-comparing-a-positron-emission-tomography-computerised-tomography-guided-watch-and-wait-policy-with-planned-neck-dissection-in-the-management-of-locally-advanced-n2-n3-nodal-metastases-in-patients
#19
Hisham Mehanna, Chris C McConkey, Joy K Rahman, Wai-Lup Wong, Alison F Smith, Chris Nutting, Andrew Gj Hartley, Peter Hall, Claire Hulme, Dharmesh K Patel, Sandra Ventorin von Zeidler, Max Robinson, Bal Sanghera, Lydia Fresco, Janet A Dunn
BACKGROUND: Planned neck dissection (ND) after radical chemoradiotherapy (CRT) for locally advanced nodal metastases in patients with head and neck squamous cell carcinoma (HNSCC) remains controversial. Thirty per cent of ND specimens show histological evidence of tumour. Consequently, a significant proportion of clinicians still practise planned ND. Fludeoxyglucose positron emission tomography (PET)-computerised tomography (CT) scanning demonstrated high negative predictive values for persistent nodal disease, providing a possible alternative paradigm to ND...
April 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28409615/peritonsillar-abscess
#20
Nicholas J Galioto
Peritonsillar abscess is the most common deep infection of the head and neck, occurring primarily in young adults. Diagnosis is usually made on the basis of clinical presentation and examination. Symptoms and findings generally include fever, sore throat, dysphagia, trismus, and a "hot potato" voice. Drainage of the abscess, antibiotic therapy, and supportive therapy for maintaining hydration and pain control are the cornerstones of treatment. Most patients can be managed in the outpatient setting. Peritonsillar abscesses are polymicrobial infections, and antibiotics effective against group A streptococcus and oral anaerobes should be first-line therapy...
April 15, 2017: American Family Physician
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