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Head and neck complications

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https://www.readbyqxmd.com/read/28092922/the-effectiveness-of-free-vascularized-fibular-flaps-in-osteonecrosis-of-the-femoral-head-and-neck-a-systematic-review
#1
Cassandra A Ligh, Jonas A Nelson, John P Fischer, Stephen J Kovach, L Scott Levin
Background Free vascularized fibular flaps (FVFFs) are accepted surgical options to treat osteonecrosis of the femoral head and neck (ONFHN) to prevent conversion to total hip replacement (THR), yet many studies are single institution cohorts, with little generalizability. Purpose The purpose of this study was to perform a systematic review examining the comparative effectiveness of FVFF to treat ONFHN, particularly preventing conversion to a THR and improving hip function/symptoms. Methods We searched PubMed and EMBASE databases using femoral head, free fibula, and femoral neck keywords...
January 16, 2017: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/28077503/european-association-for-cardio-thoracic-surgery-expert-consensus-statement-on-the-prevention-and-management-of-mediastinitis
#2
Yasir Abu-Omar, Gregor J Kocher, Paolo Bosco, Cristina Barbero, David Waller, Tomas Gudbjartsson, Miguel Sousa-Uva, Peter B Licht, Joel Dunning, Ralph A Schmid, Giuseppe Cardillo
Mediastinitis continues to be an important and life-threatening complication after median sternotomy despite advances in prevention and treatment strategies, with an incidence of 0.25-5%. It can also occur as extension of infection from adjacent structures such as the oesophagus, airways and lungs, or as descending necrotizing infection from the head and neck. In addition, there is a chronic form of 'chronic fibrosing mediastinitis' usually caused by granulomatous infections. In this expert consensus, the evidence for strategies for treatment and prevention of mediatinitis is reviewed in detail aiming at reducing the incidence and optimizing the management of this serious condition...
January 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28076460/the-accuracy-of-fine-needle-aspiration-cytology-for-diagnosis-of-parotid-gland-masses-a-clinicopathological-study-of-114-patients
#3
Jens Kristjan Gudmundsson, Aida Ajan, Jahan Abtahi
Objective: Fine-needle aspiration cytology is a valuable method for preoperative assessment of head and neck tumors. However, its accuracy in detection of salivary gland masses is controversial compared with other methods. The aim of this work was to evaluate the effectiveness and accuracy of fine-needle aspiration cytology (FNAC) in the diagnosis of parotid gland masses. Material and Methods: Over a 10-year period, 126 parotid gland masses were resected. Retrospective chart reviews of 114 patients were performed...
November 2016: Journal of Applied Oral Science: Revista FOB
https://www.readbyqxmd.com/read/28067967/feasibility-of-using-the-retroauricular-approach-without-endoscopic-or-robotic-assistance-for-excision-of-benign-neck-masses
#4
Dongbin Ahn, Jin Ho Sohn, Gil Joon Lee, Ki Ha Hwang
BACKGROUND: The purpose of this study was to present our evaluation of the feasibility of using a retroauricular approach for excision of benign upper neck mass lesions without assistance of an endoscopic or robotic system. METHODS: We enrolled 23 patients with benign neck mass lesions of the parotid gland, submandibular gland, and the level II/III region who underwent surgery via a retroauricular approach. RESULTS: In 22 of 23 patients (95...
January 9, 2017: Head & Neck
https://www.readbyqxmd.com/read/28066744/arthroscopic-release-of-iliopsoas-tendon-in-patients-with-femoro-acetabular-impingement-clinical-results-at-mid-term-follow-up
#5
Rodrigo Mardones, Alessio Giai Via, Alexander Tomic, Claudio Rodriguez, Matias Salineros, Marcelo Somarriva
BACKGROUND: The iliopsoas tendon is a recognized cause of extra-articular hip pain, and tenotomy has been described as an effective treatment in patients who do not respond to conservative treatments. Endoscopic release showed higher success rate, lower recurrence, fewer complications compared to open surgery. The aim of the study is to report the results at a mean of 4 years follow-up of a series of patients affected by femoroacetabular impingement (FAI) and an associated iliopsoas tendinopathy, treated with hip arthroscopy and transcapsular tendon release...
July 2016: Muscles, Ligaments and Tendons Journal
https://www.readbyqxmd.com/read/28063278/combined-anterolateral-thigh-and-tensor-fasciae-latae-flaps-an-option-for-reconstruction-of-large-head-and-neck-defects
#6
Ramzey Tursun, Hisham Marwan, J Marshall Green, Fawaz Alotaibi, Andre LeDoux
PURPOSE: The advent of microvascular free tissue transfer has provided the reconstructive surgeon with an enormous array of treatment options for reconstruction of large head and neck defects. However, when indicated by defect size, the need for more than 1 flap not only increases surgical complexity but also patient morbidity. The combination of the anterolateral thigh (ALT) flap and the tensor fascia latae (TFL) flap can be used to reconstruct such complex head and neck defects, thereby minimizing any additional morbidity that would be imposed by an additional flap harvest site...
December 26, 2016: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28063274/morbidity-and-functional-outcomes-with-head-and-neck-free-flap-reconstruction-in-patients-aged-90%C3%A2-years-or-older
#7
Adam P Fagin, Savannah Gelesko, Mark K Wax, Daniel Petrisor
PURPOSE: Morbidity of free tissue transfer in the extremes of age is controversial and not well studied in patients aged 90 years or older because of the rarity of these patients and many clinicians' natural hesitancy to perform such a large operation in patients of this group. The purpose of this study was to answer the following clinical question: Do patients aged 90 years or older who undergo free flap reconstruction have worse functional outcomes than their younger counterparts? MATERIALS AND METHODS: We performed a retrospective chart review of patients aged 90 years or older who underwent free flap reconstruction at Oregon Health and Science University Hospital from 2000 to 2015...
December 18, 2016: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28061548/suprafascial-harvest-of-the-radial-forearm-free-flap-decreases-the-risk-of-postoperative-tendon-exposure
#8
David C Shonka, Nikita V Kohli, Benjamin M Milam, Mark J Jameson
OBJECTIVE: To determine if suprafascial harvest of the radial forearm free flap improves postoperative donor site outcomes compared to subfascial harvest. METHODS: Retrospective chart review. RESULTS: Forty-six patients underwent reconstruction of a head and neck defect with a radial forearm free flap (RFFF). Subfascial harvest of the RFFF was performed in 25 (53%) patients and suprafascial harvest performed in 22 (47%) patients. All donor sites were covered with a split thickness skin graft and a bolster that remained in place for 6 days...
January 1, 2017: Annals of Otology, Rhinology, and Laryngology
https://www.readbyqxmd.com/read/28061519/does-a-standalone-cancer-center-improve-head-and-neck-microsurgical-outcomes
#9
Matthew L Tamplen, Jesse Tamplen, Vanessa Torrecillas, Rahul Seth, Santo Ricceri, Shirin Hemmat, Chase Heaton, William R Ryan, P Daniel Knott
Objectives To evaluate the role of hospital setting (standalone cancer center vs. large multidisciplinary hospital) on free tissue transfer (FTT) outcomes for head and neck reconstruction. Methods Medical records were reviewed of 180 consecutive patients undergoing FTT for head and neck reconstruction. Operations occurred at either a standalone academic cancer center (n = 101) or a large multidisciplinary academic medical center (n = 79) by the same surgeons. Patient outcomes, operative comparisons, and hospital costs were compared between the hospital settings...
January 6, 2017: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/28061517/supraclavicular-flap-reconstruction-of-cutaneous-defects-has-lower-complication-rate-than-mucosal-defects
#10
Sameep Kadakia, Jay Agarwal, Moustafa Mourad, Sara Ashai, Thomas Lee, Yadranko Ducic
Background The objective of this study was to determine whether there was a difference in complication rate between cutaneous and mucosal defects reconstructed with the supraclavicular artery flap. Methods Retrospective review of postoperative complications in 63 patients from 2008 to 2015 with cutaneous and mucosal head and neck defects following oncologic ablation reconstructed with the supraclavicular flap, with a minimum follow-up duration of 6 months. Of the 63 patients, 38 patients had cutaneous defects, whereas 25 had mucosal defects...
January 6, 2017: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/28061496/adult-patients-with-congenital-muscular-torticollis-treated-with-bipolar-release-report-of-31-cases
#11
Gun Sang Lee, Myung Ki Lee, Woo Jae Kim, Ho Sang Kim, Jeong Ho Kim, Yun-Suk Kim
OBJECTIVE: We assessed the surgical results of bipolar release in 31 adult patients with uncorrected congenital muscular torticollis (CMT) and more than 12 months of follow-up. METHODS: Thirty-one patients underwent a bipolar release of the sternocleidomastoid muscle (SCM) and were retrospectively analyzed. The mean follow-up period was 14.9 months (range, 12-30). The mean age at time of surgery was 30.3 years (range, 20-54). Patients were evaluated with a modified Lee's scoring system, cervicomandibular angle (CMA) measurement, and a global satisfaction rating scale using patient self-reporting...
January 1, 2017: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/28057652/study-protocol-for-a-randomised-controlled-multicentre-study-the-foraminotomy-acdf-cost-effectiveness-trial-facet-in-patients-with-cervical-radiculopathy
#12
A E H Broekema, J M A Kuijlen, G A T Lesman-Leegte, R H M A Bartels, A D I van Asselt, P C A J Vroomen, J M C van Dijk, M F Reneman, R Soer, R J M Groen
INTRODUCTION: Cervical radiculopathy due to discogenic or spondylotic stenosis of the neuroforamen can be surgically treated by an anterior discectomy with fusion (ACDF) or a posterior foraminotomy (FOR). Most surgeons prefer ACDF, although there are indications that FOR is as effective as ACDF, has a lower complication rate and is less expensive. A head-to-head comparison of the 2 surgical techniques in a randomised controlled trial has not yet been performed. The study objectives of the Foraminotomy ACDF Cost-Effectiveness Trial (FACET) study are to compare clinical outcomes, complication rates and cost-effectiveness of FOR to ACDF...
January 5, 2017: BMJ Open
https://www.readbyqxmd.com/read/28056483/complex-orofacial-reconstruction-with-the-intrinsic-chimeric-flap
#13
Andrés A Maldonado, Amanda K Silva, Laura S Humphries, Lawrence J Gottlieb
Background Ablation of locally advanced or recurrent head and neck cancer often results in large composite orofacial defects with limited recipient vessels. These complex defects lend well to intrinsic chimeric flap reconstruction, which allows greater ability to inset various flap component tissue types than composite flaps and requires only one set of microvascular anastomoses. Methods A retrospective chart review was performed on all patients who underwent orofacial reconstruction with an intrinsic chimeric free flap from 2002 to 2015...
January 5, 2017: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/28056150/trends-in-otolaryngology-consultation-patterns-at-an-academic-quaternary-care-center
#14
Kevin J Choi, Russel R Kahmke, Matthew G Crowson, Liana Puscas, Richard L Scher, Seth M Cohen
Importance: The consultation patterns of an otolaryngology-head and neck surgery service have not previously been reported. The time, resources, and attention required to operate such a consultation service are unknown. Objective: To assess trends in otolaryngology-head and neck surgery consultations conducted in emergency departments (EDs) and inpatient services. Design, Setting, and Participants: A retrospective analysis was conducted of the medical records of patients at a quaternary care center receiving inpatient otolaryngology consultations from January 1 to December 31, 2014...
January 5, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28056117/alopecia-following-bicoronal-incisions
#15
Sameep Kadakia, Arvind Badhey, Sara Ashai, Thomas S Lee, Yadranko Ducic
Importance: Multiple techniques may be used to perform bicoronal incisions, and alopecia is a known postoperative complication of this procedure. To date, no large studies exist comparing alopecia outcomes among bicoronal incision techniques with and without the use of Raney clips. Objective: To determine (1) whether postoperative alopecia is more common when bicoronal incisions are performed with monopolar cautery, Colorado microdissection tip cautery, or traditional cold steel and (2) whether this outcome is affected by the use of Raney clips...
January 5, 2017: JAMA Facial Plastic Surgery
https://www.readbyqxmd.com/read/28050062/reliability-of-the-pectoralis-major-myocutaneous-flap-in-reconstructive-oral-cancer-surgery-in-developing-countries-our-experience
#16
Atanu Bhanja, D S J D'Souza, Collin Roy, R N Poddar
BACKGROUND: Although free flaps are nowadays considered 'Gold standard' of head and neck reconstruction, pectoralis major myocutaneous (PMMC) flap is still popular among many reconstructive cancer surgeons in developing countries for its many advantages and also due to lack of resources for free flaps in most of the centers, large number of cancer patients with poor nutritional status and economic condition. However, many studies have reported high complication rate in PMMC flap. So, the purpose of our study was to evaluate the reliability of PMMC flap...
December 2016: Medical Journal, Armed Forces India
https://www.readbyqxmd.com/read/28047821/su-f-t-523-radiobiological-comparison-of-helical-tomotherapy-and-vmat-in-the-treatment-of-head-and-neck-tumors
#17
R Woods, P Mavroidis, M Lehman-Davis, M Kostich, T Cook, B Chera, S Das, J Lian
PURPOSE: This study aims at comparing the efficacy of Helical Tomotherapy (TOMO) and Volumetric Modulated Arc Therapy (VMAT) in producing highly conformal dose distributions in challenging head & neck cancer patients. Furthermore, to interpret the dosimetric findings into expected tissue response rates in order to estimate their clinical impact. METHODS: Seven patients were studied and for each patient two treatment plans (one TOMO and one VMAT) were created. Structures used for optimization were: high risk PTV, standard risk PTV, brainstem, spinal cord, parotid gland, larynx, mandible and surrounding tissue...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047619/su-g-brc-04-collimator-angle-optimization-in-volumetric-modulated-arc-therapy
#18
A Andersen, C Johnson, G Bartlett, I Das
PURPOSE: Volumetric modulated arc therapy (VMAT) has revolutionized radiation treatment by decreasing treatment time and monitor units, thus reducing scattered and whole body radiation dose. As the collimator angle changes the apparent leaf gap becomes larger which can impact plan quality, organ at risk (OAR) sparing as well as IMRT QA passing rate which is investigated. METHODS: Two sites (prostate and head and neck) that have maximum utilization of VMAT were investigated...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047336/mo-fg-202-08-real-time-monte-carlo-based-treatment-dose-reconstruction-and-monitoring-for-radiotherapy
#19
Z Tian, F Shi, X Gu, Y Graves, J Tan, N Hassan-Rezaeian, S Jiang, X Jia
PURPOSE: This proof-of-concept study is to develop a real-time Monte Carlo (MC) based treatment-dose reconstruction and monitoring system for radiotherapy, especially for the treatments with complicated delivery, to catch treatment delivery errors at the earliest possible opportunity and interrupt the treatment only when an unacceptable dosimetric deviation from our expectation occurs. METHODS: First an offline scheme is launched to pre-calculate the expected dose from the treatment plan, used as ground truth for real-time monitoring later...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28046915/su-g-tep3-11-radiobiological-cum-dosimetric-quality-assurance-of-complex-radiotherapy-plans
#20
N Paudel, G Narayanasamy, X Zhang, J Penagaricano, P Mavroidis, A Pyakuryal, E Han, X Liang, D Kim, S Morrill
PURPOSE: Dosimetric gamma-analysis used for QA of complex radiotherapy plans tests the dosimetric equivalence of a delivered plan with the treatment planning system (TPS) optimized plan. It does not examine whether a dosimetric difference results in any radiobiological difference. This study introduces a method to test the radiobiological and dosimetric equivalence between a delivered and the TPS optimized plan. METHODS: Six head and neck and seven lung cancer VMAT or IMRT plans optimized for patient treatment were calculated and delivered to an ArcCheck phantom...
June 2016: Medical Physics
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