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Head neck reconstruction

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https://www.readbyqxmd.com/read/29148237/supraclavicular-flap-repair-in-the-free-flap-era
#1
REVIEW
Jodie Trautman, Sinclair Gore, Matthew Potter, Jonathan Clark, Dylan Hyam, Ngian C Tan, Quan Ngo, Bruce Ashford
BACKGROUND: Supraclavicular flap (SCF) repair is widely reported in head and neck surgery in select patients and defects. The authors' objective is to present our series of 30 patients who underwent SCF repair for varying defects and to review the scope and outcome of SCF repair in the literature. METHODS: The authors contributed primary evidence of 30 cases of SCF repair. Our outcomes are compared with those reported in the last 5 years' literature; 33 articles published between January 2012 and January 2017 that present original clinical experience of 528 SCFs...
November 17, 2017: ANZ Journal of Surgery
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
#2
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/29140575/complications-of-double-free-flap-and-free-flap-combined-with-locoregional-flap-in-head-and-neck-reconstruction-a-systematic-review
#3
REVIEW
Collin L Chen, Joseph Zenga, Lauren T Roland, Patrik Pipkorn
BACKGROUND: The purpose of this clinical review was to assess the feasibility of reconstructing complex head and neck defects with 2 or more free flaps simultaneously. METHODS: A total of 38 articles were reviewed. The patient population included those who received 2 or more free flaps or a single free flap plus a locoregional flap. The primary outcome assessed was rate of complications. RESULTS: Among double flaps, the minor complication rate was 6...
November 15, 2017: Head & Neck
https://www.readbyqxmd.com/read/29140386/retrospective-study-of-survival-of-extraoral-endosseous-craniofacial-implants-in-head-and-neck-surgery-patients
#4
Brent J Woods, Arun Chandu
PURPOSE: To determine the survival rate of implants placed in different craniofacial locations and factors affecting survival. MATERIALS AND METHODS: This study retrospectively reviewed a consecutive series of patients treated at the Royal Melbourne Hospital who received craniofacial implants for an array of benign and malignant conditions. Implant survival per site and cumulative survival were determined. Surgical and implant variables were assessed using the Kaplan-Meier and Cox Proportional Hazards Models...
November 2017: International Journal of Oral & Maxillofacial Implants
https://www.readbyqxmd.com/read/29131450/potential-for-health-care-cost-savings-with-preoperative-gastrostomy-tube-placement-in-the-head-and-neck-cancer-population
#5
Ashley C Mays, Harrison G Bartels, Paul R Wistermayer, Matt L Rohlfing, Christopher M Gentile, Ralph D'Agostino, Joshua D Waltonen
BACKGROUND: The purpose of this study was to examine the cost differences between preoperative and postoperative placement of gastrostomy tubes (G-tubes) in patients with head and neck cancer. METHODS: We conducted a retrospective chart review of patients with aerodigestive tract cancers from 2010 to 2015. Data included inpatient and postdischarge costs, demographics, tumor characteristics, surgical treatment, length of stay (LOS), time spent in the intensive care unit (ICU), and readmissions...
November 13, 2017: Head & Neck
https://www.readbyqxmd.com/read/29127998/spectral-computed-tomography-technique-and-applications-for-head-and-neck-cancer
#6
REVIEW
Almudena Pérez-Lara, Reza Forghani
Spectral computed tomography (CT) or dual-energy CT (DECT) is an advanced form of CT with increasing applications in head and neck radiology. This article provides an overview of the DECT technique and reviews current applications for the evaluation of neck pathology, focusing on oncologic applications. Included are an overview of the basic underlying principles and approaches for DECT scan acquisition and material characterization; a discussion of various DECT reconstructions and a brief overview of practical issues pertaining to DECT implementation, including those related to workflow impact of DECT; and a discussion of various applications of DECT for the evaluation of the neck, especially in oncology...
February 2018: Magnetic Resonance Imaging Clinics of North America
https://www.readbyqxmd.com/read/29127507/influence-of-coupler-size-on-revision-rate-and-timing-of-revision-after-free-flap-tissue-transfer-in-the-head-and-neck
#7
Ulrich Kisser, Christine Adderson-Kisser, Philipp Baumeister, Maximilian Reiter
OBJECTIVE: Microvascular coupler devices have been proven an effective alternative to standard hand-sutured anastomoses in reconstructive surgery. Until now, the influence of the coupler size on the revision rate after free flap tissue transfer in head and neck surgery has not been investigated. Neither has its influence on the timing of venous revisions. MATERIALS AND METHODS: A retrospective mono-center cohort study was performed in order to analyze the influence of coupler size on timing and revision rate of microvascular procedures...
November 10, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/29126769/cardiovascular-complications-in-head-neck-microvascular-flap-reconstruction-a-retrospective-risk-stratification-and-outcomes-assessment
#8
Naseem Ghazali, Steven Caldroney, Donita Dyalram, Joshua E Lubek
BACKGROUND: To determine the incidence and predictors of cardiac complications (CC) in head & neck microvascular flap reconstruction. METHODS: A series of 216 microvascular flaps performed between 2012 and 2015 were analyzed using the Revised Cardiac Risk Index (CRCI) and the Charlson Comorbidity Index (CCI). Multivariate regression analysis was undertaken for predictive factors of outcomes. RESULTS: Twenty patients developed CC (9.7%) with transient cardiac arrhythmia (6...
October 12, 2017: Journal of Cranio-maxillo-facial Surgery
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
#9
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
#10
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...
October 10, 2017: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/29108918/donor-site-morbidity-of-the-anterolateral-thigh-flap
#11
Hannes Weise, Andreas Naros, Gunnar Blumenstock, Michael Krimmel, Sebastian Hoefert, Susanne Kluba, Stefan Hofer, Siegmar Reinert
INTRODUCTION: The purpose of this study was to investigate donor site morbidity after reconstruction of defects in the head and neck region with an anterolateral thigh (ALT) flap. METHODS: From 07/2006 to 12/2015 the anterolateral thigh flap was used for reconstruction of large intra- or extraoral defects in 138 patients. The donor sites were available to examine for morbidity in 51 patients (36.7%). All patients completed a standardized questionnaire, received a physical examination, and underwent isokinetic muscle exercises of the lower extremity with a Dynamometer...
September 30, 2017: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/29105820/the-radial-forearm-free-flap-as-a-vascular-bridge-for-secondary-microsurgical-head-and-neck-reconstruction-in-a-vessel-depleted-neck
#12
Pedro Ciudad, Mouchammed Agko, Shivprasad Date, Wei-Ling Chang, Oscar J Manrique, Tony C T Huang, Federico Lo Torto, Emilio Triganano, Hung-Chi Chen
BACKGROUND: In a vessel-depleted neck, distant recipient sites may be the only option for secondary free flap reconstruction. While interposition vein grafts and arteriovenous loops can bridge the gap between the recipient and donor pedicle, they are not without risks. In these scenarios, we examinate the reliablity of a radial forearm free flap (RFFF) as an alternative vascular conduit. PATIENTS AND METHODS: A retrospective review of cases between March 2005 and May 2016 was performed...
November 4, 2017: Microsurgery
https://www.readbyqxmd.com/read/29098278/cranioplasty-using-a-mixture-of-biologic-and-nonbiologic-agents
#13
Demetri Arnaoutakis, Arash Bahrami, Jason E Cohn, Jesse E Smith
Importance: A surgeon faces challenges with cranioplasty techniques to achieve a successful result with relatively few complications. Objective: To describe a unique technique for incorporating both biologic autologous bone and nonbiologic allograft materials for defect coverage in cranioplasty with favorable outcomes and low occurrence of complications. Design, Setting, and Participants: A retrospective medical records review of all 26 patients who underwent primary cranioplasty procedure with a modified technique between January 2011 and December 2015 at a high-volume head and neck oncologic reconstructive practice was conducted; data analysis was also performed during that period...
November 2, 2017: JAMA Facial Plastic Surgery
https://www.readbyqxmd.com/read/29092758/navigation-guided-resection-of-maxillary-tumours-the-accuracy-of%C3%A2-computer-assisted-surgery-in-terms-of-control-of-resection-margins%C3%A2-a-feasibility-study
#14
Achille Tarsitano, Francesco Ricotta, Gennaro Baldino, Giovanni Badiali, Angelo Pizzigallo, Valerio Ramieri, Piero Cascone, Claudio Marchetti
INTRODUCTION: Surgical treatment of maxillary tumours is often highly complex. The three-dimensional anatomy of the mid-face renders both correct intraoperative orientation and adequate oncological safety difficult to obtain. Recently, computer-assisted techniques and intraoperative navigation have been applied to oncological surgery treating head and neck cancer. However, only a few studies have explored whether preoperative virtual resection planning and intraoperative control of resection margins allow assessment of the surgical margins of the tumour...
September 30, 2017: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/29090194/the-pros-and-cons-of-computer-aided-surgery-for-segmental-mandibular-reconstruction-after-oncological-surgery
#15
REVIEW
Hyun Ho Han, Hak Young Kim, Jun Yong Lee
Computer-aided surgery (CAS) started being used for head and neck reconstruction in the late 2000s. Its use represented a paradigm shift, changing the concept of head and neck reconstruction as well as mandible reconstruction. Reconstruction using CAS proceeds through 4 phases: planning, modeling, surgery, and evaluation. Thus, it can overcome a number of trial-and-error issues which may occur in the operative field and reduce surgical time. However, if it is used for oncologic surgery, it is difficult to evaluate tumor margins during tumor surgery, thereby restricting pre-surgical planning...
September 2017: Arch Craniofac Surg
https://www.readbyqxmd.com/read/29083940/digital-assessment-of-the-implantation-angle-of-proximal-femoral-nail-antirotation-helical-blade-using-ct-three-dimensional-reconstruction
#16
Feiyu Luan, Wenbo Wang, Ning Liu, Yanan Zhang, Jinyi Liu
OBJECTIVES: To facilitate simple and safe manipulation during proximal femoral nail antirotation (PFNA) operation, we studied the range of safe implantation angle of the helical blade of the PFNA system by using a digital-based three-dimensional reconstruction model of CT images. METHODS: Thirty-five healthy volunteers were recruited. Original multilayer helical CT scan data of the left femur were collected and imported into Mimics software. Anatomic features of the femur, including the safe implantation angle, anterior and posterior angle, were measured...
October 30, 2017: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
https://www.readbyqxmd.com/read/29083525/antibiotic-prophylaxis-in-clean-contaminated-head-and-neck-cases-with-microvascular-free-flap-reconstruction-a-systematic-review-and-meta-analysis
#17
REVIEW
Yarah M Haidar, Prem B Tripathi, Tjoson Tjoa, Sartaaj Walia, Lishi Zhang, Yanjun Chen, Danh V Nguyen, Hossein Mahboubi, William B Armstrong, Julie A Goddard
BACKGROUND: Optimal antibiotic prophylaxis duration in head and neck clean-contaminated free-flap cases is unknown. METHODS: A systematic review/meta-analysis was conducted using PubMed/MEDLINE, Cochrane Library, Web-of-Science, and Scopus databases. RESULTS: Of the 3755 searched articles, 5 articles were included for a total of 861 patients. The recipient surgical site infection risk was significantly higher in patients receiving prophylactic antibiotics for ≤24 hours compared to >24 hours (relative risk [RR] 1...
October 30, 2017: Head & Neck
https://www.readbyqxmd.com/read/29076123/-diagnosis-related-groups-in-reconstructive-plastic-surgery-of-malignant-head-and-neck-skin-tumours
#18
Oliver Lotter, Manuela Micheel, Patrick Jaminet
Background Diagnosis Related Groups (DRGs) were introduced in Germany as a medico-economic classification system 13 years ago. In this analysis, we looked into the compensation for reconstructive plastic surgery after the excision of malignant head and neck skin tumours by DRGs. Material and methods Four main diagnoses (malignant melanoma, basal cell carcinoma, squamous cell carcinoma, carcinoma in situ) at a maximum of 6 different locations in the head and neck were combined with the following procedures: excision and primary wound closure, excision with temporary soft tissue coverage, split-thickness or full-thickness skin grafting, local, free or regional pedicle flaps, distant flaps as well as combined procedures for coverage...
October 26, 2017: Handchirurgie, Mikrochirurgie, Plastische Chirurgie
https://www.readbyqxmd.com/read/29075779/reconstruction-the-final-dimension-in-head-and-neck-surgery-the-2017-hayes-martin-lecture
#19
Mark K Wax
The Hayes Martin lecture is dedicated to a giant who was essential to developing the surgical management of patients with head and neck cancer. Since that time, advents in anesthesia, intensive care, and improved diagnostic abilities have improved our ability to surgically manage and treat head and neck cancer. The original paradigm of resection, reconstruction, and rehabilitation was formulated as we endeavored to develop paradigms of treatment for our patients. We have maximized our resective and reconstructive abilities...
October 26, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/29072217/assessment-of-quality-of-life-of-patients-1-5-years-after-treatment-for-oral-cancer
#20
Akshay Khandelwal, Arati Neeli, Akshata Gadiyar, Ankit Khandelwal
PURPOSE: The study aims to assess the quality of life (QOL) of oral cancer survivors, 1-5 years after the treatment. MATERIALS AND METHODS: The data of fifty patients concerning their QOL were gained from the Outpatient Department of K.L.E's Dr. Prabhakar Kore Hospital and Medical Research Institute, Belagavi, and Karnataka Cancer Therapy and Research Institute, Navanagar, Hubli, Karnataka, India. All the patients suffered from oral cancer (stage T2-T4) and underwent surgery with reconstruction followed by chemotherapy or radiotherapy or both...
September 2017: Indian Journal of Dental Research: Official Publication of Indian Society for Dental Research
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