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head and neck surgeons

Marc Hamoir, Sandra Schmitz, Carlos Suarez, Primoz Strojan, Kate A Hutcheson, Juan P Rodrigo, William M Mendenhall, Ricard Simo, Nabil F Saba, Anil K D'Cruz, Missak Haigentz, Carol R Bradford, Eric M Genden, Alessandra Rinaldo, Alfio Ferlito
Chemoradiotherapy has emerged as a gold standard in advanced squamous cell carcinoma of the head and neck (SCCHN). Because 50% of advanced stage patients relapse after nonsurgical primary treatment, the role of salvage surgery (SS) is critical because surgery is generally regarded as the best treatment option in patients with recurrent resectable SCCHN. Surgeons are increasingly confronted with considering operation among patients with significant effects of failed non-surgical primary treatment. Wide local excision to achieve clear margins must be balanced with the morbidity of the procedure, the functional consequences of organ mutilation, and the likelihood of success...
August 10, 2018: Cancers
Andreas Kiriakopoulos, Dimitrios Linos
Thyroid paragangliomas are rare neuroendocrine tumors. We present two cases analyzing their clinical presentation and pathology findings. A 44-year-old woman presented with a 33 mm left thyroid lobe mass. A 27-year-old male presented with a 27-mm right thyroid lobe mass and a FNA biopsy suggesting a follicular thyroid tumor. Both patients underwent total thyroidectomy. Vigorous bleeding was noted on the first case. Histologic sections revealed encapsulated tumors, whereas immunochemical stains were positive for chromogranin A, synaptophysin and NSE and negative for thyroglobulin, calcitonin, CEA and S-100...
August 2018: Journal of Surgical Case Reports
J Nick Brinkman, Shoista Kambiz, Tim de Jong, Marc A M Mureau
BACKGROUND:  The use of simultaneous, multiple free flaps has become a reliable reconstructive option in patients with extensive composite defects after resection of locally advanced head and neck cancer. However, some reluctance remains among reconstructive surgeons with concerns regarding flap outcomes and limited patient survival. Therefore, we evaluated complications, long-term patient survival, and patient-reported outcomes following these extensive head and neck reconstructions...
July 29, 2018: Journal of Reconstructive Microsurgery
Ibtihaj Nasseraldeen Bifari, Ameen Alherabi, Haddad Alkaff, Hamzeh Al-Arqen, Raid Abdulrahman Jastania
Thyroglossal duct cyst carcinoma is a rare malignancy, with an incidence of 0.7% to 1.6%. Most cases of thyroglossal duct cyst carcinoma are papillary carcinoma, with follicular carcinoma having been rarely reported. In this study, a 33-year-old man presented with a typical thyroglossal duct cyst and underwent surgical resection of the cyst, which was determined to be follicular carcinoma. We have reported this rare case to increase the awareness of such entities within the general otolaryngology and the community of head and neck surgeons, as well as among endocrine surgeons...
July 2018: Annals of Saudi Medicine
B Kohnen, C Schürmeyer, T H Schürmeyer, P Kress
PURPOSE: Thyroid surgery is mainly performed by general surgeons (GS). The aim of this study is to evaluate the safety and efficiency of thyroid surgery by ENT/head and neck surgeons (ENT), especially regarding the incidence of vocal fold palsy (VFP). METHODS: We retrospectively analysed 3509 patients (69.0% female) who underwent surgery for benign thyroid diseases (56.8% nodular goitre, 18.6% inactive nodes, 14.0% thyroid autonomy, 7.0% Graves' disease). Operations were mainly performed with intraoperative neuromonitoring by GS (n = 1933) or physicians trained for head and neck surgery (n = 1576)...
August 3, 2018: European Archives of Oto-rhino-laryngology
Jason I Kass, Eitan Prisman, Brett A Miles
Background: Virtual surgical planning (VSP), intraoperative cutting guides and stereolithographic models, provides the head and neck reconstructive surgeon with powerful tools for complex reconstruction planning. Despite its use in fibular osteocutaneous reconstruction, application to the scapular tip has not been as widely reported. Methods: From 2013 to 2014, four cases of either mandibular or maxillary reconstruction were completed with the scapular tip osseous free flap...
June 2018: Laryngoscope Investigative Otolaryngology
Rahul S Subbarayan, Lindsey Koester, Mark R Villwock, Jennifer Villwock
OBJECTIVE: Health registries and discharge-level databases are powerful tools. Commonly used data sets include the Nationwide Inpatient Sample (NIS); Surveillance, Epidemiology, and End Results Program (SEER); National Cancer Database (NCDB); and American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP). This study investigated the frequency with which these resources are being used and categorized their contributions to literature. DESIGN: A literature review from 2005 to 2016 for papers utilizing the aforementioned databases and publishing in The Laryngoscope, JAMA-Otolaryngology, Head and Neck, Otolaryngology-Head and Neck Surgery, and International Forum of Allergy and Rhinology was conducted...
September 2018: Annals of Otology, Rhinology, and Laryngology
Cigdem Kalaycik Ertugay, Ela Araz Server, Yesim Karagoz, Ozgur Yigit, Ahmet Volkan Sunter, Ahmet Gorkem Yasak
PURPOSE: Pediatric population may be more prone to complications in comparison to adults because of the variability of developmental changes of paranasal sinuses and skull base. Knowledge of standard columellar distances regarding age in addition to anatomical landmarks is an important guide during functional endoscopic sinus surgery. We aimed to identify standard distances from columella and anterior nasal spine to the anterior and posterior border of frontal and sphenoid sinus ostiums and provide an objective reference graph in regard to age in children...
July 25, 2018: European Archives of Oto-rhino-laryngology
Anthony Bared
Hair restoration can be an integral addition to the facial plastic surgery practice. As surgeons dedicated to reconstructive and aesthetic surgery of the head and neck, hair restoration is a natural complement to a facial plastic surgeon's practice. This article presents the keys to adding and starting hair restoration to one's facial plastic surgery practice.
August 2018: Facial Plastic Surgery: FPS
Yue Ma, Benjamin M Laitman, Vir Patel, Marita Teng, Eric Genden, Samuel DeMaria, Brett A Miles
Objective This study evaluated the accuracy of the Surgical Risk Calculator (SRC) of the ACS NSQIP (American College of Surgeons National Surgical Quality Improvement Program) in predicting head and neck microvascular reconstruction outcomes. Study Design Retrospective analysis. Setting Tertiary medical center. Subjects and Methods A total of 561 free flaps were included in the analysis. The SRC-predicted 30-day rates of postoperative complications, hospital length of stay (LOS), and rehabilitation discharge were compared with the actual rates and events...
July 1, 2018: Otolaryngology—Head and Neck Surgery
Steven G Hoshal, Arnaud F Bewley
PURPOSE OF REVIEW: This article reviews the recent literature on the anteromedial thigh free flap. RECENT FINDINGS: The anteromedial thigh (AMT) free flap is an excellent reconstructive option for head and neck defects. It is often overshadowed by the anterolateral thigh (ALT) free flap. Lack of familiarity with the anatomy of the AMT likely deters many surgeons from considering it as a reliable option. However, as many as one in 20 patients may not have anatomy suitable for ALT free-flap harvest, and in these cases the AMT provides an ideal alternative as it can be harvested through the same incision without added morbidity...
July 20, 2018: Current Opinion in Otolaryngology & Head and Neck Surgery
Marco Maricevich, Lawrence O Lin, Jun Liu, Edward I Chang, Matthew M Hanasono
BACKGROUND: Many surgeons are hesitant to use interposition vein grafting in head and neck microvascular free flap surgery due to concerns for elevated risk of flap loss. METHODS: We conducted a review of patients who underwent head and neck free flap reconstruction between 2005 and 2015. The effect of vein grafts on flap compromise and flap loss were analyzed using univariate and multivariate models. RESULTS: A total of 3240 free flaps were performed...
July 5, 2018: Plastic and Reconstructive Surgery
Sabrina Nicole Pavri, Cyril Gary, Rajendra Sawh Martinez, Samuel Kim, Dale Han, Stephan Ariyan, Deepak Narayan
PURPOSE: Lymphoscintigraphy (LS) is often obtained prior to sentinel lymph node biopsy (SLNB), especially in areas likely to have multiple or aberrant drainage patterns. This study aims to determine the incidence and characteristics of melanoma patients with a negative LS and to review the management options and surgical recommendations. METHODS: This is a retrospective study of patients with primary cutaneous melanoma who underwent SLNB between 2005 and 2016. Patients with nonvisualized lymph nodes on preoperative LS were compared in a 1:4 ratio with a randomly selected unmatched cohort drawn from all melanoma patients who underwent preoperative LS within the time period of the study...
July 5, 2018: Plastic and Reconstructive Surgery
Wai Keat Wong, Subhaschandra Shetty, Randall P Morton, Nicholas P McIvor, Tony Zheng
OBJECTIVE: Data pertaining to the outcomes of retrosternal goiter surgeries performed at secondary care centers, where thoracic surgery expertise is not readily available, is infrequently reported. Careful patient selection is crucial to avoid an unexpected need for a sternotomy during surgery. We sought to evaluate the surgical management of patients with retrosternal goiters treated at two secondary care centers. METHODS: Retrospective review of clinical records and computed tomographic (CT) scans of 557 patients who underwent thyroid surgery at the Departments of Otolaryngology, Head and Neck Surgery of Manukau Surgery Center and Whangarei Base Hospital...
July 12, 2018: Auris, Nasus, Larynx
Simon Leonard, Ayushi Sinha, Austin Reiter, Masaru Ishii, Gary L Gallia, Russell H Taylor, Gregory D Hager
Functional Endoscopic Sinus Surgery (FESS) is one of the most common outpatient surgical procedures performed in the head and neck region. It is used to treat chronic sinusitis, a disease characterized by inflammation in the nose and surrounding paranasal sinuses, affecting about 15% of the adult population [1]. During FESS, the nasal cavity is visualized using an endoscope, and instruments are used to remove tissues that are often within a millimeter of critical anatomical structures such as the optic nerve, carotid arteries, and nasolacrimal ducts...
May 7, 2018: IEEE Transactions on Medical Imaging
Rosh K V Sethi, Nicholas B Abt, Aaron Remenschneider, Yingbing Wang, Kevin S Emerick
Objective Preoperative single-photon emission computed tomography/computed tomography (SPECT/CT) imaging may aid in the localization of sentinel lymph nodes (SLNs) in cutaneous head and neck malignancy and has been rigorously evaluated for deep cervical lymph nodes. The purpose of this study was to assess the sensitivity, specificity, and positive predictive value (PPV) of SPECT/CT for preoperative localization of nodal basins superficial to the sternocleidomastoid muscle, with comparison to deep nodal basins of the neck...
July 1, 2018: Otolaryngology—Head and Neck Surgery
Raja Kalaiarasi, Venkataramanan Ramakrishnan, Santhosh Poyyamoli
Introduction  A pneumatized turbinate, also called concha bullosa, is a normal anatomical variant of the paranasal sinus region. Depending on the site of pneumatization, the concha is classified into extensive, bulbous or lamellar type. The middle turbinate concha bullosa has been implicated as a possible etiological factor in chronic sinusitis. Objectives  The aim of this study was to investigate the anatomical variations of the concha bullosa, based on paranasal sinus imaging, and its possible association with sinusitis...
July 2018: International Archives of Otorhinolaryngology
Haissan Iftikhar, Mubasher Ikram, Karim Rizwan Nathani, Adnan Yar Muhammad
Introduction  Thyroglossal duct cyst (TGDC) is the most common congenital anomaly of the neck, and approximately 7% of all the adult population presents it. Ectopic thyroid tissue is found in the thyroglossal duct cyst wall in up to 65% of cases. This thyroid tissue has the potential to develop some type of malignancy, the most common of which is the papillary carcinoma of the thyroid. There are just over 270 cases of thyroglossal duct cyst malignancy reported in the literature. Objectives  We aimed to study our population of patients in order to identify cases with thyroglossal duct cyst malignancy...
July 2018: International Archives of Otorhinolaryngology
Min-Jeong Cho, Nicholas T Haddock, Andrew A Gassman, Sumeet S Teotia
The success of microvascular reconstruction depends on many factors. While many factors can't be dictated by a surgeon, the success of anastomosis can be maximized by honing the anastomotic skill. However, size discrepancy of vessels still remains a common challenge given the lack of an ideal technique. In our study, we introduce our experience in using composite deep inferior epigastric (DIE) arterial and venous grafts to overcome the vessel size and pedicle length discrepancy in lateral thigh flap (LTP) and superficial inferior epigastric artery (SIEA) flaps, which can lead to higher flap failures secondary to vessel thrombosis and size discrepancy...
June 30, 2018: Plastic and Reconstructive Surgery
Rebecca W Gao, Brian A Nuyen, Vasu Divi, Davud Sirjani, Eben L Rosenthal
Importance: Complex head and neck cancer defects that require multiflap reconstructions are technically feasible, but the morbidity and patient outcomes of such large-scale head and neck operations have yet to be systematically reviewed. Objective: To systematically review existing literature to characterize the outcomes of large-scale head and neck resections that require multiple-flap reconstructions (defined as defects that require >1 flap [free, pedicled, or combinations thereof])...
July 5, 2018: JAMA Otolaryngology—Head & Neck Surgery
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