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Flaps head neck reconstruction

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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/28447103/comparison-of-clinical-outcomes-following-head-and-neck-surgery-among-patients-who-contract-to-abstain-from-alcohol-vs-patients-who-abuse-alcohol
#2
Azeem S Kaka, Songzhu Zhao, Enver Ozer, Amit Agrawal, Stephen Kang, James Rocco, Ricardo Carrau, Theodoros Teknos, John D Clapp, Harrison Weed, Matthew O Old
Importance: Alcohol abuse is highly prevalent in the population of patients with head and neck cancer, and active abuse at the time of surgery results in poor postoperative outcomes. Objective: To determine the association of alcohol abstinence with postoperative outcome in alcohol misusers undergoing major surgical procedures of the head and neck. Design, Setting, and Participants: As a case-control study, from July 2013 to August 2015, outcomes were collected in patients at an academic tertiary referral center requiring free flap reconstruction who had undergone an abstinence contract (n = 15) and compared with those who were abusers of alcohol prior to the inception of the protocol (n = 30)...
April 26, 2017: JAMA Otolaryngology—Head & Neck Surgery
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
#3
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/28434900/breast-cancer-in-a-pectoralis-major-myocutaneous-flap-used-for-the-reconstruction-of-tongue-cancer-a-case-report
#4
Eiji Hirai, Shunji Sarukaw, Kozo Yamamoto, Masahiro Okamoto
Breast cancers are the most common cancers in women. However, breast cancer occurring in a pectoralis major myocutaneous flap is extremely rare. This article describes a case of breast cancer occurring in such a flap used for reconstruction of the tongue in a 72-year-old woman. Follow-up computed tomogram depicted a slowly growing mass in the flap. Thirty-nine months postoperatively, a fine-needle aspiration biopsy specimen taken from the lesion suggested glandular carcinoma. The patient was diagnosed with breast cancer in the neck area of the flap and tumor excision was performed...
March 29, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28430347/hypopharyngeal-squamous-cell-carcinoma-and-laryngeal-neuroendocrine-carcinoma-colliding-in-the-aryepiglottic-fold-a-case-report
#5
Roberta Marangoni, Simone Mauramati, Giulia Bertino, Antonio Occhini, Marco Benazzo, Patrizia Morbini
PURPOSE: A collision tumor consists of 2 different histologically distinct and topographically independent tumors merging in the same mass. In the head and neck region they are rare, with only 4 cases reported in the larynx. CASE REPORT: A 60-year-old heavy smoker complained of a left submandibular lesion in October 2014. The lesion was excised and showed a poorly differentiated carcinoma, suggestive for adenocarcinoma. After a positron emission tomography-computed tomography scan showed increased metabolic activity in the left laterocervical region and right vocal cord, the patient underwent endoscopic biopsy of the lesion of the left piriform sinus, which was positive for moderately differentiated squamous cell carcinoma (SCC)...
April 14, 2017: Tumori
https://www.readbyqxmd.com/read/28419812/defining-quality-in-head-and-neck-reconstruction
#6
Peter M Vila, Jason T Rich, Shaun C Desai
Microvascular free flap reconstruction has now become the standard of care in the reconstruction of selected head and neck defects. Although uncommon, flap failure is a catastrophic event that results in significant patient morbidity, extended length of hospitalization, and increased cost. However, there is currently no gold standard for measuring the quality of a reconstructive center. Structure and process outcomes have recently been developed, but outcome measures are still lacking. Areas for future research include preoperative nutrition, preoperative flap planning, intraoperative fluid management, appropriate thromboembolism prophylaxis, consistent perioperative antibiotic regimens, skilled ancillary staff, and clear outcome measures for performance measurement...
April 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28416356/risk-factors-for-free-flap-failure-a-retrospective-analysis-of-881-free-flaps-for-head-and-neck-defect-reconstruction
#7
W Zhou, W-B Zhang, Y Yu, Y Wang, C Mao, C-B Guo, G-Y Yu, X Peng
The aim of this study was to identify the risk factors for free flap failure after head and neck reconstructive surgery. The data of 881 consecutive patients who underwent free flap surgery at the Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, between January 2013 and November 2016, were reviewed retrospectively. All surgeries were performed by a single head and neck surgical team. Patient demographic and surgical data that may have an influence on free flap outcomes were recorded...
April 14, 2017: International Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28408096/local-treatment-of-a-pharyngocutaneous-fistula-secondary-to-osteoradionecrosis
#8
Olga González-Antolín
Radionecrosis is a late, and difficult to treat,complication of radiotherapy performed on head and neck tumours, and it is difficult to treat. This process causes significant damage, not only in the skin, but also in muscular, nervous, vascular, and bone structures. This, in turn, leads to airway and digestive tract involvement, as well as a functional loss and a cosmetic defect that usually requires reconstructive surgery. Therefore, this process is associated with a significant loss in the quality of life of patients and involves a long hospital stay for treatment, as well as the necessary support measures...
April 10, 2017: Enfermería Clínica
https://www.readbyqxmd.com/read/28403069/using-a-pedicle-pectoralis-major-musculocutaneous-flap-in-head-and-neck-reconstruction-after-modified-radical-mastectomy-a-case-report
#9
Jen-Wu Huang, Nai-Yuan Wu, Yi-Ying Lin
RATIONALE: A pedicle pectoralis major musculocutaneous (PMMC) flap is one of the strategies for head and neck reconstruction. Seldom studies reported the case in which the skin area of previous modified radical mastectomy (MRM) had been used as a PMMC flap in head and neck reconstruction. PATIENT CONCERNS: An 84-year-old female who had suffered from left breast cancer and undergone a left modified radical mastectomy (MRM) more than 20 years earlier. DIAGNOSES: She had squamous cell carcinoma of the tongue and had undergone partial glossection and left modified radial neck dissection...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28400133/perioperative-serum-levels-of-procalcitonin-c-reactive-protein-and-leukocytes-in-head-and-neck-free-flaps
#10
S Koerdt, N Rommel, N H Rohleder, S Sandig, G Frohwitter, T Steiner, K D Wolff, M R Kesting
Microvascular free flaps are considered to be the gold standard in reconstructive head and neck surgery. However, reduced postoperative transplant perfusion is one of the serious postoperative complications and calls for close and reliable monitoring. Procalcitonin, C-reactive protein, and leukocytes are closely associated with local and systemic inflammatory reactions and might have prognostic capacity concerning tissue necrosis. This study aimed to evaluate perioperative serum levels of these three biomarkers to assess their potential in postoperative flap monitoring...
April 8, 2017: International Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28399024/immediate-reconstruction-for-plantar-melanoma-a-paradigm-shift
#11
Hunter Oliver-Allen, Merisa Piper, Carolyn Vaughn, Hani Sbitany
INTRODUCTION: Plantar melanoma tumors are traditionally treated with wide local excision based on depth of invasion, followed by delayed reconstruction once negative surgical margins are confirmed. However, delayed reconstruction requires care for an open wound, a prolonged treatment course, and the need for an additional surgery. Immediate reconstruction has been shown to be oncologically safe in head and neck melanoma, but little is described in the literature regarding immediate reconstruction in plantar melanoma...
May 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28390434/surgical-site-infections-following-oral-cavity-cancer-resection-and-reconstruction-is-a-risk-factor-for-plate-exposure
#12
Christopher M Yao, Hedyeh Ziai, Gordon Tsang, Andrea Copeland, Dale Brown, Jonathan C Irish, Ralph W Gilbert, David P Goldstein, Patrick J Gullane, John R de Almeida
BACKGROUND: Plate-related complications following head and neck cancer ablation and reconstruction remains a challenging problem often requiring further management and reconstructive surgeries. We aim to identify an association between surgical site infections (SSI) and plate exposure. METHODS: A retrospective study between 1997 and 2014 was performed to study the association between postoperative SSI and plate exposures. Eligible patients included those with a history of oral squamous cell carcinoma who underwent surgical resection, neck dissection, and free tissue reconstruction...
April 8, 2017: Journal of Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28387356/pectoralis-major-myocutaneous-flap-for-head-and-neck-defects-in-the-era-of-free-flaps-harvesting-technique-and-indications
#13
Muyuan Liu, Weiwei Liu, Xihong Yang, Haipeng Guo, Hanwei Peng
The role of the pectoralis major myocutaneous flap (PMMF) in head and neck reconstruction is challenged recently due to its natural drawbacks and the popularity of free flaps. This study was designed to evaluate the indications and reliability of using a PMMF in the current free flap era based on a single center experience. The PMMF was harvested as a pedicle-skeletonized flap, with its skin paddle caudally and medially to the areola, including the third intercostal perforator, preserving the upper one third of the pectoralis major muscle...
April 7, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28363227/morbidity-of-the-free-fibula-flap-reconstruction-in-head-and-neck-malignancies
#14
Harin Asokan, Jerry R John
No abstract text is available yet for this article.
March 31, 2017: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/28358764/a-thirty-year-experience-with-head-and-neck-flap-reconstruction
#15
Alexander Haosi Sun, Xiaolu Xu, Clarence Takashi Sasaki, Stephan Ariyan, Derek Matthew Steinbacher
BACKGROUND: Head and neck (HN) defects after tumor extirpation can be challenging to repair. Historically, pedicled flaps were the mainstay for reconstruction, but recently, free tissue transfer has been preferred. This study compares patient characteristics and flap outcomes for HN defects over a 30-year period at the authors' institution. METHODS: Head and neck cancer patients receiving flap reconstruction from 1983 to 2013 were included. Records were reviewed for demographic and perioperative data...
March 29, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28355656/morbidity-of-the-free-fibula-flap-reconstruction-in-head-and-neck-malignancies
#16
J N Lodders, E A J M Schulten, J G A M de Visscher, T Forouzanfar, K H Karagozoglu
No abstract text is available yet for this article.
March 29, 2017: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/28352931/near-total-lower-lip-reconstruction-combined-karapandzic-and-bernard-burrow-webster-flap
#17
Manuel António Campos, Paulo Varela, Carlos Marques
Lip carcinoma is a common cancer of the head and neck region. It more often affects the lower lip (> 90%), and squamous cell carcinoma represents 95% of the cases. The authors present a reconstruction of the lower lip combining two classical flaps: the Karapandzic and Bernard-Burrow-Webster flap. The surgical technique is discussed.
March 2017: Acta Dermatovenerologica Alpina, Panonica, et Adriatica
https://www.readbyqxmd.com/read/28351561/salvage-surgery-in-recurrent-head-and-neck-squamous-cell-carcinoma-oncologic-outcome-and-predictors-of-disease-free-survival
#18
Marc Hamoir, Emma Holvoet, Jerôme Ambroise, Benoît Lengelé, Sandra Schmitz
OBJECTIVE: Salvage surgery in recurrent SCCHN is associated with poor outcomes. This study aimed to better identify suitable surgical candidates and those at high risk of new recurrence. MATERIALS AND METHODS: Single-center retrospective analysis of 109 patients undergoing salvage surgery for recurrent SCCHN. Univariate and multivariate analyses were used to identify prognostic factors affecting disease-free survival (DFS). RESULTS: The following factors showed a significant impact on DFS: Disease-free interval >6months [HR 0...
April 2017: Oral Oncology
https://www.readbyqxmd.com/read/28349372/nut-midline-carcinoma-of-the-sublingual-gland-clinical-presentation-and-review
#19
Nolan B Seim, Ramez H W Philips, Lynn Schoenfield, Theodoros N Teknos, James W Rocco, Amit Agrawal, Enver Ozer, Ricardo L Carrau, Stephen Y Kang, Matthew O Old
NUT midline carcinoma (NMC) is a rare and aggressive disease encountered in the midline of the head and neck or mediastinum. Due to its sparse incidence and subtle pathologic features, we aim to increase knowledge and awareness for this pathologic entity. We present an exemplary case of a young, healthy male presenting with oral cavity pain and cervical lymphadenopathy. This patient was initially diagnosed with an unspecified, highly aggressive sublingual gland malignancy and underwent locoregional resection with free flap reconstruction however suffered a rapid local recurrence and widely extensive metastasis within just 1 month...
March 27, 2017: Head and Neck Pathology
https://www.readbyqxmd.com/read/28345267/color-duplex-ultrasonography-versus-handheld-doppler-to-plan-anterior-lateral-thigh-flaps
#20
Bernd Lethaus, Christina Loberg, Anita Kloss-Brandstätter, Alexander K Bartella, Timm Steiner, Ali Modabber, Frank Hölzle, Jan Teichmann
BACKGROUND: The anterior lateral thigh flap (ALT) has become increasingly important in reconstructive surgery in the head and neck region. To cope with the problem of anatomical variability in the supplying blood vessels, preoperative evaluation is desirable. Purpose of the study is to compare the most commonly used Doppler devices Handheld Doppler (HD) and Color Doppler Ultrasonography (CDU) for their clinical reliability. METHODS: Forty five consecutive head and neck cancer patients (mean age 66...
March 27, 2017: Microsurgery
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