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Flaps head neck reconstruction

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https://www.readbyqxmd.com/read/28937303/palliative-coverage-of-cranial-defect-following-failed-cranial-flap-for-advanced-squamous-cell-carcinoma-case-report
#1
Vyacheslav Makler, Jeffrey S Litt, N Scott Litofsky
INTRODUCTION: With advanced-stage head and neck cancers, patients may develop large and/or complex wounds despite multiple reconstruction attempts. Wound coverage may require novel approaches to palliate the patient. METHOD: We present the case of a 56-year-old female with advanced squamous cell carcinoma of the scalp and skull who required multiple surgical interventions. Despite our best reconstructive efforts, the patient subsequently developed scalp infection and sepsis, necessitating further debridement for source control...
September 22, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28910897/-the-application-of-microvascular-anastomotic-coupler-in-vascular-anastomosis-of-free-tissue-flap-for-reconstruction-of-defect-after-head-and-neck-cancer-resection
#2
Y J Zhang, Z H Wang, C H Li, J Chen
Objective: To investigate the application and operation skills in vein anastomosis by microvascular anastomotic coupler (MAC) in reconstruction of defects after head and neck cancer resection. Methods: From August 2015 to July 2016, in Department of Head and Neck Surgery, Sichuan Cancer Hosipital, 17 cases underwent the reconstruction of defects after head and neck cancer resection with free tissue flaps, including forearm flaps in 11 casess, anterolateral flaps in 4 casess and fibula flaps in 2 casess. Totally 17 MAC were used, including 14 MAC for end-to-end anastomosis and 3 MAC for end-to-side anastomosis...
September 7, 2017: Zhonghua Er Bi Yan Hou Tou Jing Wai Ke za Zhi, Chinese Journal of Otorhinolaryngology Head and Neck Surgery
https://www.readbyqxmd.com/read/28906301/a-comparative-study-of-lateral-extension-versus-conventional-deltopectoral-flap-in-head-and-neck-reconstruction-after-surgical-extirpation-of-tumor
#3
Mohd Altaf Mir, Mohd Yaseen, Mohd Fahud Khurram
BACKGROUND: We investigated outcomes for nondelayed conventional deltopectoral (CDP) flaps and lateral extension deltopectoral (LEDP) flaps. MATERIAL AND METHODS: Fifteen CDP flaps and 17 LEDP flaps were raised in 32 patients. All flaps were nondelayed. The flaps were folded only in the LEDP flap group. Six of 17 LEDP flaps were folded to become bilayered flaps to repair full thickness defects. Flap success rates and complication rates were compared between the CDP flap and LEDP flap groups...
September 12, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28895181/simultaneous-double-free-radial-forearm-flaps-combined-with-coronoidectomy-and-myotomy-to-release-bilateral-severe-trismus-a-case-report
#4
Chieh Chou, Chien-Chang Chen, Chung-Sheng Lai, Sin-Daw Lin, Yur-Ren Kuo
Oral cancers associated with submucosal fibrosis-induced trismus are common. They may affect the patients' quality of life, cause nutritional deficits, and interfere with postoperative cancer surveillance. In such cases, locating desirable recipient vessels in the head and neck can be difficult. This report presents a 47-year-old man with severe trismus caused by recurrent head and neck cancer, who had received multiple free-flap reconstructions after cancer ablation. Reconstruction was successfully achieved for the bilateral defects and releasing the trismus by using simultaneous double free radial forearm flaps as a chained flow-through pattern with one residual recipient vessel combined with the bilateral myotomy of the medial pterygoid and masseter muscles, and coronoidectomy...
September 12, 2017: Microsurgery
https://www.readbyqxmd.com/read/28894667/dual-vascular-free-anterolateral-thigh-flap
#5
Toshiaki Numajiri, Daiki Morita, Shoko Tsujiko, Hiroko Nakamura, Yoshihiro Sowa, Akihito Arai, Matsui Masahiro, Hiroshi Nakano, Shigeru Hirano
BACKGROUND: The optimum number of microvascular anastomoses for safe free tissue transfer is controversial. Although the case for 2 venous anastomoses versus 1 anastomosis has been argued, the use of an additional arterial anastomosis has not been examined in detail. METHODS: Twelve patients who underwent 2 arterial anastomoses for a free flap transfer were identified retrospectively from the medical records of patients undergoing reconstruction for head and neck cancer...
August 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28894665/late-arterial-thrombosis-after-microvascular-head-and-neck-reconstruction-due-to-combined-factors-of-pedicle-artery-loop-and-submandibular-gland-swelling
#6
Yu Kagaya, Masaki Arikawa, Shimpei Miyamoto
Late arterial thrombosis of a free flap is rare and usually unsalvageable because it is hard to detect. We herein report 2 cases of arterial thrombosis of a free flap after microvascular head and neck reconstruction due to the combined factors of pedicle artery loop and compression by a swollen submandibular gland, the occurrence of thrombosis in both of which was > 72 hours after the operation. In case 1, the arterial thrombosis was undetectable, and it was too late for a successful take-back operation, so the flap was lost...
August 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28888309/head-and-neck-reconstruction
#7
REVIEW
Shannon Wong, Alyson Melin, Debra Reilly
Management of head and neck burns involves acute and intermediate phases. Acutely, the goals are establish a secure airway and treat life-threatening injuries. Then, optimize nutrition, assess extent of the burn, perform local wound care, and provide eye protection. Management depends on the degree of the head and neck burn. Postinjury splinting and rehabilitation are vital to healing. After the acute inflammation has resolved and the scars have matured, reconstruction begins with the goals of restoring both function and aesthetics...
October 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28886357/a-retrospective-volume-matched-analysis-of-the-submental-artery-island-pedicled-flap-as-compared-to-the-forearm-free-flap-is-it-a-good-alternative-choice-for-the-reconstruction-of-defects-of-the-oral-cavity-and-oropharynx
#8
Nawaf Aslam-Pervez, Steven J Caldroney, Amal Isaiah, Joshua E Lubek
PURPOSE: The submental artery island pedicled flap (SMIF) is an underused alternative for reconstruction of head and neck defects after tumor ablation. The purpose of this study was to perform a comparative evaluation of reconstructive outcomes based on surgical site and ablative defect volume in patients who underwent reconstruction with the SMIF versus the forearm free flap (FFF). MATERIALS AND METHODS: A retrospective cohort study of all patients with oral cavity and oropharyngeal defects reconstructed with the SMIF and a cohort of patients with similar volume defects reconstructed with the FFF were compared for oncologic safety and viability of equivalent reconstructive outcomes...
August 12, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28884452/microsurgical-reconstruction-following-oncologic-resection-in-pediatric-patients-a-15-year-experience
#9
Margaret J Starnes-Roubaud, Matthew M Hanasono, Michael E Kupferman, Jun Liu, Edward I Chang
BACKGROUND: Free tissue transfer in the pediatric population is a challenging endeavor, even for experienced microsurgeons. Some surgeons argue these cases can be limited by vessel size and spasticity and should be undertaken only when absolutely necessary. We present a 15-year experience examining outcomes of free tissue transfer in pediatric oncologic patients. METHODS: All free flaps performed at a single institution in pediatric patients (age range 3-17) between January 2000 and December 2014 were reviewed...
September 7, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28880703/the-association-between-surgical-complications-and-the-possum-score-in-head-and-neck-reconstruction-a-retrospective-single-center-study
#10
Yohjiroh Makino, Katsuhiro Ishida, Keita Kishi, Hiroki Kodama, Takeshi Miyawaki
The Physiological and Operative Severity Score for the Enumeration of Mortality and Morbidity (POSSUM) is widely used to predict surgical complications affecting various organs. However, there are few reports about objective evaluation methods for head and neck surgery. In this study, we retrospectively examined the association between POSSUM score and actual surgical complications of head and neck reconstruction surgery. In total, 711 patients who underwent head and neck reconstruction after cancer extirpation between January 2007 and January 2015 were studied...
September 7, 2017: Journal of Plastic Surgery and Hand Surgery
https://www.readbyqxmd.com/read/28872500/simple-septocutaneous-free-flap-design-for-one-stage-reconstruction-of-pharyngocutaneous-and-orocutaneous-fistulae
#11
Soo Hyun Woo, Tae Hui Bae, Woo Seob Kim, Han Koo Kim
Reconstruction of pharyngocutaneous fistula (PCF) or orocutaneous fistula is always a challenging task. It has many causes and is especially related to radiation therapy after resection of head and neck cancers. There are many reports of surgical procedures for fistula repair. For example, 2-stage methods, methods of combining multiple flaps, and methods of using chimeric flaps have been reported. However, there is no established simple method as a treatment of choice. The authors describe 5 patients of head and neck fistulas and recommend a useful 1-stage reconstruction method using a double skin paddle free flap...
September 1, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28863728/venous-complications-in-one-versus-two-vein-anastomoses-in-head-and-neck-free-flaps
#12
Sobia F Khaja, Nathan Rubin, Rodrigo Bayon
OBJECTIVE: The purpose of this study was to compare rates of reexploration and flap failure in patients with 1- and 2-vein anastomoses in free flap reconstructions. METHODS: Retrospective chart review of 300 patients undergoing free flap reconstruction to head and neck defects from 2010 to 2014. RESULTS: One venous anastomosis was performed in 229 patients, and 2 venous anastomoses were performed in 71 patients. The 1-vein group had significantly more reexplorations in the operating room (36/229, 15...
September 1, 2017: Annals of Otology, Rhinology, and Laryngology
https://www.readbyqxmd.com/read/28859923/proper-choice-of-donor-site-veins-for-patients-undergoing-free-radial-forearm-flap-reconstruction-for-the-defects-of-head-and-neck
#13
Qin-Kai Zhai, Wei Dai, Xue-Xin Tan, Jian Sun, Chen-Ping Zhang, Xing-Jun Qin
PURPOSE: The purpose of this study was to analyze the reliability of the deep venous drainage system of the free radial forearm flap. MATERIALS AND METHODS: The authors implemented a retrospective cohort study and enrolled patients admitted for the evaluation and management of head and neck tumors with radial forearm flap reconstruction. The primary predictor variables were the donor site veins, including the deep, dual, and superficial venous drainage systems. The primary outcome measurement was the incidence of venous compromise...
August 3, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28858276/-surgical-treatment-of-patients-with-arteriovenous-head-and-neck-angiodisplasia
#14
I V Stepanov, M S Olshanskiy, D Yu Kharitonov, E S Stepanova
The aim of the study was to assess the results of surgical treatment in 74 patients with extensive arteriovenous angiodisplasia in the head and neck area. All patients underwent complex examination including ultrasound, CT and MRI with contrast and selective carotid angiography. The lesions excision was performed after endovascular embolization and soft tissue defects were restored by various methods selected according to prevalent vascular lesion type (arterial, arteriovenous, venous, capillary) and blood flow values (high flow, low flow, mixed)...
2017: Stomatologii︠a︡
https://www.readbyqxmd.com/read/28838837/osteomyocutaneous-fibular-flap-harvesting-computer-assisted-planning-of-perforator-vessels-using-computed-tomographic-angiography-scan-and-cutting-guide
#15
Salvatore Battaglia, Vincenzo Maiolo, Gabriella Savastio, Maurizio Zompatori, Federico Contedini, Elisa Antoniazzi, Riccardo Cipriani, Claudio Marchetti, Achille Tarsitano
INTRODUCTION: Mandibular reconstruction performed after virtual planning has become more common during recent years. The gold standard for extensive mandibular reconstruction is of course a fibular free flap. In designing an osteomyocutaneous fibula flap, poor planning, aberrant anatomy and/or inadequate perforator vessels are the most frequent causes of complications and may force the surgeon to modify the flap design, explore the contralateral leg or harvest an additional microvascular flap...
July 29, 2017: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/28815781/external-jugular-veno-accompanying-artery-adipofascial-flap-a-novel-and-convenient-flap-for-head-and-neck-reconstruction
#16
Seong Oh Park, Kyung Chan Ahn, Ki Yong Hong, Hak Chang, Nobuaki Imanishi
BACKGROUND: The veno-accompanying artery adipofascial (VAF) flap is nourished by accompanying vessels near large superficial veins. We examined whether the VAF flap can be applied to the external jugular vein. METHODS: Based on anatomic and angiographic studies, we performed reconstructive surgeries using external jugular veno-accompanying artery adipofascial (EJ-VAF) flaps. A retrospective chart review was performed for all patients who underwent this surgery. RESULTS: The presence of arteries accompanying the external jugular vein was confirmed...
August 16, 2017: Head & Neck
https://www.readbyqxmd.com/read/28804686/a-comparative-study-of-tissue-expansion-and-free-parascapular-flaps-in-extensive-facial-burn-scar-reconstruction
#17
G S Kalra, Mitesh Bedi, Vipin Kumar Barala
BACKGROUND: Large post burn scars are a very difficult problem to treat. Available methods include skin grafts and tissue expansion. The reconstructive method used should be tailored according to individual patient rather than following a textbook approach in each. PATIENTS AND METHODS: A retrospective analysis was done of cases with extensive facial burn scars in whom secondary reconstruction was done with either free parascapular flap cover or tissue expansion and flap advancement following facial burn scar excision by a single surgeon (GSK) in Department of Burns, Plastic and reconstructive surgery...
2017: International Journal of Burns and Trauma
https://www.readbyqxmd.com/read/28796101/use-of-the-ipsilateral-anteromedial-thigh-flap-for-immediate-rescue-of-nonviable-anterolateral-thigh-flaps-in-head-and-neck-cancer-reconstruction
#18
Hsu-Tang Cheng, Jin-Yi Tian, Yung-Chang Hsu, Hsin-Han Chen, Sophia Chia-Ning Chang
BACKGROUND: It is not always possible to use the anatomically variable free anterolateral thigh (ALT) flap for reconstructive surgery. An anteromedial thigh (AMT) flap serves as a good alternative, and shares the same vascular pedicle as the ALT flap. METHODS: Of 698 reconstructions performed in 2006 to 2013 following head and neck tumor ablation surgery, ALT flaps were used in 653 patients. Eighteen free AMT flaps were harvested to replace variant nonviable ALT flaps...
September 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28772277/factors-to-consider-when-deciding-on-the-type-of-free-flap-reconstruction-of-head-and-neck-soft-tissue-defects
#19
Mohammed Thabet Aladimi, Bo Han, Chunjie Li, Hussein Helal, Zhenjie Gao, Longjiang Li
OBJECTIVES: The aim of the study was to evaluate the functional and aesthetic outcomes on donor and recipient sites and to determine the effects of technical factors including flap thickness and vessel diameters measured by ultrasonography as well as the size of the defect and postoperative volume reduction of the flaps measured by magnetic resonance imaging (MRI). METHODS: In patients who had undergone soft tissue reconstructive surgery between March 2013 and March 2016 using 55 anterolateral thigh flaps (ALTFs), 30 radial forearm flaps (RFFs), and 18 latissimus dorsi flaps (LDFs), color Doppler ultrasonography was performed to measure the thickness of the flap at the site of the perforator...
2017: ORL; Journal for Oto-rhino-laryngology and its related Specialties
https://www.readbyqxmd.com/read/28755704/it-takes-two-one-resects-one-reconstructs
#20
REVIEW
Shabnam Ghazizadeh, Edward C Kuan, Jon Mallen-St Clair, Elliot Abemayor, Quang Luu, Vishad Nabili, Maie A St John
Care of patients with advanced head and neck cancer is a multidisciplinary effort through all phases of care. Head and neck cancer surgery involves balancing oncologic control, functional preservation, and aesthetics. Given the advances in free tissue reconstruction, the majority of defects can be reconstructed using free tissue transfer flaps. A 2-team approach allows for early, continual communication and meticulous operative planning. Operations can be combined into a single effort. This approach maximizes efficiency and enables multidisciplinary collaboration for comprehensive surgical treatment...
August 2017: Otolaryngologic Clinics of North America
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