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Flaps head neck reconstruction

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https://www.readbyqxmd.com/read/28648958/use-of-a-three-dimensional-custom-made-porous-titanium-prosthesis-for-mandibular-body-reconstruction
#1
Q Qassemyar, N Assouly, S Temam, F Kolb
The progress made in recent years in the field of head and neck bone reconstruction is directly related to technological advancements made in computer-aided design and manufacturing (CAD/CAM) and three-dimensional printing in particular. Today these technologies are mainly used in mandibular reconstruction to manufacture aids for harvesting and shaping bone flaps. However problems remain when addressing patients with a contraindication to microsurgery who need extensive bone reconstruction. For these patients who cannot benefit from vascularized bone grafts, surgeons have to find alternative solutions aimed at maintaining best function and aesthetics...
June 22, 2017: International Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28648581/is-long-term-post-operative-monitoring-of-microsurgical-flaps-still-necessary
#2
Giovanni Zoccali, Alexandra Molina, Jian Farhadi
Autologous microsurgical flap reconstruction has become commonplace in most plastic surgery units, and the success rates of this procedure have markedly increased over recent years. However, the possibility of flap failure still needs to be considered. A review of the literature reveals that the critical period for flap-threatening complications is the first 24-48 post-operative hours; however, the window for the onset of these complications remains open for up to 7 days post-operatively. In this study, we focus on the timing of flap complications, aiming to elucidate the time period over which meticulous flap monitoring can positively contribute to flap salvage rates...
June 1, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28646587/perioperative-pain-management-after-fibular-free-flap-harvesting-for-head-and-neck-reconstruction-using-mini-catheters-to-inject-local-anesthetic-a-pilot-study
#3
Andrea Ferri, Andrea Varazzani, Adriana Valente, Giuseppe Pedrazzi, Bernardo Bianchi, Silvano Ferrari, Enrico Sesenna
BACKGROUND: Fibular donor site pain management in the early postoperative period can help minimize complications, patient discomfort, and agitation. Traditional management of postoperative pain consists of systemic administration of opioids and NSAIDS. The use of local anesthetics in addition to systemic analgesics has the potential to improve pain control. Purpose of the study is to evaluate the efficacy of mini-catheters used to inject local anesthetic into the fibular donor site after flap harvesting for reconstruction of the head-and-neck area...
June 24, 2017: Microsurgery
https://www.readbyqxmd.com/read/28642191/new-aspects-in-free-flap-surgery-mini-perforator-flaps-and-extracorporeal-flap-perfusion
#4
Klaus-Dietrich Wolff
BACKGROUND: The scope of microvascular tissue transfer in the Head and Neck reaches from coverage of simple soft tissue defects to complex 3-D reconstructions using multiple or chimeric flaps. This paper summarises the presentation given at the Congress of the French Society of Oral and Maxillofacial Surgery in Marseille 2017. It was the aim of our work to add further elements to this wide spectrum of reconstructive possibilities. METHODS: For patients with small intraoral soft tissue defects in whom the use of a radial forearm flap would not be justified because of its donor site morbidity, but who nevertheless would take a benefit from a small free flap, we used mini-perforator flaps from the lower leg...
June 19, 2017: Journal of Stomatology, Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28636741/adenoid-cystic-carcinoma-of-the-head-and-neck-area-oncologic-treatment-and-plastic-reconstructive-options
#5
Johannes A Veit, Julia Thierauf, Thomas K Hoffmann, Jens Greve, Nicole Rotter, Patrick J Schuler, Marc O Scheithauer
Adenoid cystic carcinoma of the head and neck area is a rare malignant tumor with acceptable short-term but mediocre long-term prognosis. Radical tumor excision with clear resection margins, and sometimes resection of the facial nerve due to perineural growth, remains the fundamental therapy. We present 3 distinct clinical cases and discuss the current therapeutic options with special focus on plastic-reconstructive techniques. For reconstruction, the full armament of local and free flaps, as well as prosthetics, may be necessary...
June 2017: Ear, Nose, & Throat Journal
https://www.readbyqxmd.com/read/28617692/update-on-the-supraclavicular-flap
#6
Nicholas E Wirtz, Samir S Khariwala
PURPOSE OF REVIEW: The purpose of this study is to describe the supraclavicular flap and its utility in head and neck reconstruction in the context of recent studies. RECENT FINDINGS: Current literature regarding the supraclavicular flap has described its expanded uses in a variety of head and neck reconstructive settings. Its reliability and limited morbidity have been well demonstrated, and it has been cited as a reasonable alternative to other reconstructive options including, in some situations, free tissue transfer...
June 14, 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/28616153/a-multidisciplinary-approach-to-the-successful-management-of-gorlin-syndrome
#7
Ryan N Mello, Zaki Khan, Umar Choudry
Gorlin-Goltz syndrome (GGS) is a rare genetic syndrome with variable expressivity and autosomal dominant inheritance. The major features of GGS include numerous basal cell carcinomas (BCCs), keratocysts of the jaw, palmar/plantar pits and calcification of the falx cerebri. Authors report the case of a 51-year-old male with a 19-year history of GGS and multiple BCCs of the head and neck. He presented with a large ulcerating lesion on the right side of his face involving cutaneous, subcutaneous and muscular tissues of the temporal and orbital region...
June 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28615805/free-anteromedial-thigh-perforator-flap-complementing-and-completing-the-anterolateral-thigh-flap
#8
Dushyant Jaiswal, Amol Ghalme, Prabha Yadav, Vinaykant Shankhdhar, Akshay Deshpande
OBJECTIVE: Theobjective of this study was to determine the indications, utility, advantages and surgical approach for the anteromedial thigh (AMT) flap. MATERIALS AND METHODS: We reviewed the records of the patients in whom the AMT flap was used for head and neck reconstruction. We use an anterior approach to harvest the anterolateral thigh (ALT) flap with a non-committal straight line incision. This preserves both ALT and AMT flap territories intact, and further decision is based on the intraoperative anatomy of perforator and pedicle...
January 2017: Indian Journal of Plastic Surgery: Official Publication of the Association of Plastic Surgeons of India
https://www.readbyqxmd.com/read/28604549/transverse-cervical-artery-perforator-flap-standardized-surgical-technique-and-multiple-reconstructive-opportunity-in-head-and-neck-surgery
#9
Nicola Luca, Maria Josè Santana, Bianca Maria Festa, Fabio Collurà, Stefano Righini
The main purpose of head and neck reconstructive surgery is to provide anatomic restoration of the demolited region and to provide preservation and recovery of function. The anatomical investigations conducted over the years has enabled a detailed knowledge of human body vascularization, giving the opportunity to design and harvest more and more versatile and refined flaps, with increasingly satisfactory results. Even if in the last 2 decades free flaps have been considered a reconstructive criterion standard, they still determine a great physical impact for the patient and require a certain surgical experience...
June 9, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28581030/postoperative-anticoagulation-after-free-flap-reconstruction-for-head-and-neck-cancer-a-systematic-review
#10
REVIEW
Blair M Barton, Charles A Riley, John C Fitzpatrick, Christian P Hasney, Brian A Moore, Edward D McCoul
OBJECTIVE: Postoperative use of anticoagulation after free tissue transfer in head and neck ablative procedures is common practice, but a clear protocol has not been well established. The outcome measures including total flap failure, thrombosis, and hematoma formation for different anticoagulation regimens in free tissue transfer in the head and neck were reviewed. DATA SOURCES: PubMed, Ovid, and Cochrane databases were examined for patients who underwent free tissue transfer following head and neck ablative procedures...
June 5, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28580729/laparoscopic-harvest-of-the-gastro-omental-free-flap-for-reconstruction-after-total-pharyngolaryngectomy-operative-technique
#11
Steven J Craig, Alexander Zhang, Trevor D Gardner, Jonathan R Clark, Bruce G Ashford
Circumferential defects following salvage pharyngolaryngectomy present significant challenges in reconstructive surgery. The gastro-omental free flap has been shown to reduce the incidence of major fistula and catastrophic complications. The current technique for harvest of the flap requires laparotomy, which is potentially associated with significant post-operative complications. Laparoscopic harvest of the gastro-omental free flap can negate some of the risks associated with open surgery. We describe here the operative technique for laparoscopic gastro-omental free flap harvest for use in reconstruction following total pharyngolaryngectomy...
June 5, 2017: Head & Neck
https://www.readbyqxmd.com/read/28571928/free-tissue-flaps-in-head-and-neck-reconstruction-clinical-application-and-analysis-of-93-patients-of-a-single-institution
#12
Jiwang Liang, Tao Yu, Xu Wang, Yuejiao Zhao, Fengqin Fang, Wei Zeng, Zhendong Li
INTRODUCTION: Reconstruction with a free flap is routine in head and neck surgery because of better functional outcomes, improved esthetics, and generally higher success rates. OBJECTIVE: To evaluate the clinical outcomes in patients undergoing different microvascular free flap reconstructions. METHODS: This was a retrospective study of 93 patients undergoing reconstructions with free flaps from 2007 to 2015. Four types of free flap were performed: Anterolateral Thigh (76...
May 13, 2017: Brazilian Journal of Otorhinolaryngology
https://www.readbyqxmd.com/read/28570718/free-flap-reconstruction-monitoring-techniques-and-frequency-in-the-era-of-restricted-resident-work-hours
#13
Urjeet A Patel, David Hernandez, Yelizaveta Shnayder, Mark K Wax, Matthew M Hanasono, Joshua Hornig, Tamer A Ghanem, Matthew Old, Ryan S Jackson, Levi G Ledgerwood, Patrik Pipkorn, Lawrence Lin, Adrian Ong, Joshua B Greene, James Bekeny, Yin Yiu, Salem Noureldine, David X Li, Joel Fontanarosa, Evan Greenbaum, Jeremy M Richmon
Importance: Free flap reconstruction of the head and neck is routinely performed with success rates around 94% to 99% at most institutions. Despite experience and meticulous technique, there is a small but recognized risk of partial or total flap loss in the postoperative setting. Historically, most microvascular surgeons involve resident house staff in flap monitoring protocols, and programs relied heavily on in-house resident physicians to assure timely intervention for compromised flaps...
June 1, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28570441/significance-of-the-lateral-thoracic-artery-in-pectoralis-major-musculocutaneous-flap-reconstruction-quantitative-assessment-of-blood-circulation-using-indocyanine-green-angiography
#14
Hidetaka Miyazaki, Kimihiro Igari, Toshifumi Kudo, Toshinori Iwai, Yoshitaka Wada, Yasuhiro Takahashi, Yoshinori Inoue, Shinichi Asamura
Free tissue transfer is the preferred reconstruction option in most major head and neck reconstructions. The pectoralis major muscle musculocutaneous (PMMC) flap is commonly used in salvage of necrotic free flaps and is the first choice for patients who are not candidates for free flaps. The lateral thoracic artery (LTA), which is thought to contribute to blood perfusion of the inferior and lateral mammary area, is not preserved in a conventionally harvested PMMC flap. With regard to blood supply, it has been suggested that the LTA should be preserved, in addition to the pectoral branch of the thoracoacromial artery, when a skin island is designed in the lower chest to attain a pedicle length sufficient for head and neck reconstruction...
May 31, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28561188/reply-to-letter-to-the-editor-morbidity-of-the-free-fibula-flap-reconstruction-in-head-and-neck-malignancies
#15
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.
June 2017: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/28561187/letter-to-the-editor-morbidity-of-the-free-fibula-flap-reconstruction-in-head-and-neck-malignancies
#16
Harin Asokan, Jerry R John
No abstract text is available yet for this article.
June 2017: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/28536044/free-tissue-transfer-for-necrotizing-fasciitis-reconstruction-a-case-series
#17
Justin Peter Gawaziuk, Tianyi Liu, Leif Sigurdson, Edward Buchel, Thomas Edward Jo Hayakawa, Sarah Shiga, Sarvesh Logsetty
BACKGROUND: Necrotizing fasciitis (NF) is a life-threatening infection requiring extensive debridement that may necessitate amputation. Free tissue transfer (FTT) is an option for reconstruction in difficult cases. Currently, only case reports have described FTT in the setting of NF, and comprehensive evidence on flap outcomes is lacking. The present study characterizes outcomes in patients with FTT following NF. METHODS: All patients admitted with NF between January 1, 2005 and December 31, 2011 to our level 1 burns/trauma referral center were retrospectively reviewed...
May 20, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28530258/enhanced-recovery-program-erp-in-major-laryngeal-surgery-building-a-protocol-and-testing-its-feasibility
#18
M Gemma, S Toma, F Lira Luce, L Beretta, M Braga, M Bussi
Enhanced recovery programs (ERP) represent a multimodal approach to perioperative patient care. The benefits of ERP are well demonstrated in colorectal surgery and Enhanced Recovery After Surgery (ERAS®) programs, that epitomise the ERP concept, have being introduced in different specialties, including vascular, gastric, pancreatic, urogynecologic and orthopaedic surgery. However, no ERP has been proposed for head and neck surgery. We developed an expert-opinion-based ERP for laryngeal surgery based on the key principles of colorectal surgery ERAS®...
May 22, 2017: Acta Otorhinolaryngologica Italica
https://www.readbyqxmd.com/read/28520896/laser-assisted-indocyanine-green-dye-angiography-for-postoperative-fistulas-after-salvage-laryngectomy
#19
Erin J Partington, Lindsay S Moore, Russel Kahmke, Jason M Warram, William Carroll, Eben L Rosenthal, Benjamin J Greene
Importance: Pharyngocutaneous fistula formation is an unfortunate complication after salvage laryngectomy for head and neck cancer that is difficult to anticipate and related to a variety of factors, including the viability of native pharyngeal mucosa. Objective: To examine whether noninvasive angiography with indocyanine green (ICG) dye can be used to evaluate native pharyngeal vascularity to anticipate pharyngocutaneous fistula development. Design, Setting, and Participants: This cohort study included 37 patients enrolled from June 1, 2013, to June 1, 2016, and follow-up was for at least 1 month postoperatively...
May 18, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28514343/-effect-of-dexmedetomidine-on-perfusion-of-free-flaps-transferred-to-head-and-neck
#20
A S Dobrodeev, S A Rabinovich, I F Malykhina
The paper presents the impact of perioperative care on feasibility of free fibula flap transfer for facial reconstruction. Flaps vitality was measured by means of somatic oximetry in 85 patients aged 20-74 years receiving reconstruction procedures in midfacial and lower facial areas. The patients were divided in three groups according to sedation agent used postoperatively. It has been demonstrated that dexmedetomidine postoperative sedation significantly improved free fibula flaps perfusion compared to propofol sedation...
2017: Stomatologii︠a︡
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