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Flaps head neck reconstruction

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https://www.readbyqxmd.com/read/27913719/surgical-site-infections-in-major-head-and-neck-surgeries-involving-pedicled-flap-reconstruction
#1
Neerav Goyal, Bharat B Yarlagadda, Daniel G Deschler, Kevin S Emerick, Derrick T Lin, Debbie L Rich, James W Rocco, Marlene L Durand
OBJECTIVE: To evaluate surgical site infections (SSI) after pedicled reconstruction in head and neck surgery. METHODS: Records of patients with pedicled flap reconstructions between 2009 and 2014 at Massachusetts Eye and Ear were reviewed. Onset of SSI or fistula ≤30 days postoperatively was noted. A free flap cohort was reviewed for comparison. RESULTS: Two hundred and eight pedicled reconstructions were performed for cancer (83%), osteoradionecrosis (7%), and other reasons (10%)...
January 2017: Annals of Otology, Rhinology, and Laryngology
https://www.readbyqxmd.com/read/27898195/cost-effectiveness-of-microsurgical-reconstruction-for-head-and-neck-defects-after-oncologic-resection
#2
Lin Lin Gao, Marten Basta, Suhail K Kanchwala, Joseph M Serletti, David W Low, Liza C Wu
BACKGROUND: Microvascular free tissue transfer has become the main technique used for head and neck reconstruction. We assessed the cost-effectiveness of free flap reconstruction for head and neck defects after oncologic resection for squamous cell carcinoma (SCC). METHODS: We developed a Markov model of the cost, quality of life, survival, and incremental cost-effectiveness of reconstruction with free tissue transfer compared with locoregional flaps. Health state probabilities and quality of life scores were determined from literature...
November 29, 2016: Head & Neck
https://www.readbyqxmd.com/read/27895376/versatility-of-the-anterolateral-thigh-flap-an-akuh-experience
#3
M Fazlur Rahman, Muhammad Asif Ahsan, Muhammad Ubaid Khan, Sami Ullah, Sara Khan
Anterolateral thigh flap is used for reconstruction of various soft tissue defects. We planned the study to evaluate the versatility of the anterolateral thigh flap as it may be used for reconstruction of head and neck, torso and extremities with minimal donor-site morbidity. The retrospective study was conducted at Aga Khan University Hospital, Karachi, and comprised date from October 2012 to December 2015. Of the 75 patients in which anterolateral thigh flap was used for reconstruction, 6(8%) flaps did not survive...
October 2016: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/27894583/pre-expanded-supraclavicular-artery-perforator-flap
#4
REVIEW
Norbert Pallua, Bong-Sung Kim
The supraclavicular artery perforator (SAP) flap is a versatile flap for the reconstruction of head and neck defects. Recently, the authors have modified the SAP flap by using an anterior branch of the transverse cervical artery. The anterior SAP flap allows the harvest of a tissue island in the deltopectoral fossa, which is even thinner, is more pliable, and shows a superior color match to the face and neck compared with the original SAP flap. Pre-expansion increases flap size considerably, enabling the coverage of extended defects without the need of microsurgery...
January 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/27894572/pre-expanded-brachial-artery-perforator-flap
#5
REVIEW
Yuanbo Liu, Mengqing Zang, Maolin Tang, Shan Zhu, Jianhua Zhang, Yu Zhou
The medial upper arm flap is a time-honored yet ignored technique. It may be revitalized by combining the techniques of tissue expansion and perforator flap surgery. Pre-expansion increases flap dimension, remodels flap vasculature, and reduces donor site morbidities, making the medial arm flap a more effective option for various defect reconstructions. A pre-expanded brachial artery perforator flap achieves excellent functional and aesthetic outcomes in patients with soft tissue defects on the head and neck, axilla, chest wall, and upper extremity...
January 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/27880030/osseointegrated-implants-into-a-variety-of-composite-free-flaps-a-comparative-analysis
#6
Michael Burgess, Matthew Leung, Anthony Chellapah, Jonathan R Clark, Martin D Batstone
BACKGROUND: Significant oral function is often lost after surgical therapy for head and neck cancer. The use of osseointegrated implants for reconstruction in patients with head and neck surgery has shown to significantly improve the quality of life for these patients. Variable success rates range from 99% to 70%. METHODS: A retrospective audit of patient records was performed looking at cumulative survival of implants. Inclusion criteria were patients who were treated at 1 of 2 designated Australian Head and Neck Units and received oral osseointegrated implants...
November 23, 2016: Head & Neck
https://www.readbyqxmd.com/read/27879602/health-related-quality-of-life-following-reconstruction-for-common-head-and-neck-surgical-defects
#7
Wess A Cohen, Claudia R Albornoz, Peter G Cordeiro, Jennifer Cracchiolo, Elizabeth Encarnacion, Meghan Lee, Michele Cavalli, Snehal Patel, Andrea L Pusic, Evan Matros
BACKGROUND: Improved understanding and management of health-related quality of life represents one of the greatest unmet needs for patients with head and neck malignancies. The purpose of this study was to prospectively measure health-related quality of life associated with different anatomical (head and neck) surgical resections. METHODS: A prospective analysis of health-related quality of life was performed in patients undergoing surgical resection with flap reconstruction for stage II or III head and neck malignancies...
December 2016: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/27872534/use-of-combined-pmmc-and-nasolabial-flap-for-reconstruction-of-full-thickness-cheek-defect-involving-lip-commisure
#8
Mahendra I Katre, Sunil Deshmukh, Pramod Dhanajkar
Head neck cancer constitute significant cancer burden and among it carcinoma of oral cavity involving buccal mucosa is most common entity in India. Very often it involves lip commisure. Radical surgery along with radiotherapy still remains treatment of choice. Reconstruction of composite defect of oral cavity fallowing ablative surgery remains difficult task. Reconstruction of lip commisure defect after primary tumor excision is still a big challenge. Micro vascular technique primary repair is main modality of treatment which needs great surgical expertise in plastic surgery which is not possible in every institution...
December 2016: Indian Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27865376/free-flap-outcome-of-salvage-surgery-compared-to-primary-surgery-for-head-and-neck-defects-a-propensity-score-analysis
#9
Chung-Hwan Baek, Woori Park, Nayeon Choi, Seonhye Gu, Insuk Sohn, Man Ki Chung
OBJECTIVES: To compare free flap outcomes for head and neck defects between primary surgery and salvage surgery and identify factors affecting the outcomes in the two settings. METHODS: A total of 225 patients (primary group, n=56; salvage group, n=169) were retrospectively identified. The salvage group was previously treated with radiotherapy, chemoradiation, surgery, or any combination of these treatments. Clinical data were retrieved and analyzed between the two groups to compare the incidence and contributing factors of flap-related complications and flap failure...
November 2016: Oral Oncology
https://www.readbyqxmd.com/read/27862538/free-thyroid-transfer-short-term-results-of-a-novel-procedure-to-prevent-post-radiation-hypothyroidism
#10
Jeffrey Harris, Brittany Barber, Hani Almarzouki, Rufus Scrimger, Jacques Romney, Daniel O'Connell, Mark Urken, Hadi Seikaly
BACKGROUND: The incidence of radiation-induced hypothyroidism (RIH) in patients with head and neck cancer is >50%. The purpose of this study was to assess the long-term efficacy of free thyroid transfer (FTT) for prevention of RIH in patients with head and neck cancer. METHODS: Hemithyroid dissection was completed in 10 patients with advanced head and neck cancer undergoing ablation, radial forearm free flap (RFFF) reconstruction, and postoperative radiotherapy (RT)...
November 15, 2016: Head & Neck
https://www.readbyqxmd.com/read/27861470/-mandibular-osteoradionecrosis-orn-as-a-side-effect-of-head-and-neck-cancer-treatment-factors-that-induce-it
#11
José Francisco Gallegos-Hernández, Alejandro Reyes-Vivanco, Héctor Arias-Ceballos, Gerardo Gabriel Minauro-Muñoz, Alma Lilia Ortiz-Maldonado, Daniel Israel García-Ruiz, Martín Hernández-Sanjuán
INTRODUCTION: Osteoradionecrosis of the mandible is a relatively common complication in patients with head and neck cancer undergoing radiotherapy or concomitant chemoradiotherapy, characterized by exposure of the mandibular bone either in the mouth or in the facial skin, with no improvement with conservative treatment for six months. The risk factors are radiotherapy in head and neck region, lack of dental prophylaxis before treatment and dental extraction. MATERIAL AND METHODS: Retrospective observational study analyzing incidence and etiologic factors of osteoradionecrosis in 250 patients undergoing radiotherapy or combined treatment of cervicofacial area between 2002 and 2010...
November 2016: Gaceta Médica de México
https://www.readbyqxmd.com/read/27858701/contrast-enhanced-ultrasonography-as-a-new-method-for-assessing-autonomization-of-pedicle-and-microvascular-free-flaps-in-head-and-neck-reconstructive-surgery
#12
Steffen Mueller, Christina M Wendl, Tobias Ettl, Christoph Klingelhöffer, Sebastian Geis, Lukas Prantl, Torsten E Reichert, Ernst Michael Jung
OBJECTIVE: Evaluating vascular autonomization of pedicle and microvascular free flaps for soft tissue reconstruction in the head and neck area by means of postoperative quantitative measurement of dynamic contrast values obtained with contrast-enhanced ultrasound. METHODS: 8/18 patients underwent lip reconstruction with a pedicle flap, 10 patients reconstruction of other parts of the head with a microvascular free transplant. Ultrasound examinations were within the 1st postoperative week and 4 weeks after surgery...
November 18, 2016: Clinical Hemorheology and Microcirculation
https://www.readbyqxmd.com/read/27847738/temporomandibular-joint-chondrosarcoma-a-case-report-and-literature-review
#13
Kyungjin Lee, Seong Hwan Kim, Soung-Min Kim, Hoon Myoung
Chondrosarcoma is a malignant tumor that originates from cartilaginous cells and is characterized by cartilage formation. Only 5% to 10% of chondrosarcoma occurs in the head and neck area, and it is uncommon in the temporomandibular joint area. This report describes an unusual case with a rare, large chondrosarcoma in a 47-year-old woman who presented with painless swelling and trismus. Computed tomography showed a large mass approximately 8.5×6.0 cm in size arising adjacent to the lateral pterygoid plate and condyle...
October 2016: Journal of the Korean Association of Oral and Maxillofacial Surgeons
https://www.readbyqxmd.com/read/27836568/the-surgical-management-of-head-and-neck-sarcoma-the-newcastle-experience
#14
R W F Breakey, T P Crowley, I B Anderson, R H Milner, M Ragbir
INTRODUCTION: Head and neck sarcomas are rare and difficult to manage surgically. Factors that influence the prognosis include the type and grade of tumour, resection margins, the anatomical site and patient-specific parameters. We review our experience as plastic surgeons working in a bone and soft-tissue tumour multidisciplinary team (MDT) in managing these tumours surgically. METHODS: Data on all patients with sarcoma of the head or neck managed surgically from 2004 to 2015 was reviewed...
October 5, 2016: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/27826458/factors-influencing-the-incidence-of-severe-complications-in-head-and-neck-free-flap-reconstructions
#15
Martin Broome, Naline Juilland, Yann Litzistorf, Yan Monnier, Kishore Sandu, Philippe Pasche, Peter K Plinkert, Philippe A Federspil, Christian Simon
BACKGROUND: Complications after head and neck free-flap reconstructions are detrimental and prolong hospital stay. In an effort to identify related variables in a tertiary regional head and neck unit, the microvascular reconstruction activity over the last 5 years was captured in a database along with patient-, provider-, and volume-outcome-related parameters. METHODS: Retrospective cohort study (level of evidence 3), a modified Clavien-Dindo classification, was used to assess severe complications...
October 2016: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/27789210/a-pilot-study-demonstrating-the-feasibility-of-supermicrosurgical-end-to-side-anastomosis-onto-large-recipient-vessels-in-head-and-neck-reconstruction
#16
Takuya Iida, Hidehiko Yoshimatsu, Takumi Yamamoto, Isao Koshima
In head and neck reconstruction using free flaps, microvascular anastomosis is commonly performed in an end-to-end fashion to relatively sizable arteries including the superficial temporal, facial, and superior thyroid arteries. With the recent developments of less invasive perforator flaps such as the superficial circumflex iliac artery perforator flap, anastomosis of smaller vessels of less than 0.8 mm diameter has become necessary; however, appropriate recipient arteries for end-to-end anastomosis are often absent...
September 28, 2016: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/27773516/development-of-a-nomogram-for-predicting-the-probability-of-postoperative-delirium-in-patients-undergoing-free-flap-reconstruction-for-head-and-neck-cancer
#17
N Y Choi, E H Kim, C H Baek, I Sohn, S Yeon, M K Chung
PURPOSE: To develop nomogram for prediction of postoperative delirium (POD) in patients undergoing ablative and reconstruction surgery for head and neck cancer. METHODS: Total 341 patients were retrospectively analyzed, and clinical variables in preoperative, intraoperative and postoperative periods were compared between delirium group (n = 89) and non-delirium group (n = 252). Multivariate logistic regression, receiver operating characteristics curve, and area under the curve (AUC) were used to generate and test a nomogram, which performance was evaluated by 10-fold cross validation (CV) procedure...
October 14, 2016: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27770839/anomalous-medial-branch-of-radial-artery-a-rare-variant
#18
Surbhi Wadhwa, Vandana Tomar
Radial artery is an important consistent vessel of the upper limb. It is a useful vascular access site for coronary procedures and its reliable anatomy has resulted in an elevation of radial forearm flaps for reconstructive surgeries of head and neck. Technical failures, in both the procedures, are mainly due to anatomical variations, such as radial loops, ectopic radial arteries or tortuosity in the vessel. We present a rare and a unique anomalous medial branch of the radial artery spiraling around the flexor carpi radialis muscle in the forearm with a high rising superficial palmar branch of radial artery...
2016: Acta Medica (Hradec Králové)
https://www.readbyqxmd.com/read/27765549/factors-influencing-postoperative-complications-in-reconstructive-microsurgery-for-head-and-neck-cancer
#19
Shih-Lun Lo, Yu-Hsiu Yen, Pi-Jung Lee, Charles Chih-Ho Liu, Chi-Ming Pu
PURPOSE: The present study aimed to analyze multiple variables and to determine the factors influencing postoperative complications in reconstructive microsurgeries for head and neck cancer. MATERIALS AND METHODS: This was a retrospective review of the medical records of patients with head and neck cancer who underwent free flap reconstruction after ablation surgery at the Cathay General Hospital (Taipei, Taiwan) from January 2010 to December 2014. Clinical and surgical procedure-related factors were retrieved from a database and analyzed...
September 23, 2016: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/27759740/goal-directed-fluid-management-in-free-flap-surgery-for-cancer-of-the-head-and-neck
#20
Sanna L Lahtinen, Janne H Liisanantti, Meri M Poukkanen, Päivi A Laurila
BACKGROUND: Goal-directed fluid management using stroke volume variation (SVV) analysis is not well studied in free flap reconstruction surgery in patients with head and neck cancer. METHODS: Patients operated due to cancer of the head and neck with free flap reconstruction during 2008-2010 and 2012-2014 in Oulu University Hospital were retrospectively evaluated to determine the impact of SVV-guided fluid management on perioperative fluid balance, postoperative complications and hospital length of stay (LOS)...
October 19, 2016: Minerva Anestesiologica
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