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Flaps head neck reconstruction

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https://www.readbyqxmd.com/read/28804686/a-comparative-study-of-tissue-expansion-and-free-parascapular-flaps-in-extensive-facial-burn-scar-reconstruction
#1
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
#2
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...
August 8, 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
#3
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...
August 4, 2017: ORL; Journal for Oto-rhino-laryngology and its related Specialties
https://www.readbyqxmd.com/read/28755704/it-takes-two-one-resects-one-reconstructs
#4
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
https://www.readbyqxmd.com/read/28753219/the-retrograde-transverse-cervical-artery-as-a-recipient-vessel-for-free-tissue-transfer-in-complex-head-and-neck-reconstruction-with-a-vessel-depleted-neck
#5
Pedro Ciudad, Mouchammed Agko, Oscar J Manrique, Shivprasad Date, Kidakorn Kiranantawat, Wei Ling Chang, Fabio Nicoli, Federico Lo Torto, Michele Maruccia, Georgios Orfaniotis, Hung-Chi Chen
BACKGROUND: Reconstruction in a vessel-depleted neck is challenging. The success rates can be markedly decreased because of unavailability of suitable recipient vessels. In order to obtain a reliable flow, recipient vessels away from the zone of fibrosis, radiation, or infection need to be explored. The aim of this report is to present our experience and clinical outcomes using the retrograde flow coming from the distal transverse cervical artery (TCA) as a source for arterial inflow for complex head and neck reconstruction in patients with a vessel-depleted neck...
July 28, 2017: Microsurgery
https://www.readbyqxmd.com/read/28746932/morbidity-and-functional-outcomes-following-free-jejunal-flap-reconstruction-for-head-and-neck-cancer
#6
Song Ni, Yiming Zhu, Dong Qu, Jian Wang, Dezhi Li, Bin Zhang, Zhengang Xu, Shaoyan Liu
AIM: To evaluate the morbidity and fundamental functional outcomes (swallow and speech) after free jejunal flap (FJF) reconstruction following total pharyngolaryngo-esophagectomy (PLE) in China. METHODS: 18 patients with FJF reconstruction after total PLE were retrospectively reviewed. Scheduled barium swallow test was performed 7-10 days postoperatively. Rehabilitation of swallowing and speech for patients was assessed by the Performance Status Scale for Head and Neck Cancer Patients...
July 27, 2017: ORL; Journal for Oto-rhino-laryngology and its related Specialties
https://www.readbyqxmd.com/read/28746288/using-a-second-free-fibula-osteocutaneous-flap-after-repeated-mandibulectomy-is-associated-with-a-low-complication-rate-and-acceptable-functional-outcomes
#7
Alexander F Mericli, Mark V Schaverien, Matthew M Hanasono, Peirong Yu, Rene D Largo, Mark T Villa, Greg Reece, Charles E Butler, Patrick B Garvey
BACKGROUND: A significant percentage of patients who undergo segmental mandibulectomy for head and neck cancer will develop a new or recurrent cancer or osteoradionecrosis, necessitating a second mandibulectomy and reconstruction. In this scenario, many surgeons are reluctant to perform a reconstruction with an osseous flap because of the presumed increased morbidity and complexity. The purpose of this study was to evaluate the safety and efficacy of performing a second free fibula flap reconstruction after repeated segmental mandibulectomy...
August 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28740778/takotsubo-cardiomyopathy-after-head-and-neck-reconstructive-surgery
#8
Masanori Mori, Hayato Nagashima, Satoshi Akazawa, Noriko Saegusa, Yuichi Ichikawa, Kei Iida, Kotaro Yoshimura, Masahiro Nakagawa
Takotsubo cardiomyopathy (TCM) is a form of transient heart failure that clinically mimics acute coronary syndrome and is characterized by left ventricular wall motion abnormalities. The pathophysiology of TCM is not well established. TCM is often preceded by emotional or physical stress and may occur after surgery. We present 3 cases of TCM occurring after head and neck reconstructive surgery. Echocardiography plays a central role in the diagnosis of TCM. Left ventricular wall motion abnormalities extend beyond the territory of a single coronary artery...
June 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28740764/multiple-free-flap-reconstructions-of-head-and-neck-defects-due-to-oral-cancer
#9
Yumi Mochizuki, Hiroyuki Harada, Hiroaki Shimamoto, Hirofumi Tomioka, Hideaki Hirai
OBJECTIVE: We studied complications following multiple free flap reconstructions in the head and neck. METHODS: In this cohort, 26 patients (14 men and 12 women) who underwent multiple microvascular free flap reconstructions were included in the study. The reasons for secondary reconstruction were recurrence of tumor (12 cases), necrosis of transferred skin and/or bone (6 cases), reconstruction plate fracture or exposure (4 cases), and others (4 cases). A third reconstruction in 4 cases and a fourth reconstruction in 1 case were performed...
June 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28739194/perforator-based-rectus-free-tissue-transfer-for-head-and-neck-reconstruction-new-reconstructive-advantages-from-an-old-friend
#10
Stephen Y Kang, Matthew E Spector, Douglas B Chepeha
OBJECTIVES: To demonstrate three reconstructive advantages of the perforator based rectus free tissue transfer: long pedicle, customizable adipose tissue, and volume reconstruction without muscle atrophy within a contained space. MATERIALS AND METHODS: Thirty patients with defects of the head and neck were reconstructed with the perforator based rectus free tissue transfer. RESULTS: Transplant success was 93%. Mean pedicle length was 13.4cm...
July 21, 2017: Oral Oncology
https://www.readbyqxmd.com/read/28736943/risk-factors-for-wound-complications-in-head-and-neck-reconstruction-773-free-jejunal-reconstruction-procedures-after-total-pharyngolaryngoesophagectomy
#11
Narushi Sugiyama, Soshi Takao, Etsuji Suzuki, Yoshihiro Kimata
BACKGROUND: Most studies that examined risk factors for wound complications after head and neck reconstruction analyzed various complications collectively. Moreover, they included a wide variety of resection areas and reconstruction materials. To overcome these limitations, both the resection area and reconstruction method were constrained in the present study. METHODS: Patients who underwent free jejunal graft reconstruction after pharyngolaryngoesophagectomy for hypopharyngeal cancer were enrolled...
July 24, 2017: Head & Neck
https://www.readbyqxmd.com/read/28735639/free-flap-reconstruction-for-patients-aged-85-years-and-over-with-head-and-neck-cancer-clinical-considerations-for-comprehensive-care
#12
X F Chen, Y M Chen, S Gokavarapu, Q C Shen, T Ji
We aimed to identify and evaluate the clinical challenges involved in microvascular flap reconstructions of defects caused by resection of head and neck cancer among patients aged 85 and over. We designed a retrospective study of patients who were treated in the head and neck department of a tertiary referral centre from 2005 to 2015, and all patients aged 85 years and over who had reconstructions with microvascular flaps for head and neck cancer were entered into the study. A total of 24 patients fulfilled the criteria, of whom 15 were men and nine were women...
July 20, 2017: British Journal of Oral & Maxillofacial Surgery
https://www.readbyqxmd.com/read/28731497/the-effect-of-frailty-on-short-term-outcomes-after-head-and-neck-cancer-surgery
#13
Carrie L Nieman, Karen T Pitman, Anthony P Tufaro, David W Eisele, Kevin D Frick, Christine G Gourin
OBJECTIVE: To determine the relationship between frailty and comorbidity, in-hospital mortality, postoperative complications, length of hospital stay (LOS), and costs in head and neck cancer (HNCA) surgery. STUDY DESIGN: Cross-sectional analysis. METHODS: Discharge data from the Nationwide Inpatient Sample for 159,301 patients who underwent ablative surgery for a malignant oral cavity, laryngeal, hypopharyngeal, or oropharyngeal neoplasm in 2001 to 2010 was analyzed using cross-tabulations and multivariate regression modeling...
July 21, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28729774/clinical-applications-of-free-medial-tibial-flap-with-posterior-tibial-artery-for-head-and-neck-reconstruction-after-tumor-resection
#14
Qi Zhong, Jugao Fang, Zhigang Huang, Xiaohong Chen, Lizhen Hou, Yang Zhang, Pingdong Li, Hongzhi Ma, Hongbo Xu
Tumor resection causes damage in the head and neck which creates problems in swallowing, chewing, articulation, and vision, all of which seriously affect patients' quality of life. In this work, we evaluated the application of a free medial tibial flap in reconstruction of head and neck defects after tumor resection. We discussed the anatomy, surgical technique, and the advantages and disadvantages of the flap. We found several benefits for the flap, such as, it is especially effective for the defects that require thin-layer epithelium to cover or the separated soft tissue defect; a two-team approach can be used because the donor site is far away from the head and neck; and the flap is easy to integrate because of the subcutaneous fat layer of the free medial tibial flap is thin and the flap is soft...
June 2017: Chinese Journal of Cancer Research, Chung-kuo Yen Cheng Yen Chiu
https://www.readbyqxmd.com/read/28728327/non-melanocytic-skin-cancers-of-the-head-and-neck-a-clinical-study-in-jeju-province
#15
Jae Kyoung Kang, Byung Min Yun, Jung-Kook Song, Myoung Soo Shin
BACKGROUND: Jeju Island is geographically and socioeconomically distinct from the mainland of South Korea. Thus, the presentation and management of non-melanocytic skin cancers (NMSC) of the head and neck may differ from those in other regions of the country. We compared the clinical characteristics and treatment modalities of NMSC on Jeju Island with the findings of similar regional studies. METHODS: Patient data, including age, sex, diagnosis, tumor site, treatment, and recurrence, were obtained from the medical and pathology records of patients diagnosed with NMSC between January 2010 and June 2015...
July 2017: Archives of Plastic Surgery
https://www.readbyqxmd.com/read/28720989/trapezius-perforator-flap-for-reconstruction-of-a-posterior-cervical-defect
#16
Ricardo Nascimento, Joana Costa, Ricardo Horta, Álvaro Silva
The use of free flaps is considered the "gold standard" for reconstruction of head and neck defects. Locoregional flaps allows a better aesthetic result compared to free flaps, whenever there's an external skin defect. However the use of free flaps is not always adequate in the presence of preoperative comorbidities or previous surgeries. Since the description of the trapezius myocutaneous flap in the 1980's, many authors have published the results of the applicability of this flap in head and neck salvage reconstructive surgery...
April 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/28716300/the-effect-of-training-level-on-complications-after-free-flap-surgery-of-the-head-and-neck
#17
Jacob S Brady, Meghan M Crippen, Andrey Filimonov, Neil V Nadpara, Jean Anderson Eloy, Soly Baredes, Richard Chan Woo Park
OBJECTIVES: Analyze postoperative complications after free flap surgery based on PGY training level. METHODS: Data on free flap surgeries of the head and neck performed from 2005 to 2013 was collected from the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database. Cases identifying the status of resident participation in the surgery and the PGY level were included. RESULTS: There were 582 cases with primary surgeon data available...
June 2, 2017: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/28712070/flow-diverter-in-radiation-induced-skull-base-carotid-blowout-syndrome-do-not-write-it-off
#18
Gopinathan Anil, Junwei Zhang, Yew Kwang Ong, Francis Hui
Post-radiotherapy carotid blowout syndrome (CBS) of the skull base is a rare but often catastrophic complication of head and neck malignancies. The existing literature on the treatment of this condition with flow-diverting devices (FDD) is extremely limited and disappointing. We present a case of impending CBS in a patient previously irradiated for nasopharyngeal cancer that was successfully treated with use of multiple FDDs, adjunctive endonasal packing and delayed reinforcement with pedicled naso-septal flap, yielding an excellent outcome at 14-months follow-up...
July 16, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28709536/margin-analysis-has-free-tissue-transfer-improved-oncologic-outcomes-for-oral-squamous-cell-carcinoma
#19
REVIEW
Sean P Edwards
Microvascular reconstruction of ablative defects has become a mainstay of contemporary management of head and neck cancer patients. These techniques offer myriad tissue options that vary in character, volume, and components and have vastly improved the esthetic and functional outcomes achieved in this patient population. Although consensus exists regarding the reliability and functional and esthetic benefits of free tissue transfer, the same cannot be said for oncologic outcomes. The increase in resources required for the routine use of free tissue transfer has led to asking this question-Do vascularized free flaps allow for increased surgical margins and improvements in oncologic outcomes?...
August 2017: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/28708658/condyle-head-reimplantation-combined-with-vascularized-free-flap-for-mandibular-reconstruction
#20
Jun-Yi Zhu, Hai-Xiao Zou, Hui-Min Li, Wei Wang, Jun Jia
Due to the anatomic and functional complexity, reconstruction of the condylar process after mandibular tumor extirpation remains a surgical challenge. The aim of this study was to present the results and experience of condyle head reimplantation combined with vascularized free flap for mandibular reconstruction in our institution. In the current study, the authors evaluated the clinical features of condyle head reimplantation combined with vascularized free flap for mandibular reconstruction in 5 patients with benign mandibular intraosseous lesions from December 2013 to March 2015 in our institution...
July 13, 2017: Journal of Craniofacial Surgery
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