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Head and Neck Surgery

C Mozet, T Kuhnt, B Sattler, J Remmele, U Thome, H Stepan, R Kluge, A Dietz, M Knoedler
Objective: The diagnosis of cancer in pregnancy is rare, but might become more relevant even for head and neck cancer patients due to a shift of age of primipara towards the last third of reproductive years. Unsureness exists about the risk and benefit of diagnostic and therapeutic cancer modalities for the unborn and established recommendations are still missing. But, according to recent data, even multimodal therapeutic approaches (e. g. surgery, radiation, chemotherapy) seem possible in face of pregnancy and should be traded against the risk of prematurity...
October 2016: Laryngo- Rhino- Otologie
Markus Hoffmann, Asita Fazel, Kai-Gerrit Mews, Petra Ambrosch
OBJECTIVES: To underline the value of the microendoscopic CO2 -Laser assisted treatment (MEDCO2 ) of Zenker's diverticulum by investigating a large patient cohort treated in a single medical center. DESIGN: Retrospective Cohort Study of consecutive patients. SETTING: Dept. of Otorhinolaryngology, Head & Neck Surgery, Christian-Albrechts-University Kiel, Germany. PARTICIPANTS: 227 patients with Zenkers' diverticulum were treated by MEDCO2 and the results were compared with those reported in the literature for the open transcervical approach (OTA) and the endoscopic staple-assisted esophagodiverticulostomy (ESED)...
October 19, 2016: Clinical Otolaryngology
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
Benedicta E Beck-Broichsitter, Jörn Huck, Thomas Küchler, Daniela Hauke, Jürgen Hedderich, Jörg Wiltfang, Stephan T Becker
PURPOSE: The extent of functional impairment after ablative surgery in the orofacial region may be directly reflected in a reduction in Quality of Life. This study intended to compare the patients' perception with an objective functional evaluation of the orofacial system in order to bilaterally distinguish direct influence factors. METHODS: A total of 45 patients were included in this study and were asked to complete the European Organisation for Research and Treatment of Cancer Core Questionnaire (EORTC QLQ-30) and the Head and Neck 35 Module (H&N 35)...
October 18, 2016: Journal of Cancer Research and Clinical Oncology
Mona Taleb, Lydia Choi, Steve Kim
BACKGROUND: After wide local excision of cutaneous melanoma, large defects not amenable to simple primary closure are often covered with skin grafts. We report our experience using the rhomboid and keystone flaps to immediately close large axial and extremity wounds after potentially curative surgery for non-head and neck melanomas. METHODS: Between January 2011 and September 2016, demographic, operative, pathologic, and outcome data were prospectively collected on 60 patients who underwent wide local excision of melanoma followed by immediate flap reconstruction...
October 19, 2016: World Journal of Surgical Oncology
Takahiro Wakasaki, Hirofumi Omori, Shintaro Sueyoshi, Fumihide Rikimaru, Satoshi Toh, Kenichi Taguchi, Yuichiro Higaki, Masaru Morita, Muneyuki Masuda
BACKGROUND: Advanced head and neck squamous cell carcinomas frequently develop distant metastases to limited organs, including the lungs, bone, mediastinal lymph nodes, brain, and liver. Peritoneal carcinomatosis as an initial distant metastasis from hypopharyngeal squamous cell carcinoma is quite rare. CASE PRESENTATION: A 75-year-old man diagnosed with hypopharyngeal squamous cell carcinoma and his clinical stage was determined as T2N2cM0. Notably, the right retropharyngeal lymph node surrounded more than half of the right internal carotid artery...
October 18, 2016: World Journal of Surgical Oncology
Shujun Wang, Dawei Li, Chuanan Shen, Jiake Chai, Hongjuan Zhu, Yanlu Lin, Congying Liu
BACKGROUND: This study aimed to assess the epidemiological characteristics of pediatric burns in Beijing City. METHODS: This was a retrospective study of pediatric patients (n = 400) admitted to four burn centers in Beijing City between June 2010 and May 2011. Burn severity was determined according to total body surface area (TBSA) percentage and degree. Patients were followed up for one year. Multivariate analyses were carried out to determine the factors (burn etiology, time and place of injury, living conditions, hospital type, first-aid treatment methods, and parent/guardian knowledge of burns, educational level, occupation) affecting burn properties (severity and pigmentation/scar)...
October 18, 2016: BMC Pediatrics
Alastair Henry, James A McCaul
INTRODUCTION: Complex hard and soft tissue defects produced as a result of ablative resection of head and neck malignancy can represent a reconstructive challenge, especially when patients are medically compromised. PRESENTATION OF CASE: We present the case of 72-year-old women presenting with an oral squamous cell carcinoma of the right floor of mouth invading the right mandible. Surgical management of the disease required ablative surgery with complex free tissue transfer reconstruction to provide restoration of form and function...
October 12, 2016: International Journal of Surgery Case Reports
Jacqueline R Kelly, Zain A Husain, Barbara Burtness
Increasingly, squamous cell carcinoma of the oropharynx (OPSCC) is attributable to transformation resulting from high-risk human papillomavirus (HPV) infection. Such cancers are significantly more responsive to treatment than traditional tobacco- and alcohol-associated squamous cell cancers of the head and neck. Conventional management with definitive chemoradiation, surgery and adjuvant radiation, or radiation given with altered fractionation schemes, while effective, incurs long-term morbidity that escalates with treatment intensity and significantly impairs quality of life...
October 15, 2016: European Journal of Cancer
Min Seok Kang, Eun Jung Lee, Ji Seop Kim, In Sik Yun, Hyung Kwon Byeon
Microcystic adnexal carcinoma (MAC) is a rare malignant cutaneous adenocarcinoma that typically occurs in the head and neck, particularly at the central face. There are only slightly more than 300 patients reported worldwide, and most patients occur in Caucasians. A 72-year-old man was referred to our hospital for definitive treatment of known MAC from previous biopsy. Wide excision of nasal tip and reconstruction of nasal defect with paramedian forehead flap and nasolabial flap transposition were performed rather than conventional Mohs surgery, due to grossly evident disease...
October 14, 2016: Journal of Craniofacial Surgery
Ulrich Kisser, Christine Adderson-Kisser, Marius Förster, Klaus Stelter, Marion San Nicolo, Florian Schrötzlmair, Joachim Michael Müller, John Martin Hempel
INTRODUCTION: In Internet forums and other social media many reports regarding chronic headaches after cochlear implantation can be found. Although quite rare, there are also some reports in the literature. However, little is known regarding the true prevalence of headaches in persons who have undergone cochlear implant surgery. OBJECTIVES: The primary aim of this study was to investigate the 1-year prevalence of headache in patients having received a cochlear implantation ("cochlear implant group") in comparison with patients having undergone middle ear surgery ("surgery group") and persons with no history of head and neck surgery ("non-ear-nose-throat [ENT] group")...
October 12, 2016: Otology & Neurotology
Cindy T Y Lam, Graham E Trope, Yvonne M Buys
PURPOSE: To measure the influence of body weight on postural intraocular pressure (IOP) changes and to determine if significant weight loss effects IOP. PATIENTS AND METHODS: In this prospective case-control study 25 morbidly obese subjects scheduled for bariatric surgery and 25 age-matched and sex-matched normal weight controls were recruited. Subjects had tonometry performed in 7 positions with the order randomized: sitting with the neck in neutral position, neck flexion at 30 degrees, extension at 30 degrees, supine, right, and left lateral decubitus, and with the head and upper body elevated at 30 degrees...
October 14, 2016: Journal of Glaucoma
Natalie Wagner, Christine Fahim, Krista Dunn, Diane Reid, Ranil Sonnadara
BACKGROUND: Residency training programs worldwide are experiencing a shift from the traditional time-based curriculum to competency based medical education (CBME), due to changes in the healthcare system that have impacted clinical learning opportunities. Otolaryngology-Head and Neck Surgery (OTL-HNS) programs are one of the first North American surgical specialties to adopt the new CBME curriculum. OBJECTIVE OF REVIEW: The purpose of this scoping review is to examine the literature pertaining to CBME in OTL-HNS programs worldwide, to identify the tools that have been developed, and identify potential barriers to the implementation of CBME...
October 18, 2016: Clinical Otolaryngology
Kevin Wong, Jessica R Levi
OBJECTIVES/HYPOTHESIS: Evaluate the readability of pediatric otolaryngology-related patient education materials from leading online sources. STUDY DESIGN: Cross-sectional analysis. METHODS: All pediatric otolaryngology-related articles from the online patient health libraries of the top 10 US News & World Report-ranked children's hospitals, top 5 Doximity-ranked pediatric otolaryngology fellowships, and the American Academy of Otolaryngology-Head and Neck Surgery were collected...
October 18, 2016: Laryngoscope
Joel Wells, Jeffrey J Nepple, Karla Crook, James R Ross, Asheesh Bedi, Perry Schoenecker, John C Clohisy
BACKGROUND: Hip dysplasia represents a spectrum of complex deformities on both sides of the joint. Although many studies have described the acetabular side of the deformity, to our knowledge, little is known about the three-dimensional (3-D) head and neck offset differences of the femora of dysplastic hips. A thorough knowledge of proximal femoral anatomy is important to prevent potential impingement and improve results after acetabular reorientation. QUESTIONS/PURPOSES: (1) Are there common proximal femoral characteristics in patients with symptomatic hip dysplasia undergoing periacetabular osteotomy (PAO)? (2) Where is the location of maximal femoral head and neck offset deformity in hip dysplasia? (3) Do certain subgroups of dysplastic hips more commonly have cam-type femoral morphology? (4) Is there a relationship between hip ROM as well as impingement testing and 3-D head and neck offset deformity? METHODS: Using our hip preservation database, 153 hips (148 patients) underwent PAO from October 2013 to July 2015...
October 17, 2016: Clinical Orthopaedics and related Research
Ottavio Piccin, Giovanni Sorrenti, Francesca Milano
Sleep apnea has been shown to be more prevalent in patients who underwent radiotherapy and or surgery for head and neck cancer. Here we describe two cases of severe OSAS induced by surgery and radiotherapy, treated by Mandibular Advancing Devices as an alternative option to continuous positive airway pressure.
September 2016: Journal of Maxillofacial and Oral Surgery
Eugene T H Ek, Sophia K Paul, Robert N Hotchkiss
BACKGROUND: The role of elbow contracture release in the very young is unclear, with existing studies reporting conflicting results. This study evaluated the long-term results after open elbow contracture release in patients aged younger than 18 years. METHODS: Between 1994 and 2012, 32 patients underwent open elbow contracture release at a mean age of 13.8 years (range, 5-18 years), and their outcomes were reviewed. The primary cause was traumatic in 30 patients (4 radial head/neck fractures, 5 intra-articular distal humeral fractures, 11 extra-articular distal humeral fractures, 10 complex fracture-dislocations), and the mean time from the index injury to contracture release was 16...
October 14, 2016: Journal of Shoulder and Elbow Surgery
Merritt D Kinon, Rani Nasser, Jonathan Nakhla, Rupen Desai, Jessica R Moreno, Reza Yassari, Carlos A Bagley
Pediatric emergency physicians must have a high clinical suspicion for atlantoaxial rotatory subluxation (AARS), particularly when a child presents with neck pain and an abnormal head posture without the ability to return to a neutral position. As shown in the neurosurgical literature, timely diagnosis and swift initiation of treatment have a greater chance of treatment success for the patient. However, timely treatment is complicated because torticollis can result from a variety of maladies, including: congenital abnormalities involving the C1-C2 joint or the surrounding supporting muscles and ligaments, central nervous system abnormalities, obstetric palsies from brachial plexus injuries, clavicle fractures, head and neck surgery, and infection...
October 2016: Pediatric Emergency Care
D Rolski, J Kostrzewa-Janicka, P Zawadzki, K Życińska, E Mierzwińska-Nastalska
Morphological and functional disturbances induced by postsurgical defects and loss of tissues in the stomatognathic system due to the treatment of tumors in the maxillofacial region determine the therapeutic needs of patients. The study aimed at clinical and epidemiological evaluation of patients under prosthetic treatment in order to establish the algorithm for rehabilitation. The study group was composed of the patients after midface surgery (45.74%); surgery in a lower part of the face (47.38%); mixed postoperative losses (3...
2016: BioMed Research International
Maria Isabel Martínez-Fernández, Juan Alcalde, Mauricio Cambeiro, German Valtueña Peydró, Rafael Martínez-Monge
BACKGROUND AND PURPOSE: This study was undertaken to determine the feasibility of salvage surgery and PHDRB in patients with previously irradiated, recurrent head and neck cancer or second primary tumors arising in a previously irradiated field. METHODS AND MATERIALS: Sixty-three patients were treated with surgical resection and PHDRB. The PHDRB dose was 4Gy b.i.d.×8 (32Gy) for R0 resections and 4Gy b.i.d.×10 (40Gy) for R1 resections, respectively. Further external beam radiotherapy or chemotherapy was not given...
October 13, 2016: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
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