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Head and neck reconstruction

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https://www.readbyqxmd.com/read/28642191/new-aspects-in-free-flap-surgery-mini-perforator-flaps-and-extracorporeal-flap-perfusion
#1
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/28640732/do-nurse-staffing-levels-affect-patient-mortality-in-acute-secondary-care
#2
Barry Hill
This systematic literature review explores and considers whether registered nurse staffing levels affect patient mortality in acute secondary care settings. A discussion makes particular reference to the philosophical foundations of contrasting research approaches used within the literature. At the time of writing, the author was a modern matron for surgery, managing the ear, nose and throat; head and neck; airway; and reconstructive plastic surgery services in a large acute teaching hospital in central London...
June 22, 2017: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/28636741/adenoid-cystic-carcinoma-of-the-head-and-neck-area-oncologic-treatment-and-plastic-reconstructive-options
#3
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/28622701/free-tissue-transfers-for-head-and-neck-reconstruction-in-patients-with-end-stage-renal-disease-on-dialysis-analysis-of-outcomes-using-the-taiwan-national-health-insurance-research-database
#4
Oscar J Manrique, Pedro Ciudad, Basel Sharaf, Jorys Martinez-Jorge, Steven Moran, Samir Mardini, Hung-Chi Chen, Uldis Bite, Hsu-Tang Cheng
No abstract text is available yet for this article.
June 16, 2017: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/28617692/update-on-the-supraclavicular-flap
#5
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
#6
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
#7
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
#8
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/28601390/frequency-of-and-risk-factors-for-tumor-upstaging-after-wide-local-excision-of-primary-cutaneous-melanoma
#9
Jeremy R Etzkorn, John M Sharkey, John W Grunyk, Thuzar M Shin, Joseph F Sobanko, Christopher J Miller
BACKGROUND: Detecting a more advanced stage of the primary melanoma after wide local excision and reconstruction can complicate patient counseling about prognosis, management of surgical margins, and indications for sentinel lymph node biopsy. OBJECTIVE: To identify the frequency of and risk factors associated with upstaging after wide local excision of primary melanoma. METHODS: Retrospective, single center, cross-sectional study of 1332 consecutive in situ to stage T4a melanomas treated with wide local excision...
June 7, 2017: Journal of the American Academy of Dermatology
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/28579265/importance-of-chewing-saliva-and-swallowing-function-in-patients-with-advanced-oral-cancer-undergoing-preoperative-chemoradiotherapy-a-prospective-study-of-quality-of-life
#12
D Nemeth, L Zaleczna, A Huremovic, J Engelmann, P W Poeschl, M Strasz, S Holawe, G Kornek, A Laskus, C Sacher, B M Erovic, C Perisanidis
The primary objective of this study was to investigate the quality of life (QOL) of patients with oral squamous cell carcinoma (OSCC) undergoing curative neoadjuvant chemoradiotherapy followed by radical tumour resection and simultaneous oral cavity reconstruction, using two validated questionnaires. A secondary objective was to assess clinical variables predicting post-treatment dysfunction in chewing, saliva, and swallowing. Thirty-five patients with locally advanced OSCC who underwent preoperative chemoradiotherapy were recruited prospectively...
June 1, 2017: International Journal of Oral and Maxillofacial Surgery
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
#13
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
#14
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
#15
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/28566979/eagle-s-syndrome-with-facial-palsy
#16
Mohammed Al-Hashim, Nasser Al-Jazan, Abdulrahman Abdulqader, Mohammed Al-Ghamdi
Eagle's syndrome (ES) is a rare disease in which the styloid process is elongated and compressing adjacent structures. We describe a rare presentation of ES in which the patient presented with facial palsy. Facial palsy as a presentation of ES is very rare. A review of the English literature revealed only one previously reported case. Our case is a 39-year-old male who presented with left facial palsy. He also reported a 9-year history of the classical symptoms of ES. A computed tomography scan with three-dimensional reconstruction confirmed the diagnoses...
May 2017: Journal of Family & Community Medicine
https://www.readbyqxmd.com/read/28561188/reply-to-letter-to-the-editor-morbidity-of-the-free-fibula-flap-reconstruction-in-head-and-neck-malignancies
#17
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
#18
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/28556204/optimal-combination-of-anti-scatter-grids-and-software-correction-for-cbct-imaging
#19
Uros Stankovic, Lennert S Ploeger, Marcel van Herk, Jan-Jakob Sonke
PURPOSE: CBCT has been widely adopted in clinical practice for image-guided radiotherapy. Soft tissue contrast and Hounsfield units are impaired to presence of scattered radiation. In our previous work we proposed a high selectivity anti-scatter grid (ASG) as a possible solution to the problem. An alternative approach is the application of iterative scatter correction using deconvolution with scatter point spread function (PSF). The purpose of this work was to compare the performance of ASGs with different selectivity with and without the iterative and uniform scatter corrections in terms of CBCT image quality...
May 29, 2017: Medical Physics
https://www.readbyqxmd.com/read/28552611/care-of-long-term-survivors-of-head-and-neck-cancer-after-treatment-with-oral-or-facial-prostheses-or-both
#20
E Worrell, L Worrell, B Bisase
The current evidence of good practice in the delivery of long-term supportive care to patients who have been treated for head and neck cancer is sparse. We recruited 10 survivors so that we could follow their experience after their acute treatment was over. There were six men (mean (range) age 72 (54-86) years) and four women (mean (range) age 69 (67-73) years). After ethics committee approval had been given, we used structured interviews and questionnaires to investigate the impact of the resection and reconstruction, the patients' perceived needs, and their use of supportive care services...
May 25, 2017: British Journal of Oral & Maxillofacial Surgery
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