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Head and neck reconstruction

Blair M Barton, Charles A Riley, Jason D Pou, Christian P Hasney, Brian A Moore
Background: The submental island flap (SIF) is a pedicled flap based upon the submental artery and vein. Its utility in reconstruction following ablative head and neck procedures has been applied to various subsites including skin, lip, buccal mucosa, retromolar trigone, parotidectomy defects, and tongue. We review our experience using the SIF for reconstruction following tumor ablation. Methods: This prospective case series with medical record review includes consecutive patients undergoing SIF reconstruction following ablative surgery for malignancy at a single tertiary care facility between November 2014 and November 2016...
2018: Ochsner Journal
Mitchell L Worley, Evan M Graboyes, Julie Blair, Suhael Momin, Kent E Armeson, Terry A Day, Andrew T Huang
Objective To describe swallowing outcomes in elderly patients undergoing microvascular reconstruction of the upper aerodigestive tract and identify risk factors for poor postoperative swallowing function. Study Design Case series with chart review. Setting Academic medical center. Subjects and Methods Sixty-six patients aged ≥70 years underwent microvascular reconstruction of the upper aerodigestive tract. The primary outcome measure was the Functional Oral Intake Scale (FOIS); preoperative and postoperative scores were dichotomized to define "good swallowing" and "poor swallowing...
March 1, 2018: Otolaryngology—Head and Neck Surgery
Jimin Kim, Eunsun So, Hyun Jeong Kim, Kwang-Suk Seo, Myong-Hwan Karm
Major cardiac complication such as acute myocardial infarction can occur unexpectedly in patients without risk factors. We experienced cardiac arrest due to an unexpected acute myocardial infarction in a patient without any risk factors during head and neck reconstructive surgery. The patient was diagnosed with acute myocardial infarction after return of spontaneous circulation. With immediate percutaneous coronary intervention, the patient recovered without complications.
February 2018: Journal of Dental Anesthesia and Pain Medicine
Alexandre Bozec, Pierre Demez, Jocelyn Gal, Emmanuel Chamorey, Marie-Yolande Louis, David Blanchard, Dominique De Raucourt, Jean-Claude Merol, Esteban Brenet, Olivier Dassonville, Gilles Poissonnet, José Santini, Frédéric Peyrade, Karen Benezery, Maria Lesnik, Etienne Berta, Pierre Ransy, Emmanuel Babin
OBJECTIVE: To assess long-term quality of life (QoL) and psycho-social outcomes, and to determine their predictive factors after oropharyngeal cancer (OPC) surgery and radial forearm free-flap (RFFF) reconstruction. METHODS: Patients who had undergone OPC surgery and RFFF reconstruction who were still alive and disease-free at least 1 year after surgery were enrolled in this prospective multicentric study. Patients completed the European Organization for Research and Treatment of Cancer (EORTC) Core (QLQ-C30) and Head and Neck Cancer (QLQ-H&N35) QoL questionnaires, the Voice Handicap Index (VHI-10) questionnaire and the Hospital Anxiety and Depression Scale (HADS)...
March 2018: Surgical Oncology
Annie Liu, Alexis Botkin, Christian Murray, David Goldstein, Stefan O P Hofer, Nowell Solish, Jessica Kitchen, An-Wen Chan
BACKGROUND: Lentigo maligna is an in situ form of cutaneous melanoma that commonly arises on the head and neck. Various surgical and nonsurgical treatment options are available but no randomized trials exist to guide practice. OBJECTIVE: To determine the current treatment practices for lentigo maligna of the head and neck in Ontario, Canada. MATERIALS AND METHODS: Cross-sectional survey of dermatologists, plastic surgeons, and head and neck surgeons...
March 13, 2018: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
Jun Liu, Ping Zhen, Sheng-Hu Zhou, Qi Tian, Hui Chen, Wei Wang, Xiao-le He, Xu-Sheng Li
OBJECTIVE: To evaluate the manipulation technique and clinical outcome of Tri-Lock bone preservation stem for acetabular protrusion combined with shorten defect of femoral head and neck. METHODS: From January 2013 to December 2015, 10 patients(12 hips) with acetabular protrusion combined with shorten defect of femoral head and neck were treated with total hip arthroplasty(THA) including 5 males and 5 female with an average age of(51.6±3.0) years old ranging from 42...
February 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Jesper D Nielsen, Kristoffer H Madsen, Oula Puonti, Hartwig R Siebner, Christian Bauer, Camilla Gøbel Madsen, Guilherme B Saturnino, Axel Thielscher
Anatomically realistic volume conductor models of the human head are important for accurate forward modeling of the electric field during transcranial brain stimulation (TBS), electro- (EEG) and magnetoencephalography (MEG). In particular, the skull compartment exerts a strong influence on the field distribution due to its low conductivity, suggesting the need to represent its geometry accurately. However, automatic skull reconstruction from structural magnetic resonance (MR) images is difficult, as compact bone has a very low signal in magnetic resonance imaging (MRI)...
March 5, 2018: NeuroImage
Michael P Veve, Joshua B Greene, Amy M Williams, Susan L Davis, Nina Lu, Yelizaveta Shnayder, David X Li, Salem I Noureldine, Jeremy D Richmon, Lawrence O Lin, Matthew M Hanasono, Patrik Pipkorn, Ryan S Jackson, Joshua D Hornig, Tyler Light, Mark K Wax, Yin Yiu, James Bekeny, Matthew Old, David Hernandez, Urjeet A Patel, Tamer A Ghanem
Objective To characterize and identify risk factors for 30-day surgical site infections (SSIs) in patients with head and neck cancer who underwent microvascular reconstruction. Study Design Cross-sectional study with nested case-control design. Setting Nine American tertiary care centers. Subjects and Methods Hospitalized patients were included if they underwent head and neck cancer microvascular reconstruction from January 2003 to March 2016. Cases were defined as patients who developed 30-day SSI; controls were patients without SSI at 30 days...
March 1, 2018: Otolaryngology—Head and Neck Surgery
D Pauchet, J-L Pigot, F Chabolle, C-A Bach
Free fibula transplant is routinely used for mandibular reconstruction in head and neck cancer. Dental rehabilitation, the objective of mandibular reconstruction, requires the use of dental implants as supports for fixed or removable dentures. Positioning of fibular bone grafts and implants determines implant osseointegration and the possibilities of dental rehabilitation. Prefabrication of a fibula free flap with dental implants prior to harvesting as a free flap can promote implant osseointegration. The position of the implants must then be precisely planned...
March 2, 2018: European Annals of Otorhinolaryngology, Head and Neck Diseases
Manju Kalra, Indrani Sen, Peter Gloviczki
Few areas of venous disease provide a more satisfying experience for both the patient and the vascular specialist than reconstruction for superior vena cava (SVC) syndrome. Relief from severe, frequently incapacitating symptoms of venous congestion of the head and neck is almost instantaneous, and benefit after reconstruction is generally long lasting. This article reviews the etiologic factors, clinical presentation, and diagnostic evaluation of SVC syndrome, and current techniques and results for the endovascular and open surgical treatment of SVC occlusion...
April 2018: Surgical Clinics of North America
Wei-Fa Yang, Wing Shan Choi, Yiu Yan Leung, Justin Paul Curtin, Ruxu Du, Chun-Yu Zhang, Xian-Shuai Chen, Yu-Xiong Su
BACKGROUND: Surgical plates have been extensively used in head and neck reconstruction and conventional plates are mass-produced with universal configurations. To overcome disadvantages of conventional surgical plates, we have been exploring patient-specific surgical plates using the three-dimensional (3D) printing technology. We hypothesized that the application of 3D-printed patient-specific surgical plates in head and neck reconstruction is feasible, safe and precise. METHODS: We are conducting a prospective clinical trial to assess the feasibility, safety and accuracy of applying 3D-printed patient-specific surgical plates in head and neck reconstruction...
March 2018: Oral Oncology
Evan M Graboyes, Travis P Schrank, Mitchell L Worley, Suhael R Momin, Terry A Day, Andrew T Huang
BACKGROUND: Characteristics of 30-day unplanned readmissions after head and neck microvascular reconstruction remain poorly understood. METHODS: We conducted a retrospective cohort of patients who underwent head and neck microvascular reconstruction between 2010 and 2015. RESULTS: The 30-day unplanned readmission rate was 13.0% (64/493). The most common readmission diagnoses were dehiscence, surgical site infection, or fistula (45.3%; n = 29)...
March 1, 2018: Head & Neck
Ting Zhou, Lei Zhang, Guowen Sun, Qingang Hu
The complex area for reconstruction of the head and the neck is the buccal because of difficult anatomy of this region. This article aimed to describe our individualized design for the reconstruction of the buccal using an different categories anterolateral thigh (ALT) flap. Ninety-four patients were involved in this study. Among 94cases, the number of using the musculocutaneous ALT flap was 57, using the fasciocutaneous ALT flap was 25, and using the thin ALT flap was 12. Postoperative vessel thrombosis occurred in 8 flaps, and required operative exploration in the perioperative period, 6 flaps were complete survival after the salvages, 2 flap was failure...
February 27, 2018: Journal of Craniofacial Surgery
Leslie E Cohen, Kerry A Morrison, Erin Taylor, Julia Jin, Jason A Spector, Salvatore Caruana, Christine H Rohde
BACKGROUND: Traditional free flap reconstruction of complex intraoral defects often uses large lip-splitting incisions. To reduce morbidity and preserve aesthetics, we have adopted a more technically demanding visor technique obviating an incision through the lower lip through which the resection and reconstruction are performed. METHODS: A retrospective review was performed of patients who underwent free flap reconstruction of intraoral defects over 7 years by a single plastic surgeon (C...
February 28, 2018: Annals of Plastic Surgery
Cassandra Stambaugh
PURPOSE: To determine clinically relevant pass/question/fail criteria for gamma analysis of intensity modulated radiation therapy quality assurance (IMRT QA) plans, identify which plans should be further analyzed with dose-volume histogram (DVH) metrics, and create a workflow for performing that DVH-based analysis. METHODS: Eleven plans, five prostate and six head/neck, were selected to represent known good plans based on their high passing rate using conventional IMRT QA criteria...
February 26, 2018: Medical Physics
Alexandre Debelmas, Olivier Camuzard, Paola Aguilar, Quentin Qassemyar
Despite numerous advantages, the anterolateral thigh perforator flap suffers from the variable position and nature of its perforators. The aim of the authors' study was to assess the reliability of preoperative color Doppler ultrasound imaging for the exploration of perforator location and course of anterolateral thigh perforator flaps. A prospective cohort study involving patients for whom head and neck reconstruction was planned with thin anterolateral thigh perforator flaps was conducted. Each patient underwent a color Doppler ultrasound exploration of the thighs, in the operating room, immediately before surgery...
March 2018: Plastic and Reconstructive Surgery
Markus Pirlich, Iris-Susanne Horn, Christian Mozet, Mandy Pirlich, Andreas Dietz, Miloš Fischer
BACKGROUND: The use of the radial forearm-free flap is a well-established and reliable reconstruction method in head and neck surgery. Usually, the defect of the donor site is covered with full or split-thickness skin grafts. Since 09/2013, a direct closure of the radial forearm donor site has been performed at the ENT University Hospital Leipzig to avoid secondary donor site morbidity. However, few data are available in the literature on long-term cosmetic and functional results compared to the established indirect donor site defect coverage...
February 26, 2018: European Archives of Oto-rhino-laryngology
Max J H Witjes, Rutger H Schepers, Joep Kraeima
PURPOSE OF REVIEW: This review describes the advances in 3D virtual planning for mandibular and maxillary reconstruction surgical defects with full prosthetic rehabilitation. The primary purpose is to provide an overview of various techniques that apply 3D technology safely in primary and secondary reconstructive cases of patients suffering from head and neck cancer. RECENT FINDINGS: Methods have been developed to overcome the problem of control over the margin during surgery while the crucial decision with regard to resection margin and planning of osteotomies were predetermined by virtual planning...
April 2018: Current Opinion in Otolaryngology & Head and Neck Surgery
Julien Wegrzyn, Jean-Paul Roux, Charlotte Loriau, Nicolas Bonin, Vincent Pibarot
PURPOSE: Using a cementless femoral stem in total hip arthroplasty (THA), optimal filling of the proximal femoral metaphyseal volume (PFMV) and restoration of the extramedullary proximal femoral (PF) parameters (i.e., femoral offset (FO), neck length (FNL), and head height (FHH)) constitute key goals for optimal hip biomechanics, functional outcome, and THA survivorship. However, almost 30% of mismatch between the PF anatomy and implant geometry of the most widely implanted non-modular cementless femoral stem has been demonstrated in a computed tomography scan (CT scan) study...
February 22, 2018: International Orthopaedics
Koichiro Kiya, Tateki Kubo, Shien Seike, Ko Hosokawa
Microvascular free tissue transfer is one of the most common techniques of reconstruction for complex head and neck surgical defects. Generally, venous thrombosis is more likely to occur than arterial thrombosis in vascular anastomosis. Thus, recipient veins must be chosen carefully. Although the internal jugular vein is preferred as a recipient vein by many microsurgeons, internal jugular vein thrombosis is a potential complication, as shown in our report. Therefore, we consider that the external jugular vein still is an option as a recipient for venous anastomosis and that it is better to perform multiple vein anastomoses with 2 different venous systems, such as the internal and external jugular systems, than anastomoses within the same venous system...
January 2018: Plastic and Reconstructive Surgery. Global Open
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