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Head and neck free flap

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https://www.readbyqxmd.com/read/28430347/hypopharyngeal-squamous-cell-carcinoma-and-laryngeal-neuroendocrine-carcinoma-colliding-in-the-aryepiglottic-fold-a-case-report
#1
Roberta Marangoni, Simone Mauramati, Giulia Bertino, Antonio Occhini, Marco Benazzo, Patrizia Morbini
PURPOSE: A collision tumor consists of 2 different histologically distinct and topographically independent tumors merging in the same mass. In the head and neck region they are rare, with only 4 cases reported in the larynx. CASE REPORT: A 60-year-old heavy smoker complained of a left submandibular lesion in October 2014. The lesion was excised and showed a poorly differentiated carcinoma, suggestive for adenocarcinoma. After a positron emission tomography-computed tomography scan showed increased metabolic activity in the left laterocervical region and right vocal cord, the patient underwent endoscopic biopsy of the lesion of the left piriform sinus, which was positive for moderately differentiated squamous cell carcinoma (SCC)...
April 14, 2017: Tumori
https://www.readbyqxmd.com/read/28419812/defining-quality-in-head-and-neck-reconstruction
#2
Peter M Vila, Jason T Rich, Shaun C Desai
Microvascular free flap reconstruction has now become the standard of care in the reconstruction of selected head and neck defects. Although uncommon, flap failure is a catastrophic event that results in significant patient morbidity, extended length of hospitalization, and increased cost. However, there is currently no gold standard for measuring the quality of a reconstructive center. Structure and process outcomes have recently been developed, but outcome measures are still lacking. Areas for future research include preoperative nutrition, preoperative flap planning, intraoperative fluid management, appropriate thromboembolism prophylaxis, consistent perioperative antibiotic regimens, skilled ancillary staff, and clear outcome measures for performance measurement...
April 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28416356/risk-factors-for-free-flap-failure-a-retrospective-analysis-of-881-free-flaps-for-head-and-neck-defect-reconstruction
#3
W Zhou, W-B Zhang, Y Yu, Y Wang, C Mao, C-B Guo, G-Y Yu, X Peng
The aim of this study was to identify the risk factors for free flap failure after head and neck reconstructive surgery. The data of 881 consecutive patients who underwent free flap surgery at the Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, between January 2013 and November 2016, were reviewed retrospectively. All surgeries were performed by a single head and neck surgical team. Patient demographic and surgical data that may have an influence on free flap outcomes were recorded...
April 14, 2017: International Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28400133/perioperative-serum-levels-of-procalcitonin-c-reactive-protein-and-leukocytes-in-head-and-neck-free-flaps
#4
S Koerdt, N Rommel, N H Rohleder, S Sandig, G Frohwitter, T Steiner, K D Wolff, M R Kesting
Microvascular free flaps are considered to be the gold standard in reconstructive head and neck surgery. However, reduced postoperative transplant perfusion is one of the serious postoperative complications and calls for close and reliable monitoring. Procalcitonin, C-reactive protein, and leukocytes are closely associated with local and systemic inflammatory reactions and might have prognostic capacity concerning tissue necrosis. This study aimed to evaluate perioperative serum levels of these three biomarkers to assess their potential in postoperative flap monitoring...
April 8, 2017: International Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28399024/immediate-reconstruction-for-plantar-melanoma-a-paradigm-shift
#5
Hunter Oliver-Allen, Merisa Piper, Carolyn Vaughn, Hani Sbitany
INTRODUCTION: Plantar melanoma tumors are traditionally treated with wide local excision based on depth of invasion, followed by delayed reconstruction once negative surgical margins are confirmed. However, delayed reconstruction requires care for an open wound, a prolonged treatment course, and the need for an additional surgery. Immediate reconstruction has been shown to be oncologically safe in head and neck melanoma, but little is described in the literature regarding immediate reconstruction in plantar melanoma...
May 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28390434/surgical-site-infections-following-oral-cavity-cancer-resection-and-reconstruction-is-a-risk-factor-for-plate-exposure
#6
Christopher M Yao, Hedyeh Ziai, Gordon Tsang, Andrea Copeland, Dale Brown, Jonathan C Irish, Ralph W Gilbert, David P Goldstein, Patrick J Gullane, John R de Almeida
BACKGROUND: Plate-related complications following head and neck cancer ablation and reconstruction remains a challenging problem often requiring further management and reconstructive surgeries. We aim to identify an association between surgical site infections (SSI) and plate exposure. METHODS: A retrospective study between 1997 and 2014 was performed to study the association between postoperative SSI and plate exposures. Eligible patients included those with a history of oral squamous cell carcinoma who underwent surgical resection, neck dissection, and free tissue reconstruction...
April 8, 2017: Journal of Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28387356/pectoralis-major-myocutaneous-flap-for-head-and-neck-defects-in-the-era-of-free-flaps-harvesting-technique-and-indications
#7
Muyuan Liu, Weiwei Liu, Xihong Yang, Haipeng Guo, Hanwei Peng
The role of the pectoralis major myocutaneous flap (PMMF) in head and neck reconstruction is challenged recently due to its natural drawbacks and the popularity of free flaps. This study was designed to evaluate the indications and reliability of using a PMMF in the current free flap era based on a single center experience. The PMMF was harvested as a pedicle-skeletonized flap, with its skin paddle caudally and medially to the areola, including the third intercostal perforator, preserving the upper one third of the pectoralis major muscle...
April 7, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28370756/systematic-review-and-meta-analysis-of-venous-thromboembolism-in-otolaryngology-head-and-neck-surgery
#8
REVIEW
Sami P Moubayed, Antoine Eskander, Moustafa W Mourad, Sam P Most
BACKGROUND: The purpose of this study was to present our systematic review and meta-analysis of the data on venous thromboembolism (VTE; deep venous thrombosis [DVT] and/or pulmonary embolism [PE]) in otolaryngology-head and neck surgery (OHNS). METHODS: PubMed and Scopus databases were searched for studies reporting VTE in OHNS. Incidence of VTE and bleeding is reported and meta-analyzed overall and for chemoprophylaxis and squamous cell carcinoma (SCC)/free flap subgroups...
March 29, 2017: Head & Neck
https://www.readbyqxmd.com/read/28363227/morbidity-of-the-free-fibula-flap-reconstruction-in-head-and-neck-malignancies
#9
Harin Asokan, Jerry R John
No abstract text is available yet for this article.
March 31, 2017: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/28358764/a-thirty-year-experience-with-head-and-neck-flap-reconstruction
#10
Alexander Haosi Sun, Xiaolu Xu, Clarence Takashi Sasaki, Stephan Ariyan, Derek Matthew Steinbacher
BACKGROUND: Head and neck (HN) defects after tumor extirpation can be challenging to repair. Historically, pedicled flaps were the mainstay for reconstruction, but recently, free tissue transfer has been preferred. This study compares patient characteristics and flap outcomes for HN defects over a 30-year period at the authors' institution. METHODS: Head and neck cancer patients receiving flap reconstruction from 1983 to 2013 were included. Records were reviewed for demographic and perioperative data...
March 29, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28355656/morbidity-of-the-free-fibula-flap-reconstruction-in-head-and-neck-malignancies
#11
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.
March 29, 2017: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/28351561/salvage-surgery-in-recurrent-head-and-neck-squamous-cell-carcinoma-oncologic-outcome-and-predictors-of-disease-free-survival
#12
Marc Hamoir, Emma Holvoet, Jerôme Ambroise, Benoît Lengelé, Sandra Schmitz
OBJECTIVE: Salvage surgery in recurrent SCCHN is associated with poor outcomes. This study aimed to better identify suitable surgical candidates and those at high risk of new recurrence. MATERIALS AND METHODS: Single-center retrospective analysis of 109 patients undergoing salvage surgery for recurrent SCCHN. Univariate and multivariate analyses were used to identify prognostic factors affecting disease-free survival (DFS). RESULTS: The following factors showed a significant impact on DFS: Disease-free interval >6months [HR 0...
April 2017: Oral Oncology
https://www.readbyqxmd.com/read/28349372/nut-midline-carcinoma-of-the-sublingual-gland-clinical-presentation-and-review
#13
Nolan B Seim, Ramez H W Philips, Lynn Schoenfield, Theodoros N Teknos, James W Rocco, Amit Agrawal, Enver Ozer, Ricardo L Carrau, Stephen Y Kang, Matthew O Old
NUT midline carcinoma (NMC) is a rare and aggressive disease encountered in the midline of the head and neck or mediastinum. Due to its sparse incidence and subtle pathologic features, we aim to increase knowledge and awareness for this pathologic entity. We present an exemplary case of a young, healthy male presenting with oral cavity pain and cervical lymphadenopathy. This patient was initially diagnosed with an unspecified, highly aggressive sublingual gland malignancy and underwent locoregional resection with free flap reconstruction however suffered a rapid local recurrence and widely extensive metastasis within just 1 month...
March 27, 2017: Head and Neck Pathology
https://www.readbyqxmd.com/read/28342884/oral-cancer-reconstruction-using-the-supraclavicular-artery-island-flap-comparison-to-free-radial-forearm-flap
#14
Christian Welz, Martin Canis, Sabina Schwenk-Zieger, Jennifer L Spiegel, Bernhard G Weiss, Yiannis Pilavakis
PURPOSE: To evaluate whether the pedicled supraclavicular artery island flap (SCAIF) is a sufficient alternative to the fasciocutaneous radial forearm free flap (RFFF) for oral reconstruction in cancer surgery. PATIENTS AND METHODS: The authors designed and implemented a retrospective cohort study composed of all consecutive patients who underwent head and neck reconstruction after cancer surgery at their tertiary university hospital from 2013 to 2016. Demographics and peri- and postoperative information were recorded and statistically analyzed...
March 2, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28319459/morbidity-and-survival-in-elderly-patients-undergoing-free-flap-reconstruction-a-retrospective-cohort-study
#15
Candace A Mitchell, Richard A Goldman, Joseph M Curry, David M Cognetti, Howard Krein, Ryan Heffelfinger, Adam Luginbuhl
Objective To review a single institution's outcomes of free flap reconstruction of the head and neck in patients aged ≥80 years as compared with those <80 years. Study Design Retrospective cohort study. Setting Tertiary academic hospital. Subjects and Methods Patients aged ≥ 80 years who underwent free flap reconstruction of the head and neck between 2007 and 2013 were identified and matched by type of reconstruction with a cohort of younger patients. Outcome measures included flap success, length of stay, discharge disposition, complications, and 2-year mortality...
March 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28319260/the-second-time-flap-from-the-previously-used-anterior-thigh-donor-site-for-head-and-neck-microsurgical-reconstruction
#16
Nidal Farhan Al Deek, Chun-Ta Liao, Shiang-Fu Huang, Chung-Jan Kan, Kai-Ping Chang, Ku-Hao Fang, Chung-Kan Tsao
BACKGROUND: Multiple free tissue transfer from the same donor site is not well described for microsurgical head and neck reconstruction. METHODS: Between (8/2011 and 11/2012), 103 patients received 103 free ALT flaps for head and neck reconstruction; flaps were called first-time ALT flaps. Intra-operative findings were used to assess the presence of a favorable anatomy for a future second flap from the same donor site. And, between 9/2009 and 12/2013, second-time flaps from previously used anterior thighs were attempted either freely or guided by the intra-operative data from the previous surgery...
March 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28301644/association-of-body-mass-index-with-infectious-complications-in-free-tissue-transfer-for-head-and-neck-reconstructive-surgery
#17
Mohemmed N Khan, Jack Russo, John Spivack, Christopher Pool, Ilya Likhterov, Marita Teng, Eric M Genden, Brett A Miles
Importance: Elevated body mass index (BMI) has been proposed as a risk factor for morbidity and mortality among patients undergoing surgery. Conversely, an elevated BMI may confer a protective effect on perioperative morbidity. Objective: To examine whether an elevated BMI is an independent risk factor for perioperative and postoperative infectious complications after free tissue transfer in head and neck reconstructive surgery. Design, Setting, and Participants: This cohort study included patients undergoing major head and neck surgery requiring free tissue transfer at a tertiary care center...
March 16, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28293493/technique-to-improve-tracheostomy-speaking-valve-tolerance-after-head-and-neck-free-flap-reconstruction
#18
John T Stranix, Keri M Danziger, Veturia L Dumbrava, Ginger Mars, David L Hirsch, Jamie P Levine
Increased upper airway resistance from postoperative changes after major head and neck surgery may cause elevated transtracheal pressures and result in tracheostomy speaking valve intolerance. This may be particularly true among patients with baseline pulmonary disease. We describe a patient recovering from oral cancer resection and flap reconstruction who demonstrated prolonged ventilator dependence and tracheostomy speaking valve intolerance with abnormal tracheal manometry. We attempted to improve speaking valve tolerance through the adaptation of a valve modification intended to reduce transtracheal pressures...
December 2016: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28286397/perforator-peroneal-artery-flap-for-tongue-reconstruction
#19
Shubhra Chauhan, Sachin Chavre, Naveen Hedne Chandrashekar, Naveen B S
INTRODUCTION: Reconstruction has evolved long way from primary closure to flaps. As time evolved, better understanding of vascularity of flap has led to the development of innovative reconstructive techniques. These flaps can be raised from various parts of the body for reconstruction and have shown least donor site morbidity. We use one such peroneal artery perforator flap for tongue reconstruction with advantage of thin pliable flap, minimal donor site morbidity and hidden scar. MATERIALS AND METHODS: Our patient 57yrs old lady underwent wide local excision with selective neck dissection...
March 2017: Journal of Maxillofacial and Oral Surgery
https://www.readbyqxmd.com/read/28282676/peroneal-flap-for-tongue-reconstruction
#20
Ying-Sheng Lin, Wen-Chung Liu, Yaoh-Shiang Lin, Lee-Wei Chen, Kuo-Chung Yang
Background For large tongue defects, reconstructive surgeons have devised a variety of feasible options, such as radial forearm free flap and anterolateral thigh (ALT) flap. In our institution, peroneal flap has been the workhorse flap for the soft tissue defect in head and neck reconstruction. We present our experience using peroneal flap in tongue reconstruction. Patients and Methods The study included 47 patients who had undergone tongue reconstructions with peroneal flaps after tumor resection. The size and location of the defect after tumor resection determined whether the peroneal flaps could be harvested as pure septocutaneous flaps to solely reconstruct the neotongue or to carry an additional muscle bulk to fill the adjacent defect...
March 10, 2017: Journal of Reconstructive Microsurgery
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