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Head and neck free flap

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https://www.readbyqxmd.com/read/27919594/clinical-audit-and-national-survey-on-the-assessment-of-collateral-circulation-before-radial-forearm-free-flap-harvest
#1
Anwer Abdullakutty, Mandeep S Bajwa, Sonum Patel, Jacob D'Souza
Controversy exists regarding the use of Duplex Ultrasound (DUS) in addition to the Modified Allen's Test (MAT) for the assessment of collateral circulation prior to elevation of the Radial Forearm Free Flap (RFFF). A survey amongst members of BAOMS Head & Neck Oncology Subspecialty Interest Group and a completed local audit was undertaken to assess the need for DUS. Data for the initial audit was collected retrospectively between 2010 and 2013. Both MAT and DUS was performed routinely during this period. The results of the survey and initial audit led to a change in practice and DUS was no longer requested...
November 2, 2016: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/27913719/surgical-site-infections-in-major-head-and-neck-surgeries-involving-pedicled-flap-reconstruction
#2
Neerav Goyal, Bharat B Yarlagadda, Daniel G Deschler, Kevin S Emerick, Derrick T Lin, Debbie L Rich, James W Rocco, Marlene L Durand
OBJECTIVE: To evaluate surgical site infections (SSI) after pedicled reconstruction in head and neck surgery. METHODS: Records of patients with pedicled flap reconstructions between 2009 and 2014 at Massachusetts Eye and Ear were reviewed. Onset of SSI or fistula ≤30 days postoperatively was noted. A free flap cohort was reviewed for comparison. RESULTS: Two hundred and eight pedicled reconstructions were performed for cancer (83%), osteoradionecrosis (7%), and other reasons (10%)...
January 2017: Annals of Otology, Rhinology, and Laryngology
https://www.readbyqxmd.com/read/27898195/cost-effectiveness-of-microsurgical-reconstruction-for-head-and-neck-defects-after-oncologic-resection
#3
Lin Lin Gao, Marten Basta, Suhail K Kanchwala, Joseph M Serletti, David W Low, Liza C Wu
BACKGROUND: Microvascular free tissue transfer has become the main technique used for head and neck reconstruction. We assessed the cost-effectiveness of free flap reconstruction for head and neck defects after oncologic resection for squamous cell carcinoma (SCC). METHODS: We developed a Markov model of the cost, quality of life, survival, and incremental cost-effectiveness of reconstruction with free tissue transfer compared with locoregional flaps. Health state probabilities and quality of life scores were determined from literature...
November 29, 2016: Head & Neck
https://www.readbyqxmd.com/read/27880030/osseointegrated-implants-into-a-variety-of-composite-free-flaps-a-comparative-analysis
#4
Michael Burgess, Matthew Leung, Anthony Chellapah, Jonathan R Clark, Martin D Batstone
BACKGROUND: Significant oral function is often lost after surgical therapy for head and neck cancer. The use of osseointegrated implants for reconstruction in patients with head and neck surgery has shown to significantly improve the quality of life for these patients. Variable success rates range from 99% to 70%. METHODS: A retrospective audit of patient records was performed looking at cumulative survival of implants. Inclusion criteria were patients who were treated at 1 of 2 designated Australian Head and Neck Units and received oral osseointegrated implants...
November 23, 2016: Head & Neck
https://www.readbyqxmd.com/read/27865376/free-flap-outcome-of-salvage-surgery-compared-to-primary-surgery-for-head-and-neck-defects-a-propensity-score-analysis
#5
Chung-Hwan Baek, Woori Park, Nayeon Choi, Seonhye Gu, Insuk Sohn, Man Ki Chung
OBJECTIVES: To compare free flap outcomes for head and neck defects between primary surgery and salvage surgery and identify factors affecting the outcomes in the two settings. METHODS: A total of 225 patients (primary group, n=56; salvage group, n=169) were retrospectively identified. The salvage group was previously treated with radiotherapy, chemoradiation, surgery, or any combination of these treatments. Clinical data were retrieved and analyzed between the two groups to compare the incidence and contributing factors of flap-related complications and flap failure...
November 2016: Oral Oncology
https://www.readbyqxmd.com/read/27862538/free-thyroid-transfer-short-term-results-of-a-novel-procedure-to-prevent-post-radiation-hypothyroidism
#6
Jeffrey Harris, Brittany Barber, Hani Almarzouki, Rufus Scrimger, Jacques Romney, Daniel O'Connell, Mark Urken, Hadi Seikaly
BACKGROUND: The incidence of radiation-induced hypothyroidism (RIH) in patients with head and neck cancer is >50%. The purpose of this study was to assess the long-term efficacy of free thyroid transfer (FTT) for prevention of RIH in patients with head and neck cancer. METHODS: Hemithyroid dissection was completed in 10 patients with advanced head and neck cancer undergoing ablation, radial forearm free flap (RFFF) reconstruction, and postoperative radiotherapy (RT)...
November 15, 2016: Head & Neck
https://www.readbyqxmd.com/read/27861470/-mandibular-osteoradionecrosis-orn-as-a-side-effect-of-head-and-neck-cancer-treatment-factors-that-induce-it
#7
José Francisco Gallegos-Hernández, Alejandro Reyes-Vivanco, Héctor Arias-Ceballos, Gerardo Gabriel Minauro-Muñoz, Alma Lilia Ortiz-Maldonado, Daniel Israel García-Ruiz, Martín Hernández-Sanjuán
INTRODUCTION: Osteoradionecrosis of the mandible is a relatively common complication in patients with head and neck cancer undergoing radiotherapy or concomitant chemoradiotherapy, characterized by exposure of the mandibular bone either in the mouth or in the facial skin, with no improvement with conservative treatment for six months. The risk factors are radiotherapy in head and neck region, lack of dental prophylaxis before treatment and dental extraction. MATERIAL AND METHODS: Retrospective observational study analyzing incidence and etiologic factors of osteoradionecrosis in 250 patients undergoing radiotherapy or combined treatment of cervicofacial area between 2002 and 2010...
November 2016: Gaceta Médica de México
https://www.readbyqxmd.com/read/27858701/contrast-enhanced-ultrasonography-as-a-new-method-for-assessing-autonomization-of-pedicle-and-microvascular-free-flaps-in-head-and-neck-reconstructive-surgery
#8
Steffen Mueller, Christina M Wendl, Tobias Ettl, Christoph Klingelhöffer, Sebastian Geis, Lukas Prantl, Torsten E Reichert, Ernst Michael Jung
OBJECTIVE: Evaluating vascular autonomization of pedicle and microvascular free flaps for soft tissue reconstruction in the head and neck area by means of postoperative quantitative measurement of dynamic contrast values obtained with contrast-enhanced ultrasound. METHODS: 8/18 patients underwent lip reconstruction with a pedicle flap, 10 patients reconstruction of other parts of the head with a microvascular free transplant. Ultrasound examinations were within the 1st postoperative week and 4 weeks after surgery...
November 18, 2016: Clinical Hemorheology and Microcirculation
https://www.readbyqxmd.com/read/27847738/temporomandibular-joint-chondrosarcoma-a-case-report-and-literature-review
#9
Kyungjin Lee, Seong Hwan Kim, Soung-Min Kim, Hoon Myoung
Chondrosarcoma is a malignant tumor that originates from cartilaginous cells and is characterized by cartilage formation. Only 5% to 10% of chondrosarcoma occurs in the head and neck area, and it is uncommon in the temporomandibular joint area. This report describes an unusual case with a rare, large chondrosarcoma in a 47-year-old woman who presented with painless swelling and trismus. Computed tomography showed a large mass approximately 8.5×6.0 cm in size arising adjacent to the lateral pterygoid plate and condyle...
October 2016: Journal of the Korean Association of Oral and Maxillofacial Surgeons
https://www.readbyqxmd.com/read/27836568/the-surgical-management-of-head-and-neck-sarcoma-the-newcastle-experience
#10
R W F Breakey, T P Crowley, I B Anderson, R H Milner, M Ragbir
INTRODUCTION: Head and neck sarcomas are rare and difficult to manage surgically. Factors that influence the prognosis include the type and grade of tumour, resection margins, the anatomical site and patient-specific parameters. We review our experience as plastic surgeons working in a bone and soft-tissue tumour multidisciplinary team (MDT) in managing these tumours surgically. METHODS: Data on all patients with sarcoma of the head or neck managed surgically from 2004 to 2015 was reviewed...
October 5, 2016: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/27826458/factors-influencing-the-incidence-of-severe-complications-in-head-and-neck-free-flap-reconstructions
#11
Martin Broome, Naline Juilland, Yann Litzistorf, Yan Monnier, Kishore Sandu, Philippe Pasche, Peter K Plinkert, Philippe A Federspil, Christian Simon
BACKGROUND: Complications after head and neck free-flap reconstructions are detrimental and prolong hospital stay. In an effort to identify related variables in a tertiary regional head and neck unit, the microvascular reconstruction activity over the last 5 years was captured in a database along with patient-, provider-, and volume-outcome-related parameters. METHODS: Retrospective cohort study (level of evidence 3), a modified Clavien-Dindo classification, was used to assess severe complications...
October 2016: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/27789210/a-pilot-study-demonstrating-the-feasibility-of-supermicrosurgical-end-to-side-anastomosis-onto-large-recipient-vessels-in-head-and-neck-reconstruction
#12
Takuya Iida, Hidehiko Yoshimatsu, Takumi Yamamoto, Isao Koshima
In head and neck reconstruction using free flaps, microvascular anastomosis is commonly performed in an end-to-end fashion to relatively sizable arteries including the superficial temporal, facial, and superior thyroid arteries. With the recent developments of less invasive perforator flaps such as the superficial circumflex iliac artery perforator flap, anastomosis of smaller vessels of less than 0.8 mm diameter has become necessary; however, appropriate recipient arteries for end-to-end anastomosis are often absent...
September 28, 2016: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/27773516/development-of-a-nomogram-for-predicting-the-probability-of-postoperative-delirium-in-patients-undergoing-free-flap-reconstruction-for-head-and-neck-cancer
#13
N Y Choi, E H Kim, C H Baek, I Sohn, S Yeon, M K Chung
PURPOSE: To develop nomogram for prediction of postoperative delirium (POD) in patients undergoing ablative and reconstruction surgery for head and neck cancer. METHODS: Total 341 patients were retrospectively analyzed, and clinical variables in preoperative, intraoperative and postoperative periods were compared between delirium group (n = 89) and non-delirium group (n = 252). Multivariate logistic regression, receiver operating characteristics curve, and area under the curve (AUC) were used to generate and test a nomogram, which performance was evaluated by 10-fold cross validation (CV) procedure...
October 14, 2016: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27765549/factors-influencing-postoperative-complications-in-reconstructive-microsurgery-for-head-and-neck-cancer
#14
Shih-Lun Lo, Yu-Hsiu Yen, Pi-Jung Lee, Charles Chih-Ho Liu, Chi-Ming Pu
PURPOSE: The present study aimed to analyze multiple variables and to determine the factors influencing postoperative complications in reconstructive microsurgeries for head and neck cancer. MATERIALS AND METHODS: This was a retrospective review of the medical records of patients with head and neck cancer who underwent free flap reconstruction after ablation surgery at the Cathay General Hospital (Taipei, Taiwan) from January 2010 to December 2014. Clinical and surgical procedure-related factors were retrieved from a database and analyzed...
September 23, 2016: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/27759740/goal-directed-fluid-management-in-free-flap-surgery-for-cancer-of-the-head-and-neck
#15
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
https://www.readbyqxmd.com/read/27756320/a-case-of-peritoneal-metastasis-during-treatment-for-hypopharyngeal-squamous-cell-carcinoma
#16
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
https://www.readbyqxmd.com/read/27756030/osseocutaneous-radial-forearm-flap-with-beavertail-modification-a-case-report-of-a-novel-single-reconstructive-free-flap-for-the-tongue-floor-of-mouth-and-mandible
#17
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
https://www.readbyqxmd.com/read/27755421/microcystic-adnexal-carcinoma-of-the-nasal-tip-treated-with-surgical-excision-and-rotational-forehead-skin-flap
#18
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
https://www.readbyqxmd.com/read/27753100/salvage-arterial-anastomosis-using-a-microvascular-coupler-in-head-and-neck-free-flap-reconstruction
#19
Dane J Genther, Andrew T Day, Kanika Rana, Jeremy D Richmon
No abstract text is available yet for this article.
October 18, 2016: Laryngoscope
https://www.readbyqxmd.com/read/27737447/optimal-perioperative-care-in-major-head-and-neck-cancer-surgery-with-free-flap-reconstruction-a-consensus-review-and-recommendations-from-the-enhanced-recovery-after-surgery-society
#20
Joseph C Dort, D Gregory Farwell, Merran Findlay, Gerhard F Huber, Paul Kerr, Melissa A Shea-Budgell, Christian Simon, Jeffrey Uppington, David Zygun, Olle Ljungqvist, Jeffrey Harris
Importance: Head and neck cancers often require complex, labor-intensive surgeries, especially when free flap reconstruction is required. Enhanced recovery is important in this patient population but evidence-based protocols on perioperative care for this population are lacking. Objective: To provide a consensus-based protocol for optimal perioperative care of patients undergoing head and neck cancer surgery with free flap reconstruction. Evidence Review: Following endorsement by the Enhanced Recovery After Surgery (ERAS) Society to develop this protocol, a systematic review was conducted for each topic...
October 13, 2016: JAMA Otolaryngology—Head & Neck Surgery
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