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Head and neck free flap

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https://www.readbyqxmd.com/read/29165433/management-of-free-flap-failure-in-head-and-neck-surgery
#1
C Copelli, K Tewfik, L Cassano, N Pederneschi, S Catanzaro, A Manfuso, R Cocchi
Free flap surgery is overall considered the gold standard in head and neck reconstruction, with a success rate of 95%. The management of a total flap necrosis and which solution, between a pedicled or a second free flap, is safer for a salvage procedure is still controversial. Object of this study is to describe the authors' management of total free flap loss in head and neck reconstruction and compare the choices and results to those reported in the literature. From January 2012 to January 2016, 149 consecutive free flaps were performed at the Maxillo- Facial Operative Unit of the Hospital Casa Sollievo della Sofferenza in San Giovanni Rotondo (Italy) for reconstruction of head and neck defects...
October 2017: Acta Otorhinolaryngologica Italica
https://www.readbyqxmd.com/read/29148237/supraclavicular-flap-repair-in-the-free-flap-era
#2
REVIEW
Jodie Trautman, Sinclair Gore, Matthew Potter, Jonathan Clark, Dylan Hyam, Ngian C Tan, Quan Ngo, Bruce Ashford
BACKGROUND: Supraclavicular flap (SCF) repair is widely reported in head and neck surgery in select patients and defects. The authors' objective is to present our series of 30 patients who underwent SCF repair for varying defects and to review the scope and outcome of SCF repair in the literature. METHODS: The authors contributed primary evidence of 30 cases of SCF repair. Our outcomes are compared with those reported in the last 5 years' literature; 33 articles published between January 2012 and January 2017 that present original clinical experience of 528 SCFs...
November 17, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/29146958/third-repeat-microvascular-reconstruction-in-head-and-neck-cancer-patients-aged-65-years-and-older-a-longitudinal-and-sequential-analysis
#3
Jonas Löfstrand, Kai-Ping Chang, Jennifer An-Jou Lin, Charles Yuen Yung Loh, Hsuan-Yu Chou, Huang-Kai Kao
Performing a sequential third free flap for reconstruction of a head and neck defect after cancer resection can be challenging, and the problem is further compounded in elderly patients. The outcomes in this clinical scenario are currently unknown and this study aims to compare the results in elderly patients with younger patients in a high-volume microsurgical unit. A retrospective review of 126 consecutive patients who had undergone three sequential free flap reconstructions after head and neck cancer was performed...
November 16, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29140575/complications-of-double-free-flap-and-free-flap-combined-with-locoregional-flap-in-head-and-neck-reconstruction-a-systematic-review
#4
REVIEW
Collin L Chen, Joseph Zenga, Lauren T Roland, Patrik Pipkorn
BACKGROUND: The purpose of this clinical review was to assess the feasibility of reconstructing complex head and neck defects with 2 or more free flaps simultaneously. METHODS: A total of 38 articles were reviewed. The patient population included those who received 2 or more free flaps or a single free flap plus a locoregional flap. The primary outcome assessed was rate of complications. RESULTS: Among double flaps, the minor complication rate was 6...
November 15, 2017: Head & Neck
https://www.readbyqxmd.com/read/29127507/influence-of-coupler-size-on-revision-rate-and-timing-of-revision-after-free-flap-tissue-transfer-in-the-head-and-neck
#5
Ulrich Kisser, Christine Adderson-Kisser, Philipp Baumeister, Maximilian Reiter
OBJECTIVE: Microvascular coupler devices have been proven an effective alternative to standard hand-sutured anastomoses in reconstructive surgery. Until now, the influence of the coupler size on the revision rate after free flap tissue transfer in head and neck surgery has not been investigated. Neither has its influence on the timing of venous revisions. MATERIALS AND METHODS: A retrospective mono-center cohort study was performed in order to analyze the influence of coupler size on timing and revision rate of microvascular procedures...
November 10, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/29127127/abrikossoff-s-tumour-on-the-upper-limb-a-rare-presentation
#6
Carlos E Costa Almeida, Teresa Caroço, Marta Silva, Miguel Nico Albano
Abrikossoff's tumour or granular cell tumour is a rare entity. Most common locations are the head and neck, with only a few cases reported on the upper limbs. A 55-year-old man with a nodular lesion on the left arm resorted to surgery consultation. Nodule was firm, mobile, painless and non-ulcerated. Total excision using a Limberg flap procedure was performed. Following 3 months of follow-up, the patient is fine. Abrikossoff's tumour is frequently presented in the second to sixth decade of life as an ulcerated nodule with progressive growth...
November 9, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29124365/change-in-reimbursement-and-costs-in-german-oncological-head-and-neck-surgery-over-the-last-decade-ablative-tongue-cancer-surgery-and-reconstruction-with-split-thickness-skin-graft-vs-microvascular-radial-forearm-flap
#7
Sebastian Hoefert, Oliver Lotter
OBJECTIVES: Defects after ablative tongue cancer surgery can be reconstructed by split-thickness skin grafts or free microvascular flaps. The different surgical options may influence costs, reimbursement, and therefore possible profits. Our goal was to analyze the development of these parameters for different procedures in head and neck reconstruction in Germany over the last decade. MATERIALS AND METHODS: After tumor resection and neck dissection of tongue cancer, three different scenarios were chosen to calculate costs, reimbursement, length of stay (LoS), and profits...
November 9, 2017: Clinical Oral Investigations
https://www.readbyqxmd.com/read/29122486/trapezius-flaps-for-reconstruction-of-head-and-neck-defects-following-oncological-resection-a-systematic-review
#8
Conor M Sugrue, Grainne Rooney, Ryan M Sugrue
OBJECTIVE: Head and neck (H&N) reconstruction after cancer resection is challenging. Myocutaneous trapezius flaps provide an alternative reconstruction for patients not suitable for microvascular free tissue transfer. METHODS: A systematic review was performed on studies involving trapezius flaps for H&N reconstruction post oncological resection between the years 1985-2015. Data extracted included patient numbers and demographics, operative technique and complications...
October 10, 2017: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/29105820/the-radial-forearm-free-flap-as-a-vascular-bridge-for-secondary-microsurgical-head-and-neck-reconstruction-in-a-vessel-depleted-neck
#9
Pedro Ciudad, Mouchammed Agko, Shivprasad Date, Wei-Ling Chang, Oscar J Manrique, Tony C T Huang, Federico Lo Torto, Emilio Triganano, Hung-Chi Chen
BACKGROUND: In a vessel-depleted neck, distant recipient sites may be the only option for secondary free flap reconstruction. While interposition vein grafts and arteriovenous loops can bridge the gap between the recipient and donor pedicle, they are not without risks. In these scenarios, we examinate the reliablity of a radial forearm free flap (RFFF) as an alternative vascular conduit. PATIENTS AND METHODS: A retrospective review of cases between March 2005 and May 2016 was performed...
November 4, 2017: Microsurgery
https://www.readbyqxmd.com/read/29083525/antibiotic-prophylaxis-in-clean-contaminated-head-and-neck-cases-with-microvascular-free-flap-reconstruction-a-systematic-review-and-meta-analysis
#10
REVIEW
Yarah M Haidar, Prem B Tripathi, Tjoson Tjoa, Sartaaj Walia, Lishi Zhang, Yanjun Chen, Danh V Nguyen, Hossein Mahboubi, William B Armstrong, Julie A Goddard
BACKGROUND: Optimal antibiotic prophylaxis duration in head and neck clean-contaminated free-flap cases is unknown. METHODS: A systematic review/meta-analysis was conducted using PubMed/MEDLINE, Cochrane Library, Web-of-Science, and Scopus databases. RESULTS: Of the 3755 searched articles, 5 articles were included for a total of 861 patients. The recipient surgical site infection risk was significantly higher in patients receiving prophylactic antibiotics for ≤24 hours compared to >24 hours (relative risk [RR] 1...
October 30, 2017: Head & Neck
https://www.readbyqxmd.com/read/29076123/-diagnosis-related-groups-in-reconstructive-plastic-surgery-of-malignant-head-and-neck-skin-tumours
#11
Oliver Lotter, Manuela Micheel, Patrick Jaminet
Background Diagnosis Related Groups (DRGs) were introduced in Germany as a medico-economic classification system 13 years ago. In this analysis, we looked into the compensation for reconstructive plastic surgery after the excision of malignant head and neck skin tumours by DRGs. Material and methods Four main diagnoses (malignant melanoma, basal cell carcinoma, squamous cell carcinoma, carcinoma in situ) at a maximum of 6 different locations in the head and neck were combined with the following procedures: excision and primary wound closure, excision with temporary soft tissue coverage, split-thickness or full-thickness skin grafting, local, free or regional pedicle flaps, distant flaps as well as combined procedures for coverage...
October 26, 2017: Handchirurgie, Mikrochirurgie, Plastische Chirurgie
https://www.readbyqxmd.com/read/29068896/updates-in-head-and-neck-reconstruction
#12
Rene D Largo, Patrick B Garvey
LEARNING OBJECTIVES: After reading this article, the participant should: 1. have a basic understanding of virtual planning, rapid prototype modeling, 3D printing, and computer-assisted design and manufacture, 2. understand the principles of combining virtual planning and vascular mapping, 3. understand principles of flap choice and design in preoperative planning of free osteocutaneous flaps in mandible and midface reconstruction, and 4. discuss advantages and disadvantages of computer-assisted design and manufacture in reconstruction of advanced oncologic mandible and midface defects...
October 13, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29032418/transoral-robotic-surgery-for-squamous-cell-carcinomas-of-the-posterior-pharyngeal-wall
#13
B Lallemant, S Moriniere, P Ceruse, M Lebalch, K Aubry, S Hans, G Dolivet, O Malard, Q Bonduelle, S Vergez
Posterior pharyngeal wall squamous cell carcinomas (SCCs) are rare and have an associated poor prognosis. Progress in transoral resection techniques, in particular, transoral robotic surgery (TORS), have renewed the role of surgery in their treatment. This article presents the oncological and functional results obtained by the French Group of Head and Neck Robotic Surgery for TORS for posterior pharyngeal wall SCC-curative surgery. This retrospective, multicentre study presents data collected between September 2009 and November 2013 for patients treated with TORS for posterior pharyngeal wall SCCs...
December 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28988465/outcomes-and-reliability-of-the-flow-coupler-in-postoperative-monitoring-of-head-and-neck-free-flaps
#14
Rance J T Fujiwara, Jacqueline M Dibble, Scott V Larson, Matthew L Pierce, Saral Mehra
OBJECTIVES/HYPOTHESIS: To assess the accuracy and reliability of the flow coupler relative to the implantable arterial Doppler probe in postoperative monitoring of head and neck free flaps. STUDY DESIGN: Retrospective single-institution study, April 2015 to March 2017. METHODS: Both the venous flow coupler and arterial Doppler were employed in 120 consecutive head and neck free flap cases. When Doppler signal loss occurred, flaps were evaluated by physical exam to determine whether signal loss was a true positive necessitating operating room takeback...
October 8, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28983575/association-of-anesthesia-duration-with-complications-after-microvascular-reconstruction-of-the-head-and-neck
#15
Jacob S Brady, Stuti V Desai, Meghan M Crippen, Jean Anderson Eloy, Yuriy Gubenko, Soly Baredes, Richard Chan Woo Park
Importance: Prolonged anesthesia and operative times have deleterious effects on surgical outcomes in a variety of procedures. However, data regarding the influence of anesthesia duration on microvascular reconstruction of the head and neck are lacking. Objective: To examine the association of anesthesia duration with complications after microvascular reconstruction of the head and neck. Design, Setting, and Participants: The American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database was used to collect data...
October 5, 2017: JAMA Facial Plastic Surgery
https://www.readbyqxmd.com/read/28968323/-internet-of-things-real-time-free-flap-monitoring
#16
Sang Hun Kim, Ho Seong Shin, Sang Hwan Lee
BACKGROUND: Free flaps are a common treatment option for head and neck reconstruction in plastic reconstructive surgery, and monitoring of the free flap is the most important factor for flap survival. In this study, the authors performed real-time free flap monitoring based on an implanted Doppler system and "internet of things" (IoT)/wireless Wi-Fi, which is a convenient, accurate, and efficient approach for surgeons to monitor a free flap. METHODS: Implanted Doppler signals were checked continuously until the patient was discharged by the surgeon and residents using their own cellular phone or personal computer...
September 29, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28967346/impact-of-pre-operative-body-mass-index-in-head-and-neck-cancer-patients-undergoing-microvascular-reconstruction
#17
D-J Hyun, Y-H Joo, M-S Kim
OBJECTIVES: To analyse the relationship of pre-operative body mass index with surgical complications and oncological outcomes in patients undergoing microvascular reconstruction for head and neck squamous cell cancer. METHOD: A retrospective review was conducted of 259 patients who underwent microvascular free flap reconstruction after head and neck ablative surgery. RESULTS: Mean body mass index was 22.48 kg/m2. There were no correlations between body mass index and: flap failure (p = 0...
October 2, 2017: Journal of Laryngology and Otology
https://www.readbyqxmd.com/read/28961429/synchronous-reconstruction-of-a-total-mandibulectomy-defect-with-a-single-fibula-osteocutaneous-free-flap
#18
Ramzey Tursun, J Marshall Green, Daniel Winokur, Andre Ledoux
Osteoradionecrosis (ORN) is a well-known and usually late complication of radiation therapy in the treatment of head and neck cancer. Although the therapy can be life extending, it also produces tissue toxicity in ipsilateral and contralateral tissues in an acute and chronic fashion. In the most severe cases of ORN, such as the one presented in this report, bilateral disease results in the need for total mandibulectomy and creates a tremendous reconstructive challenge. The advent of microvascular surgery and free tissue transfer has caused an evolution of the management protocol for severe ORN cases...
September 8, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28953155/bilateral-submental-flap-an-innovative-modification
#19
Kiran Gadre, Pushkar Gadre, Divya Singh, Anushri Shetty, Ankit Malu
Early management of premalignant lesions like oral submucous fibrosis cannot be underestimated in context of prevention and control of oral malignancies. Soft tissue reconstruction of the oral cavity and face is a complex undertaking. Several flaps local and distant as well as microvascular are available, each with their pros and cons. Microvascular free flaps lay a considerable burden on resources, expertise, increased operating time, and logistics. Simple and technically reproducible alternatives are needed to tackle these issues, more so in developing countries like ours...
November 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28910897/-the-application-of-microvascular-anastomotic-coupler-in-vascular-anastomosis-of-free-tissue-flap-for-reconstruction-of-defect-after-head-and-neck-cancer-resection
#20
Y J Zhang, Z H Wang, C H Li, J Chen
Objective: To investigate the application and operation skills in vein anastomosis by microvascular anastomotic coupler (MAC) in reconstruction of defects after head and neck cancer resection. Methods: From August 2015 to July 2016, in Department of Head and Neck Surgery, Sichuan Cancer Hosipital, 17 cases underwent the reconstruction of defects after head and neck cancer resection with free tissue flaps, including forearm flaps in 11 casess, anterolateral flaps in 4 casess and fibula flaps in 2 casess. Totally 17 MAC were used, including 14 MAC for end-to-end anastomosis and 3 MAC for end-to-side anastomosis...
September 7, 2017: Zhonghua Er Bi Yan Hou Tou Jing Wai Ke za Zhi, Chinese Journal of Otorhinolaryngology Head and Neck Surgery
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