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Head and neck, reconstruction

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https://www.readbyqxmd.com/read/28525631/primary-leiomyosarcoma-of-inferior-vena-cava-adjacent-to-hepatic-veins-complete-off-pump-resection-and-inferior-vena-cava-graft-reconstruction-with-application-of-external-skin-surface-cooling
#1
Michael Malyshev, Sergey Zotov, Anton Malyshev, Andrey Rostovykh
OBJECTIVES: Resection of a leiomyosarcoma of the inferior vena cava (IVC) requires venovenous bypass, especially if IVC clamping above the hepatic veins is planned. This report describes the application of external skin surface cooling for off-pump resection of a primary IVC leiomyosarcoma adjacent to the hepatic veins with graft IVC reconstruction in conditions of suprahepatic caval clamping and uninterrupted Pringle's manoeuvre. METHODS: A 62-year-old woman presented with IVC leiomyosarcoma adjacent to the hepatic veins...
May 19, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28524733/cartilage-engineering-in-reconstructive-surgery-auricular-nasal-and-tracheal-engineering-from-a-surgical-perspective
#2
Paul Severin Wiggenhauser, Jan Thorsten Schantz, Nicole Rotter
This review provides an update on cartilage tissue engineering with particular focus on the head and neck. It is aimed at scientists and clinicians who are interested in tissue engineering and its clinical applicability. Principal tissue engineering strategies are summarized in the first part of this review. In the second part, current clinical approaches to auricular, nasal and tracheal reconstruction are discussed from a surgical perspective. By this approach, the requirements for clinical applicability are outlined and new insight into relevant aims of research is given to accelerate the transfer from bench to bedside...
May 19, 2017: Regenerative Medicine
https://www.readbyqxmd.com/read/28520896/laser-assisted-indocyanine-green-dye-angiography-for-postoperative-fistulas-after-salvage-laryngectomy
#3
Erin J Partington, Lindsay S Moore, Russel Kahmke, Jason M Warram, William Carroll, Eben L Rosenthal, Benjamin J Greene
Importance: Pharyngocutaneous fistula formation is an unfortunate complication after salvage laryngectomy for head and neck cancer that is difficult to anticipate and related to a variety of factors, including the viability of native pharyngeal mucosa. Objective: To examine whether noninvasive angiography with indocyanine green (ICG) dye can be used to evaluate native pharyngeal vascularity to anticipate pharyngocutaneous fistula development. Design, Setting, and Participants: This cohort study included 37 patients enrolled from June 1, 2013, to June 1, 2016, and follow-up was for at least 1 month postoperatively...
May 18, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28514343/-effect-of-dexmedetomidine-on-perfusion-of-free-flaps-transferred-to-head-and-neck
#4
A S Dobrodeev, S A Rabinovich, I F Malykhina
The paper presents the impact of perioperative care on feasibility of free fibula flap transfer for facial reconstruction. Flaps vitality was measured by means of somatic oximetry in 85 patients aged 20-74 years receiving reconstruction procedures in midfacial and lower facial areas. The patients were divided in three groups according to sedation agent used postoperatively. It has been demonstrated that dexmedetomidine postoperative sedation significantly improved free fibula flaps perfusion compared to propofol sedation...
2017: Stomatologii︠a︡
https://www.readbyqxmd.com/read/28512553/juxtacortical-mandibular-chondrosarcoma-during-pregnancy-a-case-report
#5
Paolo Cariati, Almudena Cabello-Serrano, Fernando Monsalve-Iglesias, Miguel Perez-de Perceval-Tara, Ildefonso Martinez-Lara
Chondrosarcoma is one of the most common malignant bone tumors in adults. It use to affect upper arm, pelvis and thigh bone. A wide surgical extirpation represent the gold standard to treat this disorder. In fact, radiotherapy and chemotherapy are no useful. Interestingly, chondrosarcoma is rare in head and neck (HNCS) and extremely uncommon during pregnancy. Thus, there is a lack of evidence about the proper treatment in these cases. A wide surgical extirpation is also considered the most effective procedure in HNCS...
May 2017: Journal of Clinical and Experimental Dentistry
https://www.readbyqxmd.com/read/28507861/absence-of-ulnar-artery-inflow-detected-by-allen-s-test-prior-to-radial-forearm-free-flap
#6
Benjamin A Taylor, Faisal Alzahrani, Eric Levi, S Mark Taylor, Matthew H Rigby, Jonathan Trites, Robert D Hart
Radial forearm free flaps are commonly used for soft-tissue reconstruction after resection of head and neck cancer. It is perfused by the radial artery, leaving the ulnar artery for perfusion of the hand and digits. The absence of distal ulnar artery and associated superficial palmar arch, however, has not been reported in cadaveric dissection. We report a case of unilateral ulnar artery flow absence, detected by Allen's test, during preoperative preparation for a radial forearm free flap. Based on the simplicity, safety, and ease, we recommend Allen's test to be performed preoperatively on every patient for whom such a flap is a consideration...
April 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28506450/utility-and-versatility-of-the-supraclavicular-artery-island-flap-in-head-and-neck-reconstruction
#7
José A González-García, Carlos M Chiesa-Estomba, Jon A Sistiaga, Ekhiñe Larruscain, Leire Álvarez, Xabier Altuna
INTRODUCTION: The supraclavicular island flap is a rotational pedicled flap and may have some advantages in head and neck reconstruction compared with free-tissue transfer when this kind of reconstruction is not affordable or recommended. MATERIAL AND METHODS: We present our experience during the year 2016 in the application of the supraclavicular island flap in five cases as an alternative to microvascular reconstruction in several defects after resection of head and neck tumours...
May 12, 2017: Acta Otorrinolaringológica Española
https://www.readbyqxmd.com/read/28502275/use-of-acellular-dermal-matrices-in-laryngotracheal-and-pharyngeal-reconstruction-systematic-review
#8
A Hui, P Hong, M Bezuhly
BACKGROUND: Acellular dermal matrices are increasingly used in laryngotracheal and pharyngeal reconstruction, but specific indications and the type of acellular dermal matrix used vary. The authors systematically reviewed outcomes relating to acellular dermal matrix use in head and neck reconstruction. METHODS: Electronic databases were searched through 1 May 2016 for literature on acellular dermal matrix use in laryngotracheal and pharyngeal reconstruction. Studies were appraised for surgical indications, outcomes and study design...
May 15, 2017: Journal of Laryngology and Otology
https://www.readbyqxmd.com/read/28494483/the-cost-of-major-head-and-neck-cancer-surgery
#9
Rahul Jayakar, Jenny Choi, Craig MacKinnon, Swee Tan
AIM: This study quantified the cost of major head and neck cancer (HNC) surgery. METHODS: Consecutive patients undergoing major HNC surgery between July 2007 and June 2012 were identified from our head and neck database. Patient demographics, tumour type, site, stage and types of resection and reconstruction, length of stay and surgical complications occurring within six months of initial surgery were retrospectively analysed. The actual cost of initial surgical treatment and hospital income were calculated...
May 12, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/28493196/head-and-neck-reconstruction-in-the-elderly-patient-a-safe-procedure
#10
Maximilian Reiter, Philipp Baumeister, Christian Jacobi
Demographic changes strongly affect industrialized countries. While free tissue transfer was initially believed to be beneficial only for younger patients, there is an increasing number of elderly patients requiring microvascular operations in our aging society. Medical and surgical risks for head and neck cancer patients over a certain age who undergo free tissue transfer has hardly been investigated. A retrospective mono-center cohort study was performed. All patients with the age 75 or higher undergoing microvascular operations were reviewed...
May 10, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28489683/intraoperative-use-of-vasopressors-does-not-increase-the-risk-of-free-flap-compromise-and-failure-in-cancer-patients
#11
Lin Fang, Jun Liu, Cuicui Yu, Matthew M Hanasono, Gang Zheng, Peirong Yu
OBJECTIVE: To examine the effects of vasopressors on free flap outcomes. BACKGROUND: Most micro-surgeons avoid the use of vasopressors during free flap surgery due to concerns of vasoconstriction, which could potentially lead to vascular thrombosis and flap failure. Previous studies lack the statistical power to draw meaningful conclusions. METHODS: All free flaps between 2004 and 2014 from a single institution were reviewed retrospectively...
May 9, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28483251/novel-case-examples-of-the-submental-island-flap-in-pediatric-head-and-neck-reconstruction
#12
Joshua P Wiedermann, Nahir Romero, Rahul K Shah, Diego Preciado, Jason E Cohn, Christopher R Kieliszak, Arjun S Joshi
The submental island flap was first described as a tool for facial reconstruction after tumor resection. It is now widely used for reconstructing numerous structures in the head and neck region of adults. Pediatric surgical reconstruction is a challenging task that continues to evolve over time. We describe two novel uses of this flap in the pediatric population. The submental island flap is an excellent option for reconstruction in pediatrics given its ease of elevation, excellent cosmetic outcomes, and low donor site morbidity...
June 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28476441/perioperative-cardiac-complications-in-patients-undergoing-head-and-neck-free-flap-reconstruction
#13
Peter J Ciolek, Kate Clancy, Michael A Fritz, Eric D Lamarre
BACKGROUND: Limited data exists on cardiac complications following head and neck free flaps. DESIGN: A retrospective review was performed on patients that underwent free flap reconstruction from 2012 to 2015. RESULTS: 368 flaps were performed. 12.5% of patients experienced a cardiac event. Hypertension, coronary artery disease, heart failure, venous thromboembolism, and anticoagulation were associated with cardiac complications. ASA class was not predictive of cardiac events...
April 6, 2017: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/28471917/radial-neck-dilatory-remodeling-following-radial-head-arthroplasty-with-an-uncemented-press-fit-fully-chemically-etched-stem-design
#14
Matthew P Sullivan, Reza Firoozabadi, Stephen A Kennedy, Julie Agel, Eric Magnusson, Brett Schiffman, Matthew Folchert, Daphne Beingessner
OBJECTIVES: To compare the radiographic outcomes of two widely used side loading, press fit, radial head arthroplasty implants used to reconstruct complex elbow trauma. DESIGN: Retrospective cohort study SETTING:: Level 1 Academic trauma center PARTICIPANTS:: Patients undergoing radial head arthroplasty INTERVENTION:: Cohort 1 received Synthes Radial Head Prosthesis. Cohort 2 received Biomet ExploR Radial Head Replacement. MAIN OUTCOME MEASUREMENTS: Radial neck dilatory remodeling RESULTS:: 82 subjects were included in final analysis, 63 from the Biomet Cohort and 19 from Synthes cohort...
April 27, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28468144/microvascular-tissue-transfers-for-midfacial-and-anterior-cranial-base-reconstruction
#15
Ali Emre Aksu, Hakan Uzun, Ozan Bitik, Gökhan Tunçbilek, Tunç Şafak
Reconstruction of a midfacial defect can represent a difficult challenge for the plastic surgeon. Although many midfacial deformities have traumatic or congenital origins, the vast majority of head and neck defects occur after resection of malignant head and neck neoplasms. Autogenous reconstruction is now routinely performed for larger, complex defects resulting from surgical resection or trauma. In this study, the authors present 27 patients with midfacial defects reconstructed with free flaps. Twenty-two of the defects were created by surgical ablation of cancer (maxillectomy) and the others were traumatic...
May 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28465039/use-of-couplers-for-vascular-anastomoses-in-601-free-flaps-for-reconstruction-of-defects-of-the-head-and-neck-technique-and-two-year-retrospective-clinical-study
#16
A Assoumane, L Wang, K Liu, Z-J Shang
We describe our experience with the use of 854 couplers for venous or arterial anastomoses, or both, in 601 free flaps for reconstruction of defects of the head and neck. We reviewed 601 patients who had had free flaps (with the microvascular anastomoses being made with couplers in 519) between July 2013 and December 2015. Personal details, and clinical data including the site of the defect, the tumour excised, the types of flaps, the size of the couplers, the method of anastomosis (venous or arterial) in which the coupler was used, and postoperative complications were recorded...
April 29, 2017: British Journal of Oral & Maxillofacial Surgery
https://www.readbyqxmd.com/read/28464749/contouring-and-dose-calculation-in-head-and-neck-cancer-radiotherapy-after-reduction-of-metal-artifacts-in-ct-images
#17
Christian Rønn Hansen, Rasmus Lübeck Christiansen, Ebbe Laugaard Lorenzen, Anders Smedegaard Bertelsen, Jon Thor Asmussen, Niels Gyldenkerne, Jesper Grau Eriksen, Jørgen Johansen, Carsten Brink
BACKGROUND: Delineation accuracy of the gross tumor volume (GTV) in radiotherapy planning for head and neck (H&N) cancer is affected by computed tomography (CT) artifacts from metal implants which obscure identification of tumor as well as organs at risk (OAR). This study investigates the impact of metal artifact reduction (MAR) in H&N patients in terms of delineation consistency and dose calculation precision in radiation treatment planning. MATERIAL AND METHODS: Tumor and OAR delineations were evaluated in planning CT scans of eleven oropharynx patients with streaking artifacts in the tumor region preceding curative radiotherapy (RT)...
June 2017: Acta Oncologica
https://www.readbyqxmd.com/read/28459758/speech-and-swallowing-outcomes-following-oral-cavity-reconstruction
#18
Camilla Dawson, Laith Al-Qamachi, Timothy Martin
PURPOSE OF REVIEW: This review explores speech and swallowing outcomes following oral cavity reconstruction for treatment of head and neck cancer, with focus on articles published within 2015-2016. RECENT FINDINGS: There is limited recent evidence that explores functional outcomes following oral cavity surgery in the literature; therefore, an overview of the literature describing surgical interventions and their associated functional outcomes is timely. SUMMARY: We discuss the challenges associated with achieving adequate surgical margins, alongside optimal functional outcomes...
June 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/28458967/improved-head-and-neck-free-flap-outcome-effects-of-a-treatment-protocol-adjustment-from-pre-to-postoperative-radiotherapy
#19
Martin Halle, Bjorn O Eriksson, Ann-Charlott Docherty Skogh, Pehr Sommar, Lalle Hammarstedt, Caroline Gahm
BACKGROUND: The impact of preoperative radiotherapy on microvascular reconstructive surgery outcome has been a subject of debate. However, data are conflicting and often dependent on local treatment protocols. We have studied the effects of radiotherapy in a unique, single-center setting where a treatment protocol change was undertaken from pre- to postoperative radiotherapy administration for microsurgical head and neck reconstructions. METHODS: A cohort study was conducted for 200 consecutive head and neck free flap cases, where 100 were operated on before and 100 after the treatment protocol adjustment in 2006...
March 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28458606/value-of-the-post-operative-ct-in-predicting-delayed-flap-failures-following-head-and-neck-cancer-surgery
#20
Bitna Kim, Dae Young Yoon, Young Lan Seo, Min Woo Park, Kee Hwan Kwon, Young-Soo Rho, Chul Hoon Chung
OBJECTIVE: To identify post-operative computed tomography (CT) findings associated with delayed flap failures following head and neck cancer surgery. MATERIALS AND METHODS: We retrospectively reviewed 60 patients who underwent flap reconstruction after head and neck cancer surgery and post-operative (3-14 days) contrast-enhanced CT scans for suspected complications. Patients were divided into two groups: delayed flap failure patients (patients required flap revision) (n = 18) and flap success patients (n = 42)...
May 2017: Korean Journal of Radiology: Official Journal of the Korean Radiological Society
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