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Head and neck, reconstruction

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https://www.readbyqxmd.com/read/28736943/risk-factors-for-wound-complications-in-head-and-neck-reconstruction-773-free-jejunal-reconstruction-procedures-after-total-pharyngolaryngoesophagectomy
#1
Narushi Sugiyama, Soshi Takao, Etsuji Suzuki, Yoshihiro Kimata
BACKGROUND: Most studies that examined risk factors for wound complications after head and neck reconstruction analyzed various complications collectively. Moreover, they included a wide variety of resection areas and reconstruction materials. To overcome these limitations, both the resection area and reconstruction method were constrained in the present study. METHODS: Patients who underwent free jejunal graft reconstruction after pharyngolaryngoesophagectomy for hypopharyngeal cancer were enrolled...
July 24, 2017: Head & Neck
https://www.readbyqxmd.com/read/28735639/free-flap-reconstruction-for-patients-aged-85-years-and-over-with-head-and-neck-cancer-clinical-considerations-for-comprehensive-care
#2
X F Chen, Y M Chen, S Gokavarapu, Q C Shen, T Ji
We aimed to identify and evaluate the clinical challenges involved in microvascular flap reconstructions of defects caused by resection of head and neck cancer among patients aged 85 and over. We designed a retrospective study of patients who were treated in the head and neck department of a tertiary referral centre from 2005 to 2015, and all patients aged 85 years and over who had reconstructions with microvascular flaps for head and neck cancer were entered into the study. A total of 24 patients fulfilled the criteria, of whom 15 were men and nine were women...
July 20, 2017: British Journal of Oral & Maxillofacial Surgery
https://www.readbyqxmd.com/read/28731497/the-effect-of-frailty-on-short-term-outcomes-after-head-and-neck-cancer-surgery
#3
Carrie L Nieman, Karen T Pitman, Anthony P Tufaro, David W Eisele, Kevin D Frick, Christine G Gourin
OBJECTIVE: To determine the relationship between frailty and comorbidity, in-hospital mortality, postoperative complications, length of hospital stay (LOS), and costs in head and neck cancer (HNCA) surgery. STUDY DESIGN: Cross-sectional analysis. METHODS: Discharge data from the Nationwide Inpatient Sample for 159,301 patients who underwent ablative surgery for a malignant oral cavity, laryngeal, hypopharyngeal, or oropharyngeal neoplasm in 2001 to 2010 was analyzed using cross-tabulations and multivariate regression modeling...
July 21, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28729774/clinical-applications-of-free-medial-tibial-flap-with-posterior-tibial-artery-for-head-and-neck-reconstruction-after-tumor-resection
#4
Qi Zhong, Jugao Fang, Zhigang Huang, Xiaohong Chen, Lizhen Hou, Yang Zhang, Pingdong Li, Hongzhi Ma, Hongbo Xu
Tumor resection causes damage in the head and neck which creates problems in swallowing, chewing, articulation, and vision, all of which seriously affect patients' quality of life. In this work, we evaluated the application of a free medial tibial flap in reconstruction of head and neck defects after tumor resection. We discussed the anatomy, surgical technique, and the advantages and disadvantages of the flap. We found several benefits for the flap, such as, it is especially effective for the defects that require thin-layer epithelium to cover or the separated soft tissue defect; a two-team approach can be used because the donor site is far away from the head and neck; and the flap is easy to integrate because of the subcutaneous fat layer of the free medial tibial flap is thin and the flap is soft...
June 2017: Chinese Journal of Cancer Research, Chung-kuo Yen Cheng Yen Chiu
https://www.readbyqxmd.com/read/28728327/non-melanocytic-skin-cancers-of-the-head-and-neck-a-clinical-study-in-jeju-province
#5
Jae Kyoung Kang, Byung Min Yun, Jung-Kook Song, Myoung Soo Shin
BACKGROUND: Jeju Island is geographically and socioeconomically distinct from the mainland of South Korea. Thus, the presentation and management of non-melanocytic skin cancers (NMSC) of the head and neck may differ from those in other regions of the country. We compared the clinical characteristics and treatment modalities of NMSC on Jeju Island with the findings of similar regional studies. METHODS: Patient data, including age, sex, diagnosis, tumor site, treatment, and recurrence, were obtained from the medical and pathology records of patients diagnosed with NMSC between January 2010 and June 2015...
July 2017: Archives of Plastic Surgery
https://www.readbyqxmd.com/read/28728078/femoral-head-necrosis-a-finite-element-analysis-of-common-and-novel-surgical-techniques
#6
Myriam Cilla, Sara Checa, Bernd Preininger, Tobias Winkler, Carsten Perka, Georg N Duda, Matthias Pumberger
BACKGROUND: Femoral head necrosis is a common cause of secondary osteoarthritis. At the early stages, treatment strategies are normally based on core decompression techniques, where the number, location and diameter of the drilling holes varies depending on the selected approach. The purpose of this study was to investigate the risk of femoral head, neck and subtrochanteric fracture following six different core decompression techniques. MATERIALS: Five common and a newly proposed techniques were analyzed in respect to their biomechanical consequences using finite element analysis...
July 6, 2017: Clinical Biomechanics
https://www.readbyqxmd.com/read/28720989/trapezius-perforator-flap-for-reconstruction-of-a-posterior-cervical-defect
#7
Ricardo Nascimento, Joana Costa, Ricardo Horta, Álvaro Silva
The use of free flaps is considered the "gold standard" for reconstruction of head and neck defects. Locoregional flaps allows a better aesthetic result compared to free flaps, whenever there's an external skin defect. However the use of free flaps is not always adequate in the presence of preoperative comorbidities or previous surgeries. Since the description of the trapezius myocutaneous flap in the 1980's, many authors have published the results of the applicability of this flap in head and neck salvage reconstructive surgery...
April 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/28716300/the-effect-of-training-level-on-complications-after-free-flap-surgery-of-the-head-and-neck
#8
Jacob S Brady, Meghan M Crippen, Andrey Filimonov, Neil V Nadpara, Jean Anderson Eloy, Soly Baredes, Richard Chan Woo Park
OBJECTIVES: Analyze postoperative complications after free flap surgery based on PGY training level. METHODS: Data on free flap surgeries of the head and neck performed from 2005 to 2013 was collected from the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database. Cases identifying the status of resident participation in the surgery and the PGY level were included. RESULTS: There were 582 cases with primary surgeon data available...
June 2, 2017: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/28712070/flow-diverter-in-radiation-induced-skull-base-carotid-blowout-syndrome-do-not-write-it-off
#9
Gopinathan Anil, Junwei Zhang, Yew Kwang Ong, Francis Hui
Post-radiotherapy carotid blowout syndrome (CBS) of the skull base is a rare but often catastrophic complication of head and neck malignancies. The existing literature on the treatment of this condition with flow-diverting devices (FDD) is extremely limited and disappointing. We present a case of impending CBS in a patient previously irradiated for nasopharyngeal cancer that was successfully treated with use of multiple FDDs, adjunctive endonasal packing and delayed reinforcement with pedicled naso-septal flap, yielding an excellent outcome at 14-months follow-up...
July 16, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28711209/dual-energy-computed-tomography-of-the-neck-a-pictorial-review-of-normal-anatomy-variants-and-pathologic-entities-using-different-energy-reconstructions-and-material-decomposition-maps
#10
REVIEW
Almudena Pérez-Lara, Reza Forghani
There is increasing use of dual-energy computed tomography (DECT) for the evaluation of head and neck pathologic entities. Optimal DECT utilization requires familiarity with the appearance of normal tissues variants, and pathologic entities on different DECT reconstructions that may be used in clinical practice. The purpose of this article is to provide a practical, pictorial review of the appearance of normal anatomic structures and different neoplastic and nonneoplastic head and neck pathologic entities on commonly used DECT reconstructions...
August 2017: Neuroimaging Clinics of North America
https://www.readbyqxmd.com/read/28711208/applications-of-dual-energy-computed-tomography-for-artifact-reduction-in-the-head-neck-and-spine
#11
REVIEW
Eric Liao, Ashok Srinivasan
Conventional computed tomography (CT) uses a polychromatic energy beam to offer superb anatomic detail of the head and spine. However, technical challenges remain that can degrade the diagnostic image quality of these examinations. Dual-energy CT analyzes the changes in attenuation of soft tissues at different energy levels, from which different reconstructions can be made to yield the optimal contrast-to-noise ratio, reduce beam-hardening artifact, or evaluate tissue composition. In this article, selective applications of the dual energy CT technique are discussed, highlighting a powerful tool in the diagnostic CT evaluation of the head, neck, and spine...
August 2017: Neuroimaging Clinics of North America
https://www.readbyqxmd.com/read/28711204/applications-of-dual-energy-computed-tomography-for-the-evaluation-of-head-and-neck-squamous-cell-carcinoma
#12
REVIEW
Reza Forghani, Hillary R Kelly, Hugh D Curtin
There are multiple emerging applications of dual-energy computed tomography (DECT) for the evaluation of pathology in the head and neck, in particular head and neck squamous cell carcinoma. Studies suggest that DECT image sets reconstructed as supplements to routine diagnostic images may improve lesion visualization, determination of tumor extent, and identification of invasion of critical anatomic structures. This article reviews the evidence for the use and potential advantages of supplementary DECT reconstructions for the evaluation of head and neck squamous cell carcinoma...
August 2017: Neuroimaging Clinics of North America
https://www.readbyqxmd.com/read/28711200/dual-energy-computed-tomography-physical-principles-approaches-to-scanning-usage-and-implementation-part-2
#13
REVIEW
Reza Forghani, Bruno De Man, Rajiv Gupta
There are increasing applications and use of spectral computed tomography or dual-energy computed tomography (DECT) in neuroradiology and head and neck imaging in routine clinical practice. Part 1 of this 2-part review covered fundamental physical principles underlying DECT scanning and the different approaches for scanning. Part 2 focuses on important and practical considerations for implementing and using DECT in clinical practice, including a review of different images and reconstructions produced by these scanners and important and practical issues, ranging from image quality and radiation dose to workflow-related aspects of DECT scanning, that routinely come up during operationalization of DECT...
August 2017: Neuroimaging Clinics of North America
https://www.readbyqxmd.com/read/28709536/margin-analysis-has-free-tissue-transfer-improved-oncologic-outcomes-for-oral-squamous-cell-carcinoma
#14
REVIEW
Sean P Edwards
Microvascular reconstruction of ablative defects has become a mainstay of contemporary management of head and neck cancer patients. These techniques offer myriad tissue options that vary in character, volume, and components and have vastly improved the esthetic and functional outcomes achieved in this patient population. Although consensus exists regarding the reliability and functional and esthetic benefits of free tissue transfer, the same cannot be said for oncologic outcomes. The increase in resources required for the routine use of free tissue transfer has led to asking this question-Do vascularized free flaps allow for increased surgical margins and improvements in oncologic outcomes?...
August 2017: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/28708658/condyle-head-reimplantation-combined-with-vascularized-free-flap-for-mandibular-reconstruction
#15
Jun-Yi Zhu, Hai-Xiao Zou, Hui-Min Li, Wei Wang, Jun Jia
Due to the anatomic and functional complexity, reconstruction of the condylar process after mandibular tumor extirpation remains a surgical challenge. The aim of this study was to present the results and experience of condyle head reimplantation combined with vascularized free flap for mandibular reconstruction in our institution. In the current study, the authors evaluated the clinical features of condyle head reimplantation combined with vascularized free flap for mandibular reconstruction in 5 patients with benign mandibular intraosseous lesions from December 2013 to March 2015 in our institution...
July 13, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28696999/the-expanding-role-of-scapular-free-flaps
#16
Alice L Tang, Shethal Bearelly, Kyle Mannion
PURPOSE OF REVIEW: The review evaluates the expanding role of scapular free flaps and its application in various complex head and neck defects. RECENT FINDINGS: The recent literature published focuses on the use of three-dimensional modeling for maxillectomy defects, expanded uses in both the megaflap, the various application of the scapular tip flap, and the feasibility of osseointegrated implants. SUMMARY: The subscapular system of flaps remains a versatile option in head and neck reconstruction...
July 10, 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/28690778/vacuum-assisted-closure-therapy-after-resection-of-giant-basal-cell-carcinoma-of-the-scalp
#17
Silvia Pereira, Wilson Malta, António Canha, José Polónia
Management of complicated wounds is a challenge in head and neck reconstruction. Although the negative pressure wound therapy or wound vacuum-assisted closure has been widely used in complicated wounds and shows promising results, its application in the head and neck region after reconstruction for the head and neck cancer is rarely presented. A 77-year-old woman underwent a radical resection of an extensive basal cell carcinoma of the scalp and forehead involving the periosteum, where classic reconstruction was difficult, but successfully treated with negative pressure wound therapy...
July 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28677576/methods-to-reduce-postoperative-surgical-site-infections-after-head-and-neck-oncology-surgery
#18
REVIEW
Richard B Cannon, Jeffrey J Houlton, Eduardo Mendez, Neal D Futran
Head and neck cancer surgery is often a complex multi-step procedure that includes major resections, vascularised tissue reconstruction, and extensive neck dissection. The upper aerodigestive tract mucosal lining is often disrupted during surgery, which requires the management of a clean-contaminated field and the need to reconstruct the mucosal lining. With bacterial contamination, surgical site infections (SSI) are a serious complication that can result in delayed wound healing, wound breakdown, fistula formation, and compromised tissue reconstruction...
July 2017: Lancet Oncology
https://www.readbyqxmd.com/read/28676163/scalp-and-forehead-defects-in-the-post-mohs-surgery-patient
#19
REVIEW
Michael D Olson, Grant S Hamilton
Scalp and forehead reconstruction after Mohs micrographic surgery can encompass subcentimeter defects to entire scalp reconstruction. Knowledge of anatomy, flap design, and execution will prepare surgeons who operate in the head and neck area to confidently approach a variety of reconstructive challenges in this area.
August 2017: Facial Plastic Surgery Clinics of North America
https://www.readbyqxmd.com/read/28675554/osteocutaneous-radial-forearm-free-flap-in-nonmandible-head-and-neck-reconstruction
#20
Faisal I Ahmad, Casey Means, Alex B Labby, Scott H Troob, Javier D Gonzalez, Michael M Kim, Ryan J Li, Mark K Wax
BACKGROUND: The osteocutaneous radial forearm free flap (RFFF) is a versatile flap primarily used to reconstruct composite defects involving the mandible. The purpose of this study was to describe our experience with this flap for nonmandible reconstruction. METHODS: All patients undergoing nonmandible osseous reconstruction with free-tissue transfer were reviewed. Patients with osteocutaneous RFFF reconstructions were evaluated. The retrospective review of all osteocutaneous RFFFs was performed from 1998 to 2014...
July 4, 2017: Head & Neck
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