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Head and neck, reconstruction

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https://www.readbyqxmd.com/read/28334798/risk-factors-for-postoperative-delirium-in-patients-undergoing-major-head-and-neck-cancer-surgery-a-meta-analysis
#1
Yun Zhu, Gangpu Wang, Shengwen Liu, Shanghui Zhou, Ying Lian, Chenping Zhang, Wenjun Yang
Objective: Postoperative delirium is common after extensive surgery. This study aimed to collate and synthesize published literature on risk factors for delirium in patients with head and neck cancer surgery. Methods: Three databases were searched (MEDLINE, Embase, and Cochrane Library) between January 1987 and July 2016. The Newcastle Ottawa Scale (NOS) was adopted to evaluate the study quality. Pooled odds ratios or mean differences for individual risk factors were estimated using the Mantel-Haenszel and inverse-variance methods...
February 24, 2017: Japanese Journal of Clinical Oncology
https://www.readbyqxmd.com/read/28322117/effect-of-overlapping-operations-on-outcomes-in-microvascular-reconstructions-of-the-head-and-neck
#2
Larissa Sweeny, Eben L Rosenthal, Tyler Light, Jessica Grayson, Daniel Petrisor, Scott H Troob, Benjamin J Greene, William R Carroll, Mark K Wax
Objective To compare outcomes after microvascular reconstructions of head and neck defects between overlapping and nonoverlapping operations. Study Design Retrospective cohort study. Setting Tertiary care center. Subjects and Methods Patients undergoing microvascular free tissue transfer operations between January 2010 and February 2015 at 2 tertiary care institutions were included (n = 1315). Patients were divided into 2 cohorts by whether the senior authors performed a single or consecutive microvascular reconstruction (nonoverlapping; n = 773, 59%) vs performing overlapping microvascular reconstructions (overlapping; n = 542, 41%)...
March 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28319459/morbidity-and-survival-in-elderly-patients-undergoing-free-flap-reconstruction-a-retrospective-cohort-study
#3
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
#4
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 20, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28318866/innovations-in-joint-preservation-procedures-for-the-dysplastic-hip-the-periacetabular-osteotomy
#5
Cecilia Pascual-Garrido, Michael D Harris, John C Clohisy
The Bernese periacetabular osteotomy is an effective treatment for symptomatic developmental dysplasia in the prearthritic young adult hip. Refinements in the periacetabular osteotomy technique and perioperative management have markedly improved the clinical outcomes and recovery in these patients. We will review the clinical presentation of acetabular dysplasia, indications for surgery, perioperative management, and contemporary refinements in technique including refined acetabular reduction, adjunctive hip arthroscopy, femoral head-neck osteochondroplasty, femoral procedures, and rapid recovery protocols...
February 14, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28315184/epiphyseal-arterial-network-and-inferior-retinacular-artery-seem-critical-to-femoral-head-perfusion-in-adults-with-femoral-neck-fractures
#6
Dewei Zhao, Xing Qiu, Benjie Wang, Zihua Wang, Wei Wang, Jun Ouyang, Rona M Silva, Xiaotian Shi, Kai Kang, Dachuan Xu, Chuang Li, Shizhen Zhong, Yu Zhang, Kent E Pinkerton
BACKGROUND: A better understanding of the blood supply of the femoral head is essential to guide therapeutic strategies for patients with femoral neck fractures. However, because of the limitations of conventional techniques, the precise distribution and characteristics of intraosseous arteries of the femoral head are not well displayed. QUESTIONS/PURPOSES: To explore the characteristics and interconnections of the intraosseous vessel system between different areas of the femoral head and the possible blood supply compensatory mechanism after femoral neck fracture...
March 17, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28301644/association-of-body-mass-index-with-infectious-complications-in-free-tissue-transfer-for-head-and-neck-reconstructive-surgery
#7
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/28301365/preserving-the-legitimacy-of-board-certification
#8
Michael S Hanemann, Holly C Wall, John A Dean
OBJECTIVES: The aims of this discussion were to inform the medical community about the American Board of Cosmetic Surgery's ongoing attempts in Louisiana to achieve equivalency to American Board of Medical Specialties (ABMS) member boards so that its diplomates may use the term "board certified" in advertising and to ensure public safety by upholding the standards for medical board certification. BACKGROUND: In 2011, Louisiana passed a truth in medical advertising law, which was intended to protect the public by prohibiting the use of the term "board certified" by improperly credentialed physicians...
March 16, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28297354/quantitative-evaluation-of-patient-setup-uncertainty-of-stereotactic-radiotherapy-with-the-frameless-6d-exactrac-system-using-statistical-modeling
#9
Vance Keeling, Sabbir Hossain, Hosang Jin, Ozer Algan, Salahuddin Ahmad, Imad Ali
The purpose of this study is to evaluate patient setup accuracy and quantify individual and cumulative positioning uncertainties associated with different hardware and software components of the stereotactic radiotherapy (SRS/SRT) with the frameless 6D ExacTrac system. A statistical model is used to evaluate positioning uncertainties of the different components of SRS/SRT treatment with the Brainlab 6D ExacTrac system using the positioning shifts of 35 patients having cranial lesions. All these patients are immobilized with rigid head-and-neck masks, simulated with Brainlab localizer and planned with iPlan treatment planning system...
May 2016: Journal of Applied Clinical Medical Physics
https://www.readbyqxmd.com/read/28293493/technique-to-improve-tracheostomy-speaking-valve-tolerance-after-head-and-neck-free-flap-reconstruction
#10
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
#11
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
#12
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
https://www.readbyqxmd.com/read/28278181/the-myodural-bridge-existing-in-the-nephocaena-phocaenoides
#13
Pei Liu, Chan Li, Nan Zheng, Qiang Xu, Sheng-Bo Yu, Hong-Jin Sui
Recent studies have identified that the myodural bridge (MDB) between the rectus capitis posterior minor (RCPmi) and the cervical spinal dura mater in the posterior atlanto-occipital interspace in humans. And it was supposed that the MDB may play essential physiological roles. As a result, the MDB is possibly a highly conserved structure in the evolution of mammals. However, there is little confirmative description about the existence of the MDB in marine mammals. The objective of this study was to explore the existence and the fiber property of the MDB in the Neophocaena phocaenoides...
2017: PloS One
https://www.readbyqxmd.com/read/28273739/dual-energy-ct-with-virtual-monochromatic-images-and-metal-artifact-reduction-software-for-reducing-metallic-dental-artifacts
#14
Jihoon Cha, Hyung-Jin Kim, Sung Tae Kim, Yi Kyung Kim, Ha Youn Kim, Gyeong Min Park
Background Metallic dental prostheses may degrade image quality on head and neck computed tomography (CT). However, there is little information available on the use of dual-energy CT (DECT) and metal artifact reduction software (MARS) in the head and neck regions to reduce metallic dental artifacts. Purpose To assess the usefulness of DECT with virtual monochromatic imaging and MARS to reduce metallic dental artifacts. Material and Methods DECT was performed using fast kilovoltage (kV)-switching between 80-kV and 140-kV in 20 patients with metallic dental prostheses...
January 1, 2017: Acta Radiologica
https://www.readbyqxmd.com/read/28270276/third-generation-dual-source-ct-for-head-and-neck-ct-angiography-with-70-kv-tube-voltage-and-20-25-ml-contrast-medium-in-patients-with-body-weight-lower-than-75-kg
#15
Yu Chen, Yuanli Zhu, Huadan Xue, Yun Wang, Yumei Li, Zhuhua Zhang, Zhengyu Jin
Objective To investigate the image quality of head and neck CT angiography (CTA)using the third-generation dual-source CT combined with 70 kV tube voltage and 20-25 ml contrast medium (CM),and evaluate the effects of venous artifacts arising from the CM on the ipsilateral side of injection. Methods Totally 40 consecutive patients with suspected vascular diseases and body weight lower than 75 kg prospectively underwent head and neck CTA examination using the third-generation dual-source CT. CTA was performed with a third-generation dual-source CT system...
February 20, 2017: Zhongguo Yi Xue Ke Xue Yuan Xue Bao. Acta Academiae Medicinae Sinicae
https://www.readbyqxmd.com/read/28263728/is-there-a-role-for-craniofacial-surgery-in-the-treatment-of-extensive-or-recurrent-head-and-neck-tumors-involving-the-cranial-base
#16
Chunyue Ma, Jun Li, Yi Shen, Yiqun Wu, Runjie Shi, Jian Sun
PURPOSE: Extensive or recurrent head and neck tumors involving the cranial base are extremely difficult to treat from a surgical perspective. The purposes of this study were to estimate and identify factors associated with overall survival after traditional craniofacial resection in these cases and to discuss the specific indications and treatment outcomes. MATERIALS AND METHODS: From January 2005 to December 2014, a retrospective cohort study was performed with the analysis of patients diagnosed with extensive or recurrent head and neck tumors extending to the skull base...
February 8, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28263239/early-and-delayed-evaluation-of-solid-tumours-with-64cu-atsm-pet-ct-a-pilot-study-on-semiquantitative-and-computer-aided-fractal-geometry-analysis
#17
Egesta Lopci, Fabio Grizzi, Carlo Russo, Luca Toschi, Ilaria Grassi, Gianfranco Cicoria, Filippo Lodi, Sandro Mattioli, Stefano Fanti
OBJECTIVE: The aim of this study was to analyse early and delayed acquisition on copper-64 diacetyl-bisN4-methylthiosemicarbazone (Cu-ATSM) PET/CT in a small cohort of patients by comparing semiquantitative and computer-aided fractal geometry analyses. PATIENTS AND METHODS: Five cancer patients, including non-small-cell lung cancer and head and neck cancer, were investigated with Cu-ATSM PET/CT. Participants received an intravenous injection of Cu-ATSM according to body size and were imaged 60 min (early) and 16 h (delayed) later on hybrid PET/CT...
April 2017: Nuclear Medicine Communications
https://www.readbyqxmd.com/read/28252544/applying-the-keystone-design-perforator-island-flap-concept-in-a-variety-of-anatomic-locations-a-review-of-60-consecutive-cases-by-a-single-surgeon
#18
Michael Alan Lanni, Emily Van Kouwenberg, Alan Yan, Kristen M Rezak, Ashit Patel
BACKGROUND: The keystone design perforator island flap has been gaining popularity for reconstruction of cutaneous defects. Published experience of this technique in North America is limited predominantly to the trunk and extremities; our study aims to demonstrate expanding applications. METHODS: Retrospective chart review was conducted on all patients who underwent keystone flap reconstruction by a single surgeon. Outcomes of interest were wound healing complications (WHC) and surgical site infections (SSI)...
March 1, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28249001/accuracy-and-reproducibility-of-virtual-cutting-guides-and-3d-navigation-for-osteotomies-of-the-mandible-and-maxilla
#19
Jonathan M Bernstein, Michael J Daly, Harley Chan, Jimmy Qiu, David Goldstein, Nidal Muhanna, John R de Almeida, Jonathan C Irish
BACKGROUND: We set out to determine the accuracy of 3D-navigated mandibular and maxillary osteotomies with the ultimate aim to integrate virtual cutting guides and 3D-navigation into ablative and reconstructive head and neck surgery. METHODS: Four surgeons (two attending, two clinical fellows) completed 224 unnavigated and 224 3D-navigated osteotomies on anatomical models according to preoperative 3D plans. The osteotomized bones were scanned and analyzed. RESULTS: Median distance from the virtual plan was 2...
2017: PloS One
https://www.readbyqxmd.com/read/28244121/multiple-pilomatrixomas-in-children-the-need-for-long-term-follow-up-and-aesthetically-sensitive-incisions
#20
K Brannigan, L L Touil, A Y Fattah
Pilomatrixomas are benign, calcified epitheliomas of the hair follicle, predominately affecting children and commonly presenting in the head and neck region. The current literature is almost unanimous in recommending surgical excision. Reconstruction of these defects may require the need for a skin graft, resulting in poor cosmetic outcome and donor site morbidity. We present two cases demonstrating the benefits of minimal access incisions for pilomatrixomas in children. We recommend that multiple or recurrent lesions should prompt referral to a specialist for management and long-term follow-up...
February 28, 2017: Clinical and Experimental Dermatology
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