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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
#1
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
#2
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
#3
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/29126769/cardiovascular-complications-in-head-neck-microvascular-flap-reconstruction-a-retrospective-risk-stratification-and-outcomes-assessment
#4
Naseem Ghazali, Steven Caldroney, Donita Dyalram, Joshua E Lubek
BACKGROUND: To determine the incidence and predictors of cardiac complications (CC) in head & neck microvascular flap reconstruction. METHODS: A series of 216 microvascular flaps performed between 2012 and 2015 were analyzed using the Revised Cardiac Risk Index (CRCI) and the Charlson Comorbidity Index (CCI). Multivariate regression analysis was undertaken for predictive factors of outcomes. RESULTS: Twenty patients developed CC (9.7%) with transient cardiac arrhythmia (6...
October 12, 2017: Journal of Cranio-maxillo-facial Surgery
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
#5
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
#6
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/29108918/donor-site-morbidity-of-the-anterolateral-thigh-flap
#7
Hannes Weise, Andreas Naros, Gunnar Blumenstock, Michael Krimmel, Sebastian Hoefert, Susanne Kluba, Stefan Hofer, Siegmar Reinert
INTRODUCTION: The purpose of this study was to investigate donor site morbidity after reconstruction of defects in the head and neck region with an anterolateral thigh (ALT) flap. METHODS: From 07/2006 to 12/2015 the anterolateral thigh flap was used for reconstruction of large intra- or extraoral defects in 138 patients. The donor sites were available to examine for morbidity in 51 patients (36.7%). All patients completed a standardized questionnaire, received a physical examination, and underwent isokinetic muscle exercises of the lower extremity with a Dynamometer...
September 30, 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
#8
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/29105818/simplified-profunda-artery-perforator-pap-flap-design-using-power-doppler-ultrasonography-pdu-a-prospective-study
#9
Andreas Kehrer, Ming-Yi Hsu, Yu-Ting Chen, Neil S Sachanandani, Chung-Kan Tsao
INTRODUCTION: Optimal design of PAP flaps requires precise perforator mapping. In a systematic review, Doppler ultrasonography demonstrated the highest sensitivity and positive predictive value (PPV). We present a prospective study of PAP flap design comparing PDU, handheld Doppler (HHD), and clinical findings. METHODS: From May to July 2016, 12 head and neck cancer patients receiving PAP flaps were examined with PDU and HHD. We used PDU to evaluate number, course, emergence point, peak systolic velocity (PSV), and arterial diameter of perforators...
November 4, 2017: Microsurgery
https://www.readbyqxmd.com/read/29098278/cranioplasty-using-a-mixture-of-biologic-and-nonbiologic-agents
#10
Demetri Arnaoutakis, Arash Bahrami, Jason E Cohn, Jesse E Smith
Importance: A surgeon faces challenges with cranioplasty techniques to achieve a successful result with relatively few complications. Objective: To describe a unique technique for incorporating both biologic autologous bone and nonbiologic allograft materials for defect coverage in cranioplasty with favorable outcomes and low occurrence of complications. Design, Setting, and Participants: A retrospective medical records review of all 26 patients who underwent primary cranioplasty procedure with a modified technique between January 2011 and December 2015 at a high-volume head and neck oncologic reconstructive practice was conducted; data analysis was also performed during that period...
November 2, 2017: JAMA Facial Plastic Surgery
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
#11
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
#12
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/29073917/benefit-of-salvage-total-pharyngolaryngoesophagectomy-for-recurrent-locally-advanced-head-and-neck-cancer-after-radiotherapy
#13
Jie Liu, Ye Zhang, Zhengjiang Li, Shaoyan Liu, Huizheng Li, Zhengang Xu
BACKGROUND: The treatment modalities for recurrent locally advanced head and neck cancer failure after radiotherapy are limited with poor prognosis. Salvage supra-radical operation seems to be an option. It has not been established which patients will benefit from salvage total pharyngolaryngoesophagectomy. METHODS: We retrospectively reviewed 66 patients with previously irradiated recurrent T4 head and neck cancer who underwent salvage total pharyngolaryngoesophagectomy at our institution between January 2001 and June 2014...
October 26, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/29068896/updates-in-head-and-neck-reconstruction
#14
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/29067796/risk-factors-of-and-treatments-for-pharyngocutaneous-fistula-occurring-after-oropharynx-and-hypopharynx-reconstruction
#15
Su Bin Do, Chul Hoon Chung, Yong Joon Chang, Byeong Jun Kim, Young Soo Rho
Background: A pharyngocutaneous fistula is a common and difficult-to-manage complication after head and neck reconstruction. It can lead to serious complications such as flap failure, carotid artery rupture, and pharyngeal stricture, and may require additional surgery. Previous radiotherapy, a low serum albumin level, and a higher T stage have been proposed as contributing factors. We aimed to clarify the risk factors for pharyngocutaneous fistula in patients who underwent flap reconstruction and to describe our experiences in treating pharyngocutaneous fistula...
October 25, 2017: Archives of Plastic Surgery
https://www.readbyqxmd.com/read/29056125/quantification-and-further-refinements-of-dorsal-metacarpal-artery-perforator-flap-for-reconstruction-of-wounds-of-fingers-upto-distal-interphalangeal-joints
#16
Muhammad Amin Yousaf, Zain Ul Abidin, Farrukh Aslam Khalid, Kamran Khalid, Muhammad Saleem, Muhammad Jibran Rabbani, Abdul Malik Mujahid, Moazzam Nazeer Tarrar
OBJECTIVE: To assess the outcome of dorsal metacarpal artery perforator flap for coverage of finger defects extending upto distal interphalangeal joint (DIPJ). STUDY DESIGN: Case series. PLACE AND DURATION OF STUDY: Jinnah Burn and Reconstructive Surgery Centre, Lahore, from March 2015 to May 2017. METHODOLOGY: Our study was carried out in two parts. 1st part of study was to measure average flap length in our population...
October 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/29032418/transoral-robotic-surgery-for-squamous-cell-carcinomas-of-the-posterior-pharyngeal-wall
#17
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/29024597/significant-chondrocyte-viability-is-present-in-acetabular-chondral-flaps-associated-with-femoroacetabular-impingement
#18
Vonda J Wright, Christopher Laurence McCrum, Hongshuai Li, Michael J Tranovich, Johnny Huard
BACKGROUND: Patients presenting with cam deformity of the femoral head and neck sustain repeated trauma to the articular cartilage of the superior acetabulum, with chondral delamination injuries found during hip arthroscopy. Two previous studies reveal conflicting chondrocyte viability data in these traumatic cartilage injuries. The full-thickness nature of flaps may suggest that chondrocytes residing in the cartilage flap matrix in the joint environment would remain viable despite shear trauma...
October 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/29024491/surgical-morbidity-and-mortality-in-patients-after-microvascular-reconstruction-for-head-and-neck-cancer
#19
Young-Hoon Joo, Kwang-Jae Cho, Jun-Ook Park, Sang-Yeon Kim, Min-Sik Kim
OBJECTIVES: The aim was to evaluate the importance of clinical factors in the prediction of postoperative complications in patients with microvascular reconstruction for head and neck squamous cell cancer (HNSCC). DESIGN: A retrospective review of case notes was performed. SETTING: Patients treated at a single institute. PARTICIPANTS: The present study included 259 patients with HNSCC treated with radical surgery and microvascular reconstruction between 1993 and 2014...
October 11, 2017: Clinical Otolaryngology
https://www.readbyqxmd.com/read/29021615/a-new-pedicled-internal-mammary-osteomyocutaneous-chimeric-flap-pimoc-for-salvage-head-and-neck-reconstruction-anatomic-study-and-clinical-application
#20
Guilherme C Barreiro, Chelsea C Snider, Flavio H F Galvão, Rachel R Baptista, Kiril E Kasai, Daniel M Dos Anjos, Marcus C Ferreira
Well-vascularized composite tissue offers improved outcomes for complex head and neck reconstruction. Patients with vessel-depleted necks and failed reconstructions require alternative reconstructive options. We describe a pedicled internal mammary artery osteomyocutaneous chimeric flap (PIMOC) for salvage head and neck reconstruction. Bilateral dissections of 35 fresh cadavers were performed to study individual tissue components and vascular pedicles to develop the PIMOC technique. The flap was then utilized in a series of patients with vessel-depleted neck anatomy...
October 11, 2017: Scientific Reports
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