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https://www.readbyqxmd.com/read/29775982/the-supraclavicular-artery-perforator-flap-a-comparative-study-of-imaging-techniques-used-in-preoperative-mapping
#1
Hemin Oathman Sheriff, Kawa Abdullah Mahmood, Nzar Hamawandi, Aram Jamal Mirza, Jawad Hawas, Esther Granell Moreno, Juan Antonio Clavero, Christopher Hankins, Jaume Masia
BACKGROUND:  The supraclavicular artery flap is an excellent flap for head and neck reconstruction. The aim of this study is to assess imaging techniques to define the precise vascular boundaries of this flap. METHODS:  Six imaging techniques were used for supraclavicular artery mapping in 65 cases; handheld Doppler, triplex ultrasound, computed tomography angiography, magnetic resonance angiography, digital subtraction angiography, and indocyanine green angiography...
May 18, 2018: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/29762448/pectoralis-major-musculocutaneous-flap-with-a-midline-sternal-skin-paddle-for-head-and-neck-reconstruction-a-new-design
#2
Jeongseok Oh, Hee Chang Ahn, Seungki Youn, Kyung Tae
PURPOSE: The pectoralis major musculocutaneous (PMMC) flap is a classic flap for head and neck reconstruction, relatively unpopular with the advancement of microsurgery and free flaps. The classic parasternal paddle design provided a thick flap with a small rotation arch leaving objectionable scarring. Our new symmetric midsternal design overcomes these problems. METHODS: Chart review was done from the years 2000 to 2017. Flap skin paddle was placed symmetrically on both sides of the midsternal line...
May 14, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29762438/venous-anastomoses-in-anterolateral-thigh-flaps-for-the-lower-extremity-vessel-selection-in-lieu-of-obligatory-number
#3
David Mattos, Shawn Diamond, Anmol S Chattha, Johanna N Riesel, Matthew L Iorio
BACKGROUND: Dual venous drainage for anterolateral thigh flaps has been proposed to protect against flap-related complications in head and neck applications. Here we report our experience with single vs dual venous anastomosis during lower extremity free-tissue transfer. METHODS: All free anterolateral thigh flaps for lower extremity reconstruction from 2011 to 2017 were retrospectively reviewed. An algorithm was used to determine the type and number of venous anastomoses, emphasizing patient anatomy, venous quality, and size match...
May 14, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29756392/successful-treatment-of-severe-facial-lymphedema-by-lymphovenous-anastomosis
#4
Yusuke Inatomi, Sei Yoshida, Kenichi Kamizono, Masuo Hanada, Ryuji Yasumatsu, Hideki Kadota
BACKGROUND: Facial edema is a common complication after neck dissection and/or chemoradiotherapy for head and neck cancer. Edema subsides spontaneously in most cases but sometimes persists, in which case surgical intervention is required. We report a case of severe facial edema that showed significant improvement upon lymphovenous anastomosis (LVA). METHODS: A 66-year-old man with oral floor cancer developed progressive facial lymphedema after tumor resection, bilateral neck dissections, chemoradiotherapy, and fibular and rectus abdominis musculocutaneous flap transfer...
May 13, 2018: Head & Neck
https://www.readbyqxmd.com/read/29750670/modern-postoperative-monitoring-of-free-flaps
#5
Minna Kääriäinen, Elina Halme, Jussi Laranne
PURPOSE OF REVIEW: Flap failure in microvascular reconstruction is a costly complication with total flap loss being the worst-case scenario. With the aim to rapidly identify a postoperative circulatory problem, some susceptible flaps can be saved by careful clinical monitoring or by various technical monitoring methods. In head and neck surgery, where the flaps are often buried and difficult to monitor clinically, a reliable technical monitoring method would be useful. A broad range of different techniques are in use varying according to practical and personal preferences among clinics and surgeons...
May 9, 2018: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/29747054/a-modification-of-the-bjork-flap-in-tracheostomies-for-head-and-neck-cancer-patients
#6
Panagiotis Stathopoulos, Leo Stassen
The etymology of the word tracheotomy derives from two Ancient Greek words: the word trachea (Greek τραχɛία tracheía) and the word stoma (Greek στóμα stóma) meaning "mouth," and refers to the making of an opening. It is believed that an early tracheostomy was performed by the Greek physician Asclepiades of Bithynia, in order to treat upper airway obstruction. A secure airway in the intraoperative and early postoperative period is of paramount importance for a number patients undergoing head and neck cancer surgery...
May 7, 2018: Journal of Stomatology, Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29734459/-application-of-vacuum-wound-therapy-with-split-thickness-skin-grafts-in-the-head-and-neck-area
#7
Julia Thierauf, Paul Severin Wiggenhauser, Thomas Karl Hoffmann, Jens Greve, Marc Scheithauer, Johannes Adrian Veit
OBJECTIVE: In vacuum wound therapy (VAC) a negative pressure can continuously clean effusions and enhance the formation of granulation tissue significantly. In visceral, trauma and burns surgery this technique is used frequently in critical wounds. In the head and neck area there is limited experience and publications. Especially in the combined use of split-thickness-skin grafts (STSG) and VAC there is no published evidence. MATERIAL AND METHODS: A retrospective database analysis was done and resulted in 36 single VAC therapies in 13 patients...
May 7, 2018: Laryngo- Rhino- Otologie
https://www.readbyqxmd.com/read/29730061/computed-tomographic-angiographic-perforator-localization-for-virtual-surgical-planning-of-osteocutaneous-fibular-free-flaps-in-head-and-neck-reconstruction
#8
Kyle S Ettinger, Amy E Alexander, Kevin Arce
Virtual surgical planning (VSP), computer-aided design and computer-aided modeling, and 3-dimensional printing are 3 distinct technologies that have become increasingly used in head and neck oncology and microvascular reconstruction. Although each of these technologies has long been used for treatment planning in other surgical disciplines, such as craniofacial surgery, trauma surgery, temporomandibular joint surgery, and orthognathic surgery, its widespread use in head and neck reconstructive surgery remains a much more recent event...
April 10, 2018: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29727305/improving-aesthetic-outcomes-after-head-and-neck-reconstruction
#9
Ayham Al Afif, H Kendal Uys, S Mark Taylor
PURPOSE OF REVIEW: Tremendous advancements have been made in head and neck reconstruction following oncologic resection. Despite this, many patients are left with disfiguring postoperative changes. The focus of this review highlights various techniques aimed at improving aesthetic outcomes following head and neck cancer therapy, with a focus on liposuction and fat augmentation. RECENT FINDINGS: Over the past decade, the use of liposuction in treating lymphedema after head and neck cancer therapy has showed promising results...
May 2, 2018: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/29723399/outcomes-of-microvascular-flap-reconstruction-of-the-head-and-neck-in-patients-receiving-systemic-immunosuppressive-therapy-for-organ-transplantation
#10
Mark V Schaverien, Riley A Dean, Jeffrey N Myers, Lin Fang, Rene D Largo, Peirong Yu
BACKGROUND: For organ transplant recipients, cancer secondary to immunosuppressive therapy threatens long-term survival. The associated multiple comorbidities make major free flap reconstruction following cancer surgery a complicated event. This study evaluates the outcomes of free flap reconstruction in this population. METHODS: A retrospective chart review of all head and neck free flap cases in patients with a history of organ transplantation receiving systemic immunosuppressive therapy between 2005 and 2017 at a single-institution was conducted...
May 3, 2018: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29720267/efficacy-of-postoperative-pain-management-in-head-and-neck-cancer-patients
#11
Ashley Hinther, Steven C Nakoneshny, Shamir P Chandarana, T Wayne Matthews, Joseph C Dort
BACKGROUND: Our study quantifies the effectiveness of perioperative pain control in a cohort of patients undergoing major head and neck surgery with free flap reconstruction. Our long-term goal is to improve pain control and thereby increase mobility, decrease postoperative complications and decrease hospital stay. METHODS: A retrospective analysis was performed at a tertiary, academic head and neck surgical oncology program in Calgary, Alberta, Canada from January 1, 2015 - December 31, 2015...
May 2, 2018: Journal of Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/29710229/association-of-celecoxib-use-with-decreased-opioid-requirements-after-head-and-neck-cancer-surgery-with-free-tissue-reconstruction
#12
Patrick S Carpenter, Hailey M Shepherd, Hilary McCrary, Vanessa Torrecillas, Amanda Kull, Jason P Hunt, Marcus M Monroe, Luke O Buchmann, Richard B Cannon
Importance: Head and neck cancer (HNC) surgery with free tissue reconstruction is associated with considerable postoperative pain. Opioids are typically used but can have adverse effects, including respiratory depression and high rates of dependence and addiction. Safe alternative analgesics that minimize opioid requirements are beneficial in HNC surgery. Objective: To investigate the association of celecoxib use with opioid requirements in the postoperative setting after HNC surgery with free tissue reconstruction...
April 18, 2018: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/29702024/video-preoperative-ct-angiography-for-fibular-free-flap-reconstructions
#13
Bilal Mujtaba, Gaurav K Synghal, Patrick B Garvey, Behrang Amini, Tamara Miner Haygood, John E Madewell, Colleen M Costelloe
OBJECTIVE: The objective of this video article is to provide an introduction to the use of fibular free flaps. Normal and variant vascular anatomy of the fibular free flap is discussed, as are imaging acquisition and CT angiography interpretation, computer-assisted design and manufacturing, and the limitations of the fibular free flap. CONCLUSION: The fibular free flap is commonly used for head and neck reconstructive surgery. Variation exists between individuals regarding the origin of the peroneal artery and the perforating arteries...
April 27, 2018: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/29690934/multi-dimensional-analysis-of-oral-cavity-and-oropharyngeal-defects-following-cancer-extirpation-surgery-a-cadaveric-study
#14
Sherif Idris, Alex M Mlynarek, Khalid Ansari, Jeffrey R Harris, Nabil Rizk, David Cote, Daniel A O'Connell, Heather Allen, Peter Dziegielewski, Hadi Seikaly
BACKGROUND: Defects following resection of tumors in the head and neck region are complex; more detailed and defect-specific reconstruction would likely result in better functional and cosmetic outcomes. The objectives of our study were: 1) to improve the understanding of the two- and three-dimensional nature of oral cavity and oropharyngeal defects following oncological resection and 2) to assess the geometric dimensions and the shapes of fasciocutaneous free flaps and locoregional tissue flaps required for reconstruction of these defects...
April 24, 2018: Journal of Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/29664694/immediate-use-of-uncuffed-tracheostomy-after-free-flap-reconstruction-of-the-head-and-neck
#15
Priyesh N Patel, Al C Valmadrid, Daniel Y Hong, David O Francis, Michael W Sim, Sarah L Rohde
Objective To determine if immediate postoperative uncuffed tracheostomy placement following oral cavity or oropharyngeal head and neck free flap reconstruction is associated with shorter hospital length of stay and higher inpatient decannulation rates without an increase in respiratory complications, as compared with immediate placement of cuffed tracheostomy. Study Design Retrospective cohort. Setting Tertiary referral center. Subjects and Methods Patients were included if they underwent free flap reconstruction for oral cavity or oropharyngeal squamous cell carcinoma and had an intraoperative tracheostomy placed between 2005 and 2016...
April 1, 2018: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/29645392/patient-satisfaction-in-1-827-patients-following-various-methods-of-facial-reconstruction-based-on-age-defect-size-and-site
#16
Saskia Maria Schnabl, Helmut Breuninger, Eleni Iordanou, Alexander Scheu, Lukas Kofler, Hans-Martin Häfner, Franziska Carola Eberle
BACKGROUND: Defect coverage following tumor excision requires a case-by-case decision as regards the optimal reconstruction technique. In the head and neck region in particular, the cosmetic outcome is of major importance. The objective of the present study was to compare various reconstruction methods in terms of their functional and aesthetic outcome based on patient age, defect size and site. PATIENTS AND METHODS: Overall, 1,827 patients (age: 18-92 years, median age: 56 years) were contacted...
April 2018: Journal der Deutschen Dermatologischen Gesellschaft, Journal of the German Society of Dermatology: JDDG
https://www.readbyqxmd.com/read/29642922/an-anterolateral-thigh-chimeric-flap-for-dynamic-facial-and-esthetic-reconstruction-after-oncological-surgery-in-the-maxillofacial-region-a-case-report
#17
Zoltán Lóderer, Tamás Vereb, Róbert Paczona, Ágnes Janovszky, József Piffkó
BACKGROUND: The surgical management of malignant tumors in the head and neck region often leads to functional and esthetic defects that impair the quality of life of the patients. Reconstruction can be solved with prostheses in these cases, but various types of microsurgical free flaps can provide a better clinical outcome. CASE PRESENTATION: In this case report, the tumor and parts of the involved facial muscles and nerve were excised surgically from a 42-year-old patient after a third relapse of basal cell carcinoma in the left midface...
April 11, 2018: Head & Face Medicine
https://www.readbyqxmd.com/read/29629890/infective-complications-after-free-flaps-reconstruction-in-patients-affected-by-head-and-neck-cancer-our-experience-on-77-cases
#18
Giovanni Dell'Aversana Orabona, Raffaele Corvino, Fabio Maglitto, Vincenzo Abbate, Paola Bonavolontà, Antonio Romano, Giovanni Salzano, Luigi Califano
AIM: The success rates of free flaps in patients undergoing head and neck cancer (HNC) surgery are very high (95%- 97%) but the development of a surgical site infection (SSI) can put flap viability at risk. The aim of our study is to identify the risk factors for SSI in patients undergo free flaps reconstruction after head and neck cancer removal. MATERIAL OF STUDY: Seventyseven patients (44 male and 33 female) from April 2006 to April 2015 admitted at the Department of Maxillofacial Surgery of the University of Naples "Federico II" were included in this study...
2018: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/29627200/computer-assisted-resection-and-reconstruction-of-bilateral-osteoradionecrosis-of-the-mandible-using-2-separate-flaps-prepared-from-a-single-fibula
#19
Rui Chen, Han-Qing Zhang, Zi-Xian Huang, Shi-Hao Li, Da-Ming Zhang, Zhi-Quan Huang
OBJECTIVES: Osteoradionecrosis of the mandible is a late radiation-induced complication, which is a major concern in survivors of head and neck cancer. STUDY DESIGN: In this study, we present a case of a patient with nasopharyngeal carcinoma who developed extensive bilateral osteoradionecrosis of the ascending ramus of the mandible. After preoperative virtual surgical planning, the obtained data were used to fabricate patient-specific cutting templates. The bilateral mandibular defects were reconstructed using 2 separate flaps prepared from a single fibula...
March 7, 2018: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
https://www.readbyqxmd.com/read/29627149/combined-bilobed-trapezius-myocutaneous-and-scapula-osteomyocutaneous-flaps-for-the-restoration-of-through-and-through-defects-of-the-mandible-following-salvage-surgery-for-recurrent-head-and-neck-tumours
#20
W-L Chen, Z-Q Huang, B Zhou, Y Wang, R Chen
This study was performed to evaluate the outcomes of combined bilobed trapezius myocutaneous and scapula osteomyocutaneous flaps for the restoration of through-and-through defects of the mandible. The subjects were six patients with recurrent malignant tumours who underwent salvage surgeries and reconstruction with combined flaps based on the transverse cervical vessels (TCVs). All patients had combined bone (four type H, one type LCL, and one type C) and extensive soft tissue defects (through-and-through defects) following salvage surgery...
April 4, 2018: International Journal of Oral and Maxillofacial Surgery
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