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flap head neck

Blair M Barton, Charles A Riley, Jason D Pou, Christian P Hasney, Brian A Moore
Background: The submental island flap (SIF) is a pedicled flap based upon the submental artery and vein. Its utility in reconstruction following ablative head and neck procedures has been applied to various subsites including skin, lip, buccal mucosa, retromolar trigone, parotidectomy defects, and tongue. We review our experience using the SIF for reconstruction following tumor ablation. Methods: This prospective case series with medical record review includes consecutive patients undergoing SIF reconstruction following ablative surgery for malignancy at a single tertiary care facility between November 2014 and November 2016...
2018: Ochsner Journal
Alexandre Bozec, Pierre Demez, Jocelyn Gal, Emmanuel Chamorey, Marie-Yolande Louis, David Blanchard, Dominique De Raucourt, Jean-Claude Merol, Esteban Brenet, Olivier Dassonville, Gilles Poissonnet, José Santini, Frédéric Peyrade, Karen Benezery, Maria Lesnik, Etienne Berta, Pierre Ransy, Emmanuel Babin
OBJECTIVE: To assess long-term quality of life (QoL) and psycho-social outcomes, and to determine their predictive factors after oropharyngeal cancer (OPC) surgery and radial forearm free-flap (RFFF) reconstruction. METHODS: Patients who had undergone OPC surgery and RFFF reconstruction who were still alive and disease-free at least 1 year after surgery were enrolled in this prospective multicentric study. Patients completed the European Organization for Research and Treatment of Cancer (EORTC) Core (QLQ-C30) and Head and Neck Cancer (QLQ-H&N35) QoL questionnaires, the Voice Handicap Index (VHI-10) questionnaire and the Hospital Anxiety and Depression Scale (HADS)...
March 2018: Surgical Oncology
D Pauchet, J-L Pigot, F Chabolle, C-A Bach
Free fibula transplant is routinely used for mandibular reconstruction in head and neck cancer. Dental rehabilitation, the objective of mandibular reconstruction, requires the use of dental implants as supports for fixed or removable dentures. Positioning of fibular bone grafts and implants determines implant osseointegration and the possibilities of dental rehabilitation. Prefabrication of a fibula free flap with dental implants prior to harvesting as a free flap can promote implant osseointegration. The position of the implants must then be precisely planned...
March 2, 2018: European Annals of Otorhinolaryngology, Head and Neck Diseases
Ting Zhou, Lei Zhang, Guowen Sun, Qingang Hu
The complex area for reconstruction of the head and the neck is the buccal because of difficult anatomy of this region. This article aimed to describe our individualized design for the reconstruction of the buccal using an different categories anterolateral thigh (ALT) flap. Ninety-four patients were involved in this study. Among 94cases, the number of using the musculocutaneous ALT flap was 57, using the fasciocutaneous ALT flap was 25, and using the thin ALT flap was 12. Postoperative vessel thrombosis occurred in 8 flaps, and required operative exploration in the perioperative period, 6 flaps were complete survival after the salvages, 2 flap was failure...
February 27, 2018: Journal of Craniofacial Surgery
Leslie E Cohen, Kerry A Morrison, Erin Taylor, Julia Jin, Jason A Spector, Salvatore Caruana, Christine H Rohde
BACKGROUND: Traditional free flap reconstruction of complex intraoral defects often uses large lip-splitting incisions. To reduce morbidity and preserve aesthetics, we have adopted a more technically demanding visor technique obviating an incision through the lower lip through which the resection and reconstruction are performed. METHODS: A retrospective review was performed of patients who underwent free flap reconstruction of intraoral defects over 7 years by a single plastic surgeon (C...
February 28, 2018: Annals of Plastic Surgery
Alexandre Debelmas, Olivier Camuzard, Paola Aguilar, Quentin Qassemyar
Despite numerous advantages, the anterolateral thigh perforator flap suffers from the variable position and nature of its perforators. The aim of the authors' study was to assess the reliability of preoperative color Doppler ultrasound imaging for the exploration of perforator location and course of anterolateral thigh perforator flaps. A prospective cohort study involving patients for whom head and neck reconstruction was planned with thin anterolateral thigh perforator flaps was conducted. Each patient underwent a color Doppler ultrasound exploration of the thighs, in the operating room, immediately before surgery...
March 2018: Plastic and Reconstructive Surgery
Markus Pirlich, Iris-Susanne Horn, Christian Mozet, Mandy Pirlich, Andreas Dietz, Miloš Fischer
BACKGROUND: The use of the radial forearm-free flap is a well-established and reliable reconstruction method in head and neck surgery. Usually, the defect of the donor site is covered with full or split-thickness skin grafts. Since 09/2013, a direct closure of the radial forearm donor site has been performed at the ENT University Hospital Leipzig to avoid secondary donor site morbidity. However, few data are available in the literature on long-term cosmetic and functional results compared to the established indirect donor site defect coverage...
February 26, 2018: European Archives of Oto-rhino-laryngology
Max J H Witjes, Rutger H Schepers, Joep Kraeima
PURPOSE OF REVIEW: This review describes the advances in 3D virtual planning for mandibular and maxillary reconstruction surgical defects with full prosthetic rehabilitation. The primary purpose is to provide an overview of various techniques that apply 3D technology safely in primary and secondary reconstructive cases of patients suffering from head and neck cancer. RECENT FINDINGS: Methods have been developed to overcome the problem of control over the margin during surgery while the crucial decision with regard to resection margin and planning of osteotomies were predetermined by virtual planning...
April 2018: Current Opinion in Otolaryngology & Head and Neck Surgery
Koichiro Kiya, Tateki Kubo, Shien Seike, Ko Hosokawa
Microvascular free tissue transfer is one of the most common techniques of reconstruction for complex head and neck surgical defects. Generally, venous thrombosis is more likely to occur than arterial thrombosis in vascular anastomosis. Thus, recipient veins must be chosen carefully. Although the internal jugular vein is preferred as a recipient vein by many microsurgeons, internal jugular vein thrombosis is a potential complication, as shown in our report. Therefore, we consider that the external jugular vein still is an option as a recipient for venous anastomosis and that it is better to perform multiple vein anastomoses with 2 different venous systems, such as the internal and external jugular systems, than anastomoses within the same venous system...
January 2018: Plastic and Reconstructive Surgery. Global Open
Ian R Wisecarver, Gerhard S Mundinger, Michael S Tarakji, Hugo St Hilaire
Squamous cell carcinoma (SCC) of the head and neck affects a significant number of people around the world every year. Treatment generally entails surgical resection, radiotherapy, chemotherapy, or some combination of the three. Following resection, microsurgical reconstruction can provide definitive coverage, replace many tissue types simultaneously, and bring healthy tissue to irradiated wound beds. Microsurgical engineering, the manipulation and reorganization of native vascular tissue, can further augment the adaptability of free tissue transfer to complex, compromised wound beds...
January 2018: Plastic and Reconstructive Surgery. Global Open
Edward Ray
Head and neck reconstruction following surgical extirpative management of head and neck cancer requires critical assessment and meticulous correction of both aesthetic and functional deficits to optimize the physical and psychological well-being of the patient. Unique to head and neck cancers is the potential alteration of one's senses, breathing, speech, and swallowing functions, as well as overall head and neck aesthetics. When possible, tissue defects are replaced with similar tissues, though donor sites may be anatomically local, regional, or distant...
2018: Cancer Treatment and Research
Y Wu, B Zhang, Z Huang, Y Ruan, Z Huang
The aim of this study was to evaluate the clinical results of surgery for head and neck cancer (HNC) in elderly patients and to determine whether surgery for elderly HNC patients is safe and what types of surgery result in the most favourable outcomes for this age group. The cases of 637 elderly patients who were diagnosed with HNC and underwent surgical treatment were studied retrospectively. Patient demographic characteristics and treatment data were extracted from the appropriate patient records and analysed...
February 8, 2018: International Journal of Oral and Maxillofacial Surgery
Nobuhiro Hanai, Hoshino Terada, Hitoshi Hirakawa, Hidenori Suzuki, Daisuke Nishikawa, Shintaro Beppu, Yasuhisa Hasegawa
Objectives: The purpose of this study is to evaluate whether a nutritional supplement with a high blend ratio of ω-3 fatty acids can minimize weight loss and attenuate increases in inflammatory marker levels during the perioperative period in patients undergoing surgery for head and neck carcinoma. Methods: Patients with ≥5% weight loss within 6 months were considered as targets for aggressive nutritional intervention. Among these patients, those with head and neck squamous cell carcinoma, who underwent major invasive surgery with free flap reconstruction were included in the present study...
February 6, 2018: Japanese Journal of Clinical Oncology
Sunil Rajan, Soumya Srikumar, Pulak Tosh, Lakshmi Kumar
Background and Aims: Use of lactated intravenous fluids during long surgeries could cause lactate accumulation and lactic acidosis. Acetate-based solutions could be advantageous as they are devoid of lactate. The primary aim of the study was to assess the effect of use of an acetated solution or Ringer's lactate (RL) as intraoperative fluid on lactate levels in patients without hepatic dysfunction undergoing prolonged surgeries. Material and Methods: This was a prospective, randomized, controlled trial involving sixty patients belonging to American Society of Anesthesiologists Physical Status I to II undergoing major head and neck surgeries with free flap reconstruction...
October 2017: Journal of Anaesthesiology, Clinical Pharmacology
Priyesh N Patel, Asitha D L Jayawardena, Rachel L Walden, Edward B Penn, David O Francis
Objective To identify and clarify current evidence supporting and disputing the effectiveness of perioperative antibiotic use for common otolaryngology procedures. Data Sources PubMed, Embase (OVID), and CINAHL (EBSCO). Review Methods English-language, original research (systematic reviews/meta-analyses, randomized control trials, prospective or retrospective cohort studies, case-control studies, or case series) studies that evaluated the role of perioperative antibiotic use in common otolaryngology surgeries were systematically extracted using standardized search criteria by 2 investigators independently...
January 1, 2018: Otolaryngology—Head and Neck Surgery
J A LoGiudice, J G Yan, B L Massey, J Neilson, N Flugstad, J Mann
The anterolateral thigh flap (ALT) is a workhorse for a spectrum of reconstructive problems including head and neck defects. Its versatility as a chimeric flap employing a variety of soft tissues with a robust pedicle is useful for three-dimensional defects. The authors investigated the anatomical relationship between the vascular supply to the ALT and anterior femur. We studied 16 fresh cadaver limbs to identify the typical branching patterns to the femur off the descending branch of the lateral circumflex femoral artery...
December 20, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
S Christianto, A Lau, K Y Li, W F Yang, Y X Su
Venous compromise is still the most common cause of free flap failure. The use of two venous anastomoses has been advocated to reduce venous compromise. However, the effectiveness of this approach remains controversial. A systematic review and cumulative meta-analysis was performed to assess the effect of one versus two venous anastomoses on venous compromise and free flap failure in head and neck microsurgical reconstruction. A total of 27 articles reporting 7389 flaps were included in this study. On comparison of one versus two venous anastomoses, the odds ratio (OR) for flap failure was 1...
January 29, 2018: International Journal of Oral and Maxillofacial Surgery
Shawn T Joseph, B S Naveen, Mihir Mohan T, Jose Tharayil T
BACKGROUND: Restoring the anatomy and function of a partial laryngopharyngectomy with hemicricoid defect is an extremely challenging area in head and neck cancer surgery. Procedures such as tracheal autotransplantation described for these defects are complex and attempted in very few centers. Therefore, the purpose of this article was to share our technique of reconstructing such defects with tracheal advancement with myomucosal island flap for laryngopharyngeal defect (TAMMIL), which allows functional reconstruction of the larynx...
February 1, 2018: Head & Neck
Markus Lilja, Mari Markkanen-Leppänen, Sanna Viitasalo, Kauko Saarilahti, Andrew Lindford, Patrik Lassus, Antti Mäkitie
BACKGROUND: The senses of smell and taste can be adversely affected by both tumour- and treatment-related factors amongst head and neck cancer patients. The consequences may negatively impact nutritional status as well as quality of life in this patient population. PATIENTS AND METHODS: This prospective longitudinal follow-up study is consisted of 44 patients treated for oral cavity, oropharyngeal or hypopharyngeal cancer with tumour resection and microvascular free tissue transfer reconstruction at the Helsinki University Hospital, Helsinki, Finland...
January 27, 2018: European Archives of Oto-rhino-laryngology
Wan-Yu Hung, Cheng-Cheng Tung, Wan-Yun Fang, Wen-Pin Kao, Shih-Lung Lin, Yi Poon, Wai-Nang Chao
BACKGROUND: The incidence of skin cancer appearing on the head and neck areas is higher in elderly patients. Although free flap reconstruction is the mainstay after tumor excision, it is challenging to complete in elderly patients, owing to the high risk of complications and/or mortality rates associated with the use of general anesthesia. In this study, we used only local anesthesia in free tissue reconstruction of the head and neck in five elderly patients. MATERIALS AND METHODS: From 2013 to 2016, 5 elderly patients with high risk of general anesthesia underwent reconstruction with either anterolateral thigh free flaps or groin free flap under local anesthesia, after wide excision of malignant tumors at head and neck...
February 2018: Annals of Plastic Surgery
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