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https://www.readbyqxmd.com/read/28617692/update-on-the-supraclavicular-flap
#1
Nicholas E Wirtz, Samir S Khariwala
PURPOSE OF REVIEW: The purpose of this study is to describe the supraclavicular flap and its utility in head and neck reconstruction in the context of recent studies. RECENT FINDINGS: Current literature regarding the supraclavicular flap has described its expanded uses in a variety of head and neck reconstructive settings. Its reliability and limited morbidity have been well demonstrated, and it has been cited as a reasonable alternative to other reconstructive options including, in some situations, free tissue transfer...
June 14, 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/28616153/a-multidisciplinary-approach-to-the-successful-management-of-gorlin-syndrome
#2
Ryan N Mello, Zaki Khan, Umar Choudry
Gorlin-Goltz syndrome (GGS) is a rare genetic syndrome with variable expressivity and autosomal dominant inheritance. The major features of GGS include numerous basal cell carcinomas (BCCs), keratocysts of the jaw, palmar/plantar pits and calcification of the falx cerebri. Authors report the case of a 51-year-old male with a 19-year history of GGS and multiple BCCs of the head and neck. He presented with a large ulcerating lesion on the right side of his face involving cutaneous, subcutaneous and muscular tissues of the temporal and orbital region...
June 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28615807/soft-embalming-of-cadavers-for-training-purposes-optimising-for-long-term-use-in-tropical-weather
#3
Raghuveer Reddy, Subramania Iyer, Minnie Pillay, Krishnakumar Thankappan, Janarthanan Ramu
BACKGROUND: Surgical and anatomical training has been found to be most optimally simulated in a cadaver than any other available methods. Soft embalming methods have made the bodies more 'lifelike' and better suited for training. The widely accepted soft embalming techniques, including Thiel embalming, are designed for temperate climates. Their use in tropical locations has been found to be associated with poor short-term and long-term preservation of the bodies. In fact, adequate reports from tropical countries on effective methods for soft embalming are lacking...
January 2017: Indian Journal of Plastic Surgery: Official Publication of the Association of Plastic Surgeons of India
https://www.readbyqxmd.com/read/28615805/free-anteromedial-thigh-perforator-flap-complementing-and-completing-the-anterolateral-thigh-flap
#4
Dushyant Jaiswal, Amol Ghalme, Prabha Yadav, Vinaykant Shankhdhar, Akshay Deshpande
OBJECTIVE: Theobjective of this study was to determine the indications, utility, advantages and surgical approach for the anteromedial thigh (AMT) flap. MATERIALS AND METHODS: We reviewed the records of the patients in whom the AMT flap was used for head and neck reconstruction. We use an anterior approach to harvest the anterolateral thigh (ALT) flap with a non-committal straight line incision. This preserves both ALT and AMT flap territories intact, and further decision is based on the intraoperative anatomy of perforator and pedicle...
January 2017: Indian Journal of Plastic Surgery: Official Publication of the Association of Plastic Surgeons of India
https://www.readbyqxmd.com/read/28604549/transverse-cervical-artery-perforator-flap-standardized-surgical-technique-and-multiple-reconstructive-opportunity-in-head-and-neck-surgery
#5
Nicola Luca, Maria Josè Santana, Bianca Maria Festa, Fabio Collurà, Stefano Righini
The main purpose of head and neck reconstructive surgery is to provide anatomic restoration of the demolited region and to provide preservation and recovery of function. The anatomical investigations conducted over the years has enabled a detailed knowledge of human body vascularization, giving the opportunity to design and harvest more and more versatile and refined flaps, with increasingly satisfactory results. Even if in the last 2 decades free flaps have been considered a reconstructive criterion standard, they still determine a great physical impact for the patient and require a certain surgical experience...
June 9, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28604404/perioperative-care-of-head-and-neck-free-flap-patients
#6
Michael R Kinzinger, Arnaud F Bewley
PURPOSE OF REVIEW: This article reviews the recent literature on the perioperative care of head and neck surgical patients undergoing free tissue transfer. RECENT FINDINGS: As the overall success of head and neck free flaps has plateaued above 95%, recent literature on perioperative flap management has focused on minimizing complications, length of stay, and cost of treatment. Current areas of research include preoperative risk stratification, preoperative and postoperative nutrition, intraoperative fluid management, postoperative level of care, postoperative antibiotic prophylaxis, defining the impact of comorbidities, and developing comprehensive evidence-based perioperative care protocols...
June 9, 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/28602040/the-impact-of-a-head-and-neck-microvascular-fellowship-program-on-otolaryngology-resident-training
#7
Chad A Zender, Kate Clancy, Sami Melki, Shawn Li, Nicole Fowler
OBJECTIVE: To assess the impact of a microvascular head and neck (H&N) fellowship on senior residents' surgical experience. STUDY DESIGN: Retrospective review of Accreditation Council for Graduate Medical Education-generated operative case log reports, retrospective chart review, and electronic survey. METHODS: A retrospective review of one institution's residents' H&N operative case logs and free flap operative reports was performed to determine changes in key indicator cases (KICs) after the addition of a H&N fellowship...
June 11, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28583233/myxofibrosarcoma-of-the-maxillary-sinus
#8
Anni Wong, Richard Chan Woo Park, Neena M Mirani, Jean Anderson Eloy
BACKGROUND: Myxofibrosarcoma (MFS) is a common sarcoma in the extremities of older individuals but is extremely uncommon in the head and neck region. Diagnosis may be challenging but is critical to the management of the patient. We discuss the radiographic and histopathologic characteristics of this destructive tumor. The distinguishing features of MFS and its differential diagnosis are reviewed to familiarize the managing otolaryngologist with this rare entity. METHODS: A 61-year-old woman presents with a 6-week history of severe left facial pain and left eye pain...
June 1, 2017: Allergy & Rhinology
https://www.readbyqxmd.com/read/28581030/postoperative-anticoagulation-after-free-flap-reconstruction-for-head-and-neck-cancer-a-systematic-review
#9
REVIEW
Blair M Barton, Charles A Riley, John C Fitzpatrick, Christian P Hasney, Brian A Moore, Edward D McCoul
OBJECTIVE: Postoperative use of anticoagulation after free tissue transfer in head and neck ablative procedures is common practice, but a clear protocol has not been well established. The outcome measures including total flap failure, thrombosis, and hematoma formation for different anticoagulation regimens in free tissue transfer in the head and neck were reviewed. DATA SOURCES: PubMed, Ovid, and Cochrane databases were examined for patients who underwent free tissue transfer following head and neck ablative procedures...
June 5, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28580729/laparoscopic-harvest-of-the-gastro-omental-free-flap-for-reconstruction-after-total-pharyngolaryngectomy-operative-technique
#10
Steven J Craig, Alexander Zhang, Trevor D Gardner, Jonathan R Clark, Bruce G Ashford
Circumferential defects following salvage pharyngolaryngectomy present significant challenges in reconstructive surgery. The gastro-omental free flap has been shown to reduce the incidence of major fistula and catastrophic complications. The current technique for harvest of the flap requires laparotomy, which is potentially associated with significant post-operative complications. Laparoscopic harvest of the gastro-omental free flap can negate some of the risks associated with open surgery. We describe here the operative technique for laparoscopic gastro-omental free flap harvest for use in reconstruction following total pharyngolaryngectomy...
June 5, 2017: Head & Neck
https://www.readbyqxmd.com/read/28571928/free-tissue-flaps-in-head-and-neck-reconstruction-clinical-application-and-analysis-of-93-patients-of-a-single-institution
#11
Jiwang Liang, Tao Yu, Xu Wang, Yuejiao Zhao, Fengqin Fang, Wei Zeng, Zhendong Li
INTRODUCTION: Reconstruction with a free flap is routine in head and neck surgery because of better functional outcomes, improved esthetics, and generally higher success rates. OBJECTIVE: To evaluate the clinical outcomes in patients undergoing different microvascular free flap reconstructions. METHODS: This was a retrospective study of 93 patients undergoing reconstructions with free flaps from 2007 to 2015. Four types of free flap were performed: Anterolateral Thigh (76...
May 13, 2017: Brazilian Journal of Otorhinolaryngology
https://www.readbyqxmd.com/read/28570718/free-flap-reconstruction-monitoring-techniques-and-frequency-in-the-era-of-restricted-resident-work-hours
#12
Urjeet A Patel, David Hernandez, Yelizaveta Shnayder, Mark K Wax, Matthew M Hanasono, Joshua Hornig, Tamer A Ghanem, Matthew Old, Ryan S Jackson, Levi G Ledgerwood, Patrik Pipkorn, Lawrence Lin, Adrian Ong, Joshua B Greene, James Bekeny, Yin Yiu, Salem Noureldine, David X Li, Joel Fontanarosa, Evan Greenbaum, Jeremy M Richmon
Importance: Free flap reconstruction of the head and neck is routinely performed with success rates around 94% to 99% at most institutions. Despite experience and meticulous technique, there is a small but recognized risk of partial or total flap loss in the postoperative setting. Historically, most microvascular surgeons involve resident house staff in flap monitoring protocols, and programs relied heavily on in-house resident physicians to assure timely intervention for compromised flaps...
June 1, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28570441/significance-of-the-lateral-thoracic-artery-in-pectoralis-major-musculocutaneous-flap-reconstruction-quantitative-assessment-of-blood-circulation-using-indocyanine-green-angiography
#13
Hidetaka Miyazaki, Kimihiro Igari, Toshifumi Kudo, Toshinori Iwai, Yoshitaka Wada, Yasuhiro Takahashi, Yoshinori Inoue, Shinichi Asamura
Free tissue transfer is the preferred reconstruction option in most major head and neck reconstructions. The pectoralis major muscle musculocutaneous (PMMC) flap is commonly used in salvage of necrotic free flaps and is the first choice for patients who are not candidates for free flaps. The lateral thoracic artery (LTA), which is thought to contribute to blood perfusion of the inferior and lateral mammary area, is not preserved in a conventionally harvested PMMC flap. With regard to blood supply, it has been suggested that the LTA should be preserved, in addition to the pectoral branch of the thoracoacromial artery, when a skin island is designed in the lower chest to attain a pedicle length sufficient for head and neck reconstruction...
May 31, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28561188/reply-to-letter-to-the-editor-morbidity-of-the-free-fibula-flap-reconstruction-in-head-and-neck-malignancies
#14
J N Lodders, E A J M Schulten, J G A M de Visscher, T Forouzanfar, K H Karagozoglu
No abstract text is available yet for this article.
June 2017: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/28561187/letter-to-the-editor-morbidity-of-the-free-fibula-flap-reconstruction-in-head-and-neck-malignancies
#15
Harin Asokan, Jerry R John
No abstract text is available yet for this article.
June 2017: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/28536044/free-tissue-transfer-for-necrotizing-fasciitis-reconstruction-a-case-series
#16
Justin Peter Gawaziuk, Tianyi Liu, Leif Sigurdson, Edward Buchel, Thomas Edward Jo Hayakawa, Sarah Shiga, Sarvesh Logsetty
BACKGROUND: Necrotizing fasciitis (NF) is a life-threatening infection requiring extensive debridement that may necessitate amputation. Free tissue transfer (FTT) is an option for reconstruction in difficult cases. Currently, only case reports have described FTT in the setting of NF, and comprehensive evidence on flap outcomes is lacking. The present study characterizes outcomes in patients with FTT following NF. METHODS: All patients admitted with NF between January 1, 2005 and December 31, 2011 to our level 1 burns/trauma referral center were retrospectively reviewed...
May 20, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28530258/enhanced-recovery-program-erp-in-major-laryngeal-surgery-building-a-protocol-and-testing-its-feasibility
#17
M Gemma, S Toma, F Lira Luce, L Beretta, M Braga, M Bussi
Enhanced recovery programs (ERP) represent a multimodal approach to perioperative patient care. The benefits of ERP are well demonstrated in colorectal surgery and Enhanced Recovery After Surgery (ERAS®) programs, that epitomise the ERP concept, have being introduced in different specialties, including vascular, gastric, pancreatic, urogynecologic and orthopaedic surgery. However, no ERP has been proposed for head and neck surgery. We developed an expert-opinion-based ERP for laryngeal surgery based on the key principles of colorectal surgery ERAS®...
May 22, 2017: Acta Otorhinolaryngologica Italica
https://www.readbyqxmd.com/read/28529663/the-modified-dunn-procedure-for-slipped-capital-femoral-epiphysis-the-bernese-experience
#18
M Tannast, L M Jost, T D Lerch, F Schmaranzer, K Ziebarth, K A Siebenrock
PURPOSE: Based on previous investigations on the vascular blood supply to the femoral head, a technique for anatomical reduction after slipped capital femoral epiphysis was developed. This technique is a modification of the original technique by Dunn using a retinacular soft-tissue flap. This allows the visual control of the epiphyseal vascular blood supply. We report the experience at the inventor's institution with a critical discussion of the available literature. METHODS: Using a trochanteric osteotomy for surgical dislocation of the hip, a retinacular soft tissue flap is created containing the deep branch of the medial femoral circumflex artery, the external rotators and the capsule...
April 2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/28520896/laser-assisted-indocyanine-green-dye-angiography-for-postoperative-fistulas-after-salvage-laryngectomy
#19
Erin J Partington, Lindsay S Moore, Russel Kahmke, Jason M Warram, William Carroll, Eben L Rosenthal, Benjamin J Greene
Importance: Pharyngocutaneous fistula formation is an unfortunate complication after salvage laryngectomy for head and neck cancer that is difficult to anticipate and related to a variety of factors, including the viability of native pharyngeal mucosa. Objective: To examine whether noninvasive angiography with indocyanine green (ICG) dye can be used to evaluate native pharyngeal vascularity to anticipate pharyngocutaneous fistula development. Design, Setting, and Participants: This cohort study included 37 patients enrolled from June 1, 2013, to June 1, 2016, and follow-up was for at least 1 month postoperatively...
May 18, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28514343/-effect-of-dexmedetomidine-on-perfusion-of-free-flaps-transferred-to-head-and-neck
#20
A S Dobrodeev, S A Rabinovich, I F Malykhina
The paper presents the impact of perioperative care on feasibility of free fibula flap transfer for facial reconstruction. Flaps vitality was measured by means of somatic oximetry in 85 patients aged 20-74 years receiving reconstruction procedures in midfacial and lower facial areas. The patients were divided in three groups according to sedation agent used postoperatively. It has been demonstrated that dexmedetomidine postoperative sedation significantly improved free fibula flaps perfusion compared to propofol sedation...
2017: Stomatologii︠a︡
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