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https://www.readbyqxmd.com/read/28109470/the-fate-of-the-free-flap-pedicle-after-free-tissue-transfer-to-the-head-and-neck-area
#1
Maarten L V Van Genechten, Martin D Batstone
OBJECTIVES: Little is understood about what happens to the vascular pedicle following free tissue transfer in the head and neck region. The viability of a free flap completely depends on the vascular supply by its vascular pedicle until neovascularization occurs from surrounding tissues. The aim of this study is to find out how long a vascular pedicle lasts following free tissue transfer in the head and neck region. MATERIALS AND METHODS: Patients were recruited from the Maxillofacial Unit at the Royal Brisbane & Women's Hospital...
February 2017: Oral Oncology
https://www.readbyqxmd.com/read/28092922/the-effectiveness-of-free-vascularized-fibular-flaps-in-osteonecrosis-of-the-femoral-head-and-neck-a-systematic-review
#2
Cassandra A Ligh, Jonas A Nelson, John P Fischer, Stephen J Kovach, L Scott Levin
Background Free vascularized fibular flaps (FVFFs) are accepted surgical options to treat osteonecrosis of the femoral head and neck (ONFHN) to prevent conversion to total hip replacement (THR), yet many studies are single institution cohorts, with little generalizability. Purpose The purpose of this study was to perform a systematic review examining the comparative effectiveness of FVFF to treat ONFHN, particularly preventing conversion to a THR and improving hip function/symptoms. Methods We searched PubMed and EMBASE databases using femoral head, free fibula, and femoral neck keywords...
January 16, 2017: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/28067972/single-innervated-segmented-vastus-lateralis-for-midfacial-reanimation-during-radical-parotidectomy
#3
Lauren Sh Chong, Timothy J Eviston, Bruce Ashford, Ardalan Ebrahami, Jonathan R Clark
BACKGROUND: Innervated free muscle transfer using the gracilis muscle or temporalis myoplasty has been successfully utilized for facial reanimation in chronic facial palsy. These techniques are less suited to immediate facial reconstruction in the setting of radical parotidectomy, in which the complexity of the defect, patient age, postoperative radiotherapy, and limited life expectancy pose particular challenges. METHODS: We present a novel description of the use of a chimeric anterolateral thigh (ALT) flap and innervated vastus lateralis to achieve midface static suspension and dynamic reanimation in the setting of radical parotidectomy...
January 9, 2017: Head & Neck
https://www.readbyqxmd.com/read/28064382/early-assessment-of-feasibility-and-technical-specificities-of-transoral-robotic-surgery-using-the-da-vinci-xi
#4
Philippe Gorphe, Jean Von Tan, Sophie El Bedoui, Dana M Hartl, Anne Auperin, Quentin Qassemyar, Antoine Moya-Plana, François Janot, Morbize Julieron, Stephane Temam
The latest generation Da Vinci(®) Xi™ Surgical System Robot released has not been evaluated to date in transoral surgery for head and neck cancers. We report here the 1-year results of a non-randomized phase II multicentric prospective trial aimed at assessing its feasibility and technical specificities. Our primary objective was to evaluate the feasibility of transoral robotic surgery using the da Vinci(®) Xi™ Surgical System Robot. The secondary objective was to assess peroperative outcomes. Twenty-seven patients, mean age 62...
January 7, 2017: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/28063278/combined-anterolateral-thigh-and-tensor-fasciae-latae-flaps-an-option-for-reconstruction-of-large-head-and-neck-defects
#5
Ramzey Tursun, Hisham Marwan, J Marshall Green, Fawaz Alotaibi, Andre LeDoux
PURPOSE: The advent of microvascular free tissue transfer has provided the reconstructive surgeon with an enormous array of treatment options for reconstruction of large head and neck defects. However, when indicated by defect size, the need for more than 1 flap not only increases surgical complexity but also patient morbidity. The combination of the anterolateral thigh (ALT) flap and the tensor fascia latae (TFL) flap can be used to reconstruct such complex head and neck defects, thereby minimizing any additional morbidity that would be imposed by an additional flap harvest site...
December 26, 2016: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28063277/straightforward-method-for-coverage-of-major-vessels-after-modified-radical-neck-dissection
#6
Raúl González-García, Carlos Moreno-García, Manuel Moreno-Sánchez, Leticia Román-Romero
A new method for covering the internal jugular vein and carotid artery after exposure of the cervical vascular axis subsequent to neck dissection is presented. To cover the most caudal part of the vascular axis, a platysma coli muscle flap is harvested from its most medial and inferior part of the neck in a caudally based fashion and is slightly rotated posteriorly up to 45°. In addition, a superiorly based sternocleidomastoid muscle flap involving the posterior half of the muscle after detachment of the clavicle head is harvested and rotated 45° anteriorly to cover the upper two thirds of the vascular axis...
December 15, 2016: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28063274/morbidity-and-functional-outcomes-with-head-and-neck-free-flap-reconstruction-in-patients-aged-90%C3%A2-years-or-older
#7
Adam P Fagin, Savannah Gelesko, Mark K Wax, Daniel Petrisor
PURPOSE: Morbidity of free tissue transfer in the extremes of age is controversial and not well studied in patients aged 90 years or older because of the rarity of these patients and many clinicians' natural hesitancy to perform such a large operation in patients of this group. The purpose of this study was to answer the following clinical question: Do patients aged 90 years or older who undergo free flap reconstruction have worse functional outcomes than their younger counterparts? MATERIALS AND METHODS: We performed a retrospective chart review of patients aged 90 years or older who underwent free flap reconstruction at Oregon Health and Science University Hospital from 2000 to 2015...
December 18, 2016: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28062176/characteristics-and-surgical-management-of-flap-compromise-caused-by-thrombosis-of-the-internal-jugular-vein
#8
Bin Yang, Yi Qu, Ming Su, Jinzhong Li, Hua Li, Rudong Xing, Zhengxue Han
BACKGROUND: A principal reason for flap compromise in oral and maxillofacial head and neck surgery, and failure of a free flap transfer, is thrombosis of a drainage vein such as the internal jugular vein. This study characterized flap compromise caused by internal jugular vein thrombosis after a free flap transfer, and its management. PATIENTS AND METHODS: A retrospective clinical study was conducted of 306 consecutive microvascular free flaps performed for 305 patients with head and neck cancer from March 2003 to March 2013 at the Department of Oral and Maxillofacial Surgery at Beijing Stomatological Hospital, Capital Medical University...
December 18, 2016: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/28061548/suprafascial-harvest-of-the-radial-forearm-free-flap-decreases-the-risk-of-postoperative-tendon-exposure
#9
David C Shonka, Nikita V Kohli, Benjamin M Milam, Mark J Jameson
OBJECTIVE: To determine if suprafascial harvest of the radial forearm free flap improves postoperative donor site outcomes compared to subfascial harvest. METHODS: Retrospective chart review. RESULTS: Forty-six patients underwent reconstruction of a head and neck defect with a radial forearm free flap (RFFF). Subfascial harvest of the RFFF was performed in 25 (53%) patients and suprafascial harvest performed in 22 (47%) patients. All donor sites were covered with a split thickness skin graft and a bolster that remained in place for 6 days...
January 1, 2017: Annals of Otology, Rhinology, and Laryngology
https://www.readbyqxmd.com/read/28061517/supraclavicular-flap-reconstruction-of-cutaneous-defects-has-lower-complication-rate-than-mucosal-defects
#10
Sameep Kadakia, Jay Agarwal, Moustafa Mourad, Sara Ashai, Thomas Lee, Yadranko Ducic
Background The objective of this study was to determine whether there was a difference in complication rate between cutaneous and mucosal defects reconstructed with the supraclavicular artery flap. Methods Retrospective review of postoperative complications in 63 patients from 2008 to 2015 with cutaneous and mucosal head and neck defects following oncologic ablation reconstructed with the supraclavicular flap, with a minimum follow-up duration of 6 months. Of the 63 patients, 38 patients had cutaneous defects, whereas 25 had mucosal defects...
January 6, 2017: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/28056483/complex-orofacial-reconstruction-with-the-intrinsic-chimeric-flap
#11
Andrés A Maldonado, Amanda K Silva, Laura S Humphries, Lawrence J Gottlieb
Background Ablation of locally advanced or recurrent head and neck cancer often results in large composite orofacial defects with limited recipient vessels. These complex defects lend well to intrinsic chimeric flap reconstruction, which allows greater ability to inset various flap component tissue types than composite flaps and requires only one set of microvascular anastomoses. Methods A retrospective chart review was performed on all patients who underwent orofacial reconstruction with an intrinsic chimeric free flap from 2002 to 2015...
January 5, 2017: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/28056334/immediate-microsurgical-bone-and-nerve-reconstruction-in-the-irradiation-treated-patient-a-case-report
#12
Ramzey Tursun, J Marshall Green
Microsurgical reconstructive techniques have revolutionized the treatment of large head and neck defects. These defects were once forever life altering because of the considerable morbidity to both the form and function of the patient. As time has progressed, microsurgical technique has improved dramatically and has become institutionalized in our training programs. Free flap outcomes in head and neck reconstruction have improved dramatically, and optimization of these outcomes is now key. One overlooked area has been neurosensory reconstruction...
December 11, 2016: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28050062/reliability-of-the-pectoralis-major-myocutaneous-flap-in-reconstructive-oral-cancer-surgery-in-developing-countries-our-experience
#13
Atanu Bhanja, D S J D'Souza, Collin Roy, R N Poddar
BACKGROUND: Although free flaps are nowadays considered 'Gold standard' of head and neck reconstruction, pectoralis major myocutaneous (PMMC) flap is still popular among many reconstructive cancer surgeons in developing countries for its many advantages and also due to lack of resources for free flaps in most of the centers, large number of cancer patients with poor nutritional status and economic condition. However, many studies have reported high complication rate in PMMC flap. So, the purpose of our study was to evaluate the reliability of PMMC flap...
December 2016: Medical Journal, Armed Forces India
https://www.readbyqxmd.com/read/28043710/complication-and-surgical-site-infection-for-salvage-surgery-in-head-and-neck-cancer-after-chemoradiotherapy-and-bioradiotherapy
#14
Hidenori Suzuki, Nobuhiro Hanai, Daisuke Nishikawa, Yujiro Fukuda, Yasuhisa Hasegawa
OBJECTIVE: We aimed to investigate the complications, surgical site infection (SSI), and survival in salvage surgery without free-flap reconstruction for patients with head and neck squamous cell carcinoma who were treated by platinum-based chemoradiotherapy (Plat-CRT) or cetuximab-based bioradiotherapy (Cet-BRT). METHODS: Thirty-three patients treated by Plat-CRT and six treated by Cet-BRT had salvage surgery. We categorized postoperative complications according to the Clavien-Dindo classification and SSI according to the wound grading scale...
December 30, 2016: Auris, Nasus, Larynx
https://www.readbyqxmd.com/read/28032690/free-profunda-femoris-artery-perforator-flap-as-a-first-line-choice-of-reconstruction-for-partial-glossectomy-defects
#15
Ricardo Fernández-Riera, Shao-Yu Hung, Jerry Chih-Wei Wu, Chung-Kan Tsao
BACKGROUND: Free profunda artery perforator (PAP) flap has recently been brought back for head and neck reconstruction. During the course of 1 year, we performed this procedure for reconstruction of partial glossectomy defects with excellent results. METHODS: From January through December 2015, 21 patients underwent partial glossectomy reconstruction with PAP flaps. Demographics, surgical technique, anatomic variations, success rates, complications, and characteristics are described...
December 29, 2016: Head & Neck
https://www.readbyqxmd.com/read/28007392/donor-site-morbidity-and-quality-of-life-after-microvascular-head-and-neck-reconstruction-with-free-fibula-and-deep-circumflex-iliac-artery-flaps
#16
Christopher Schardt, Angela Schmid, Jens Bodem, Johannes Krisam, Jürgen Hoffmann, Christian Mertens
PURPOSE: Bone defects after resective tumor surgeries often require the use of microvascular reanastomized bone grafts for reconstruction. The decision as to which specific flap is most suitable for the particular patient is dependent on various factors. The aspects donor site morbidity and quality of life are rarely taken into account in this connection. The aim of this study was to analyze whether these factors, in the future, should influence the choice of donor site. MATERIAL AND METHODS: In this study, the donor sites of 46 patients with respect to deep-circumflex iliac artery (DCIA) and fibula flaps were analyzed using subjective and objective parameters...
November 30, 2016: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/28005812/microcystic-adnexal-carcinoma-of-the-nasal-tip-treated-with-surgical-excision-and-rotational-forehead-skin-flap
#17
Min Seok Kang, Eun Jung Lee, Ji Seop Kim, In Sik Yun, Hyung Kwon Byeon
Microcystic adnexal carcinoma (MAC) is a rare malignant cutaneous adenocarcinoma that typically occurs in the head and neck, particularly at the central face. There are only slightly more than 300 patients reported worldwide, and most patients occur in Caucasians. A 72-year-old man was referred to our hospital for definitive treatment of known MAC from previous biopsy. Wide excision of nasal tip and reconstruction of nasal defect with paramedian forehead flap and nasolabial flap transposition were performed rather than conventional Mohs surgery, due to grossly evident disease...
November 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28005734/risk-factors-leading-to-free-flap-failure-analysis-from-the-national-surgical-quality-improvement-program-database
#18
Paymon Sanati-Mehrizy, Benjamin B Massenburg, John M Rozehnal, Michael J Ingargiola, Jonatan Hernandez Rosa, Peter J Taub
BACKGROUND: The objective of this study was to identify risk factors for free flap failure among various anatomically based free flap subgroups. METHODS: The 2005 to 2012 American College of Surgeons National Surgical Quality Improvement Program database was queried for patients undergoing microvascular free tissue transfer based on current procedural terminology codes. Univariate analysis was performed to identify any association between flap failure and the following factors: age, gender, race, body mass index (BMI), diabetes, smoking, alcohol use, hypertension, intraoperative transfusion, functional health status, American Society of Anesthesiologists class, operative time, and flap location...
November 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28000297/use-of-free-tissue-transfer-in-head-and-neck-cancer-surgery-and-risk-of-overall-and-serious-complication-s-an-american-college-of-surgeons-national-surgical-quality-improvement-project-analysis-of-free-tissue-transfer-to-the-head-and-neck
#19
Steven B Cannady, Kyle M Hatten, Andres M Bur, Jason Brant, John P Fischer, Jason G Newman, Ara A Chalian
BACKGROUND: The purpose of this article was to assess the rates of head and neck free tissue transfer and variables available in the American College of Surgeons - National Surgical Quality Improvement Project (ACS-NSQIP) dataset to predict overall and serious complications. METHODS: We conducted a data analysis from 2005 to 2014 on free tissue cases in the head and neck with descriptive and cross-sectional analysis to examine correlation of NSQIP variables with complications (p < ...
December 21, 2016: Head & Neck
https://www.readbyqxmd.com/read/28000215/double-paddle-ulnar-perforator-free-flap-in-reconstruction-of-through-and-through-and-fistulous-defects-of-the-head-and-neck
#20
Andrew T Huang, Terry A Day
No abstract text is available yet for this article.
December 21, 2016: Laryngoscope
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