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facial oncology

Daniel Alam, Yaseen Ali, Christopher Klem, Daniel Coventry
Orbito-malar reconstruction after oncological resection represents one of the most challenging facial reconstructive procedures. Until the last few decades, rehabilitation was typically prosthesis based with a limited role for surgery. The advent of microsurgical techniques allowed large-volume tissue reconstitution from a distant donor site, revolutionizing the potential approaches to these defects. The authors report a novel surgery-based algorithm and a classification scheme for complete midface reconstruction with a foundation in the Gillies principles of like-to-like reconstruction and with a significant role of computer-aided virtual planning...
November 2016: Facial Plastic Surgery Clinics of North America
Susanna Ranta, Maarit Palomäki, Mette Levinsen, Mervi Taskinen, Jonas Abrahamsson, Karin Mellgren, Riitta Niinimäki, Kjeld Schmiegelow, Mats Heyman, Arja Harila-Saari
BACKGROUND: Each year approximately 200 children and adolescents are diagnosed with acute lymphoblastic leukemia (ALL) in the five Nordic countries, and 3% of these have central nervous system (CNS) involvement confirmed by leukemic cells in the cerebrospinal fluid (CSF) or neurological symptoms. We sought to determine the significance of neuraxis imaging in such patients. PROCEDURE: Magnetic resonance images of children aged 1-17.9 with CNS leukemia at diagnosis of ALL were centrally reviewed and clinical data were retrieved from the medical records and the Nordic leukemia registry...
August 24, 2016: Pediatric Blood & Cancer
Q Qassemyar, F Kolb
Head and neck reconstruction in pediatric oncology, even if it is based on adult experience, presents important characteristics including age-related growth, the type of tumor and donor sites features. Indications of free flaps are rare but required care that should be codified, taking into account the details specific to context, and not giving place for improvisation as it is important that surgical outcomes must be as simple as possible. The objective of this article is not to present the technical details of free flaps harvesting in children because it is what is certainly the least different with adults...
October 2016: Annales de Chirurgie Plastique et Esthétique
Pallavi A Kumbla, Nathan Lee, Mary K Kimbrough
Mucormycosis is a rare fungal infection in immunocompetent patients. It is not commonly seen in trauma patients who sustain multisystem injuries and are often exposed to numerous infectious sources. A multidisciplinary approach between medical and surgical specialties is crucial to ensuring timely diagnosis and treatment as morbidity and mortality can be high once acquired. In addition to antifungal therapy, radical debridement and reconstruction by plastic surgery is often necessary. Review of the literature shows that there is no definitive reconstructive technique for mucormycosis of the forehead and sinuses because the amount of tissue destruction may be varied in location and depth, therefore requiring varying extents of debridement...
July 2016: Plastic and Reconstructive Surgery. Global Open
K-L Bruchhage, A Leichtle, B Wollenberg
BACKGROUND: Reconstruction of defects after extirpation of head and neck cancer is a highly challenging and complex surgical undertaking. Commonly used techniques, e.g., the radial forearm flap, the anterior lateral thigh flap, or flaps harvested from the chest-deltopectoral or pectoralis major-share numerous disadvantages, such as donor-site morbidity, poor color matching for cutaneous reconstruction, and excessive tissue bulk. The use of a supraclavicular artery island flap is a long-forgotten but increasingly popular option for reconstruction in the head and neck area...
August 15, 2016: HNO
Lara Cristóbal, Sora Linder, Beatriz Lopez, Maria Mani, Andres Rodríguez-Lorenzo
BACKGROUND: Radical tumor ablation in the periauricular area often results in extensive soft tissue defects, including facial nerve sacrifice, bone and/or dura defects. Reconstruction of these defects should aim at restoring facial reanimation, wound closure, and facial and neck contours. We present our experience using free anterolateral thigh flap (ALT) in combination with masseter nerve to facial nerve transfer in managing complex defects in the periauricular area. METHODS: Between 2011 and 2015 six patients underwent a combined procedure of ALT flap reconstruction and masseter nerve transfer, to reconstruct extensive, post tumor resection, periauricular defects...
August 8, 2016: Microsurgery
Nathan Jowett, Tessa A Hadlock, Eyal Sela, Miklos Toth, Rainald Knecht, Balazs B Lörincz
OBJECTIVE: To objectively assess donor site morbidity after harvesting the facial artery musculomucosal flap. Use of the FAMM-flap in oral cavity reconstruction remains sporadic. This case series describes our newly developed standardized assessment of this flap in a floor of mouth (FOM) reconstructive setting. METHODS: Standardized postoperative assessment of the FAMM flap for donor site wound complications, functional, facial mimetic and oncologic outcomes. RESULTS: There were no wound complications...
July 21, 2016: Auris, Nasus, Larynx
Ricardo Horta, Sergio Teixeira, Ricardo Nascimento, Alvaro Silva, Jose Amarante
The reconstruction of defects involving the nasolabial, paranasal, and periorbital regions may be challenging, because they often involve more than one facial aesthetic unit, and can lead to functional problems. An average of 5 facial artery perforators of caliber >0.5 mm can be found above the mandible. A reference point for the location of the most constantly encountered perforator was suggested as being 1.5 cm lateral to the oral commissure, and at its same level in height or slightly inferior to the commissure...
July 2016: Journal of Craniofacial Surgery
Faya Liang, Song Fan, Ping Han, Qian Cai, Peiliang Lin, Renhui Chen, Shitong Yu, Xiaoming Huang
BACKGROUND: Primary tumors of early-stage (T1-2N0M0) head and neck squamous cell carcinoma (HNSCC) can be treated by transoral minimally invasive surgery, but the cervical lymph node lacks corresponding minimally invasive treatment. Therefore, our study was to evaluate the safety and effectiveness of endoscopic-assisted selective neck dissection (EASND) via small lateral neck incision in treatment of early-stage HNSCC. METHODS: From May 2008 to April 2012, 29 patients with early-stage HNSCC were enrolled in this retrospective study...
July 1, 2016: Surgical Endoscopy
Franco Ionna, Massimiliano Amantea, Filiberto Mastrangelo, Andrea Ballini, Maria Grazia Maglione, Corrado Aversa, Rossella De Cecio, Daniela Russo, Massimo Marrelli, Marco Tatullo
Synovial chondromatosis (SC) is an uncommon disease characterized by a benign nodular cartilaginous proliferation arising from the joint synovium, bursae, or tendon sheaths. Although the temporomandibular joint is rarely affected by neoplastic lesions, SC is the most common neoplastic lesion of this joint. The treatment of this disease consists in the extraoral surgery with a wide removal of the lesion; in this study, the authors described a more conservative intraoral surgical approach. Patient with SC of temporomandibular joint typically refer a limitation in the mouth opening, together with a persistent not physiological mandibular protrusion and an appearance of a neoformation located at the right preauricular region: the authors reported 1 scholar patient...
July 2016: Journal of Craniofacial Surgery
Edward I Chang, Matthew M Hanasono
Oncologic resection involving the midface results in potentially disfiguring and challenging defects for the reconstructive surgeon. As with any defect, restoration of form and function is critical, but is particularly difficult in the midface, which is paramount to a patient's physical appearance and identify, as well as the patient's ability to breath, speak, see, and eat. Here, we present an algorithmic approach for optimizing outcomes in midfacial reconstruction utilizing the state-of-the-art reconstructive techniques...
June 2016: Journal of Surgical Oncology
Megan V Hilgers, Chester B Whitley, Christopher L Moertel
We report a patient with stage 3 ganglioneuroblastoma who initially presented with clinical and laboratory features consistent with mucopolysaccharidosis including coarse facial features, developmental delay, and an elevated quantitative urine glycosaminoglycan (GAG) level. All mucopolysaccharidosis features resolved following successful treatment of neuroblastoma. High GAG levels have been documented in the pediatric oncology literature, yet not as a potential marker of malignancy or other target for clinical utility...
August 2016: Journal of Pediatric Hematology/oncology
J Rodrigo Diaz-Siso, Michael Sosin, Natalie M Plana, Eduardo D Rodriguez
Clinical face transplantation, only 10 years old, has evolved into a safe and preferred reconstructive option for the most severe facial defects, in which traditional reconstructive methods have yielded poor outcomes. The ability to simultaneously restore facial function and aesthetics has shown to improve patient's quality of life. Its applicability to post-oncologic resection, however, remains guarded given the current international experience with respect to long term outcomes. J. Surg. Oncol. 2016;113:971-975...
June 2016: Journal of Surgical Oncology
Leone Giordano, Davide Di Santo, Antonio Occhini, Andrea Galli, Giulia Bertino, Marco Benazzo, Mario Bussi
Over the last 20 years, free flaps have represented the gold standard for moderate to large head and neck reconstruction. However, regional flaps continue to evolve and still play an important role in a reconstructive surgeon's armamentarium, especially for the more delicate patients who would certainly benefit from simpler surgical procedures. The supraclavicular artery island flap (SCAIF) is a pedicled flap that has recently gained great popularity for reconstruction of most head and neck sites, because of its unusual versatility and wide arc of rotation...
May 11, 2016: European Archives of Oto-rhino-laryngology
Nelson Fernandes, Jacobus van den Heever, Christiaan Hoogendijk, Sarel Botha, Gerrie Booysen, Johan Els
Malignant peripheral nerve sheath tumors are extremely rare tumors arising in peripheral nerves. Only 17 cases involving the trigeminal nerve have ever been reported. These tumors have a very poor prognosis and very high rates of recurrence and metastases. Their recommended treatment involves complete tumor resection followed by radiation. This can be problematic in the head and neck region. We present a clinical case involving a 33-year-old female patient presenting with a slow-growing, exophytic mass of the anterior maxilla...
April 28, 2016: Journal of Prosthodontics: Official Journal of the American College of Prosthodontists
Hansotto Reiber
The analysis of intrathecal IgG, IgA and IgM synthesis in cerebrospinal fluid (CSF) and evaluation in combined quotient diagrams provides disease-related patterns. The compilation with complementary parameters (barrier function, i.e., CSF flow rate, cytology, lactate, antibodies) in a cumulative CSF data report allows a knowledge-based interpretation and provides analytical and medical plausibility for the quality assessment in CSF laboratories. The diagnostic relevance is described for neurological and psychiatric diseases, for which CSF analysis can't be replaced by other diagnostic methods without loss of information...
April 2016: Arquivos de Neuro-psiquiatria
Rocío Sánchez-Burgos, Teresa Gonzalez Otero, Luis Lassaletta, Javier Arias Gallo, Ignacio Navarro Cuellar, Miguel Burgueño García
INTRODUCTION: To describe the oncological management and functional outcome of patients with advanced parotid malignant tumors undergoing facial nerve reconstruction after radical parotidectomy and subtotal petrosectomy. MATERIALS AND METHODS: A combined approach was used to treat advanced stage parotid malignancies with intrapetrous involvement of the facial nerve main trunk or abutment on the stylomastoid foramen. Patients underwent facial nerve rehabilitation with cable graft reconstruction or with static techniques...
July 2015: Annals of Maxillofacial Surgery
Federico Biglioli, Filippo Tarabbia, Fabiana Allevi, Valeria Colombo, Federica Giovanditto, Mahfuz Latiff, Alessandro Lozza, Antonino Previtera, Silvia Cupello, Dimitri Rabbiosi
The extracranial facial nerve may be sacrificed together with the parotid gland during a radical parotidectomy, and immediate reconstruction of the facial nerve is essential to maintain at least part of its function. We report five patients who had had radical parotidectomy (two with postoperative radiotherapy) and immediate (n=3) or recent (n=2) reconstructions of the masseteric-thoracodorsal-facial nerve branch. The first mimetic musculature movements started 6.2 (range 4-8.5) months postoperatively. At 24 months postoperatively clinical evaluation (modified House-Brackmann classification) showed grade V (n=3), grade IV (n=1), and grade III (n=1) repairs...
June 2016: British Journal of Oral & Maxillofacial Surgery
Luigi Mele, Pietro Paolo Vitiello, Virginia Tirino, Francesca Paino, Alfredo De Rosa, Davide Liccardo, Gianpaolo Papaccio, Vincenzo Desiderio
Craniofacial area represent a unique district of human body characterized by a very high complexity of tissues, innervation and vascularization, and being deputed to many fundamental function such as eating, speech, expression of emotions, delivery of sensations such as taste, sight, and earing. For this reasons, tissue loss in this area following trauma or for example oncologic resection, have a tremendous impact on patients' quality of life. In the last 20 years regenerative medicine has emerged as one of the most promising approach to solve problem related to trauma, tissue loss, organ failure etc...
2016: Frontiers in Physiology
Mark R Gilbert, Arun Sharma, Nicole C Schmitt, Jonas T Johnson, Robert L Ferris, Umamaheswar Duvvuri, Seungwon Kim
IMPORTANCE: Salivary duct carcinoma is a rare, aggressive malignancy of the salivary glands. Owing to its rare nature, clinical data are limited, and only a few clinical studies comprise more than 50 patients. OBJECTIVE: To review the University of Pittsburgh Medical Center's experience with salivary duct carcinoma over a 20-year period, focusing on demographics, presentation, treatment, and outcome. DESIGN, SETTING, AND PARTICIPANTS: This investigation was a retrospective cohort study in a multihospital institution with tertiary referral...
May 1, 2016: JAMA Otolaryngology—Head & Neck Surgery
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