Pirgousis

Study Design: Prospective cohort study. Objective: Reconstruction with microvascular free flaps is quite predictable but excessive fluids intraoperatively and excessive use of vasopressors have been implicated in postoperative complications. However, vasopressors assist in limiting fluid administration and counteract vasodilatory effects of general anesthetics, while maintaining proper intravascular volume. This is of paramount importance during surgery to ensure adequate tissue and organ perfusion...

INTRODUCTION: Patients who become severely ill from coronavirus disease 2019 (COVID-19) have a high likelihood of needing prolonged intubation, making tracheostomy a likely consideration. The infectious nature of COVID-19 poses an additional risk of transmission to healthcare workers that should be taken into consideration. METHODS: We explore current literature and recommendations for tracheostomy in patients with COVID-19 and look back at previous data from severe acute respiratory syndrome coronavirus 1 (SARS-CoV-1), the virus responsible for the SARS outbreak of 2003...

BACKGROUND: Venous invasion (VI) is not frequently evaluated on routine histologic examination of head and neck squamous cell carcinoma (HNSCC), and the prognostic significance is largely unknown. Studies have shown that extramural venous invasion is an adverse prognostic factor in colorectal carcinoma. To our knowledge, this is the first study evaluating the prognostic significance of venous invasion in node-negative (without clinical or pathologic evidence of lymph node involvement) HNSCC, utilizing the elastic stain...

Objective  The objective of this study was to report the outcomes on a preliminary cohort of patients with tumor encasement of either, or both, the cervical internal carotid artery (ICA) and common carotid artery (CCA) following preoperative covered stent placement and surgical resection. Setting  This study was set at the University of Florida College of Medicine, Jacksonville, FL. Participants  Subjects who received preoperative stenting of the cervical ICA/CCA before surgical resection of head and neck tumors between April 1, 2015, and July 31, 2015 were participated...

PURPOSE: Clinical pathways have become an important and simple method of improving patient outcomes and decreasing health care resource usage. The purpose of this study was to evaluate early outcomes associated with the implementation of a clinical pathway in a maxillofacial head and neck surgery unit. MATERIALS AND METHODS: This investigation is a retrospective cohort study of patients who underwent microvascular reconstruction of the head and neck from January 1, 2014 through December 31, 2014...

BACKGROUND: Limited outcome data exist regarding the survival of microvascular free flaps for head and neck reconstruction in children. The objectives of this study were to perform a systematic review of the literature and meta-analysis comparing the survival of the most commonly used free flaps used for head and neck reconstruction in children. METHODS: A systematic search of PubMed, Embase, and Scopus was conducted using various keywords up to January 1, 2015...

PURPOSE: To report disease outcomes after proton therapy (PT) for sinonasal cancer. METHODS AND MATERIALS: Eighty-four adult patients without metastases received primary (13%) or adjuvant (87%) PT for sinonasal cancers (excluding melanoma, sarcoma, and lymphoma). Common histologies were olfactory neuroblastoma (23%), squamous cell carcinoma (22%), and adenoid cystic carcinoma (17%). Advanced stage (T3 in 25% and T4 in 69%) and high-grade histology (51%) were common...

PURPOSE: To compare military with civilian gunshot wounds (GSWs) in the maxillofacial region in order to establish differences in presentation, morbidity, and surgical management. MATERIALS AND METHODS: A cross-sectional study design was used. The University of Florida at Jacksonville oral and maxillofacial surgery operating room census and hospital trauma registry were both reviewed to identify maxillofacial GSW cases from 2005 through 2011. Military GSW data (2005 through 2011) were obtained from the US Department of Defense (DOD)...

BACKGROUND: Free tissue transfer is commonly used in the reconstruction of post-ablative defects of the mandible. Due to lack of statistical power, comparing the survival of various free flaps, even in large studies, is challenging. The purpose of this study was to perform a meta-analysis comparing the survival of the most commonly used free flaps for mandibular reconstruction. METHODS: We searched PubMed, EMBASE, and SCOPUS for relevant studies. A meta-analysis using the Peto one-step odds ratio (OR) with 95% confidence intervals (CI) was used to compare the pooled survival of the most commonly used free flaps for mandibular reconstruction...

PURPOSE: Mandibular reconstruction continues to be a challenge, even for the seasoned reconstructive surgeon. The present study sought to determine the normal anatomic mandibular angle and to establish a predictable angle of resection for the fibula bone cut to re-create the neomandibular body-ascending ramus angle. MATERIALS AND METHODS: A total of 30 random male and female panoramic radiographs were selected from our database. The selection criteria included age older than 21 years and a full or near total complement of teeth...

Head and neck squamous cell carcinomas frequently metastasize to cervical lymph nodes. Distant metastasis by hematogenous dissemination pathways is less common. Cardiac involvement is a particularly rare occurrence. The first case of cardiac metastasis was reported in the early 18th century as a postmortem discovery. Since then, there have been sporadic reports of oropharyngeal cancer with cardiac metastasis. This report describes a case of metastatic squamous cell carcinoma of an unknown primary site involving the lungs, heart, and soft tissue of the bilateral paraspinal regions and lower extremity...

BACKGROUND: Treatment for tumors of the oral cavity and the oropharynx disrupts normal swallow function. The ability for oral diet postoperatively varies and may be influenced by surgery and patient-related factors. METHODS: In all, 114 patients treated with surgery with and without chemoradiotherapy for advanced oral/oropharyngeal cancer were recruited. Clinicopathologic tumor parameters and reconstruction modalities were recorded. Swallow function was determined by oral intake, using the Functional Oral Intake Scale (FOIS) pretreatment and posttreatment...

PURPOSE: The advent of microvascular free tissue transfer has given reconstructive surgeons a vast repertoire of treatment options for reconstruction of head and neck defects. However, the success of free flaps in head and neck reconstruction depends on the presence and quality of the recipient vessels in the neck for microvascular anastomosis. The supraclavicular artery island flap can be used to reconstruct a variety of head and neck defects, allowing the reconstructive surgeons to circumvent some of the problems inherent in vessel-depleted necks...

Ideal reconstruction of the mandible is important for a multitude of reasons and has been and continues to be among the most common surgical challenges for reconstructive surgeons of the head and neck. Historically, pedicle flaps, such as the pectoralis major and deltopectoral myocutaneous flaps, were workhorse flaps for lower facial third head and neck reconstruction. This article outlines the relevant anatomy of the perimandibular region, reconstructive options including second free flaps, relevant workup, and complications pertaining to reoperative mandibular surgery...

Dermoid cysts in the head and neck are a relatively uncommon entity with only 6.9% occurring in this site. They most commonly occur in the lateral third of the eyebrow with 26% found in the floor of the mouth.(1) They are believed to arise from failure of the overlying surface ectoderm to separate from underlying structures. Typically, dermoid cysts present as slow-growing nontender midline floor of the mouth or submental swellings that can develop to significant dimensions before producing symptoms.(2) We report 2 such cases where large dermoid cysts produced progressive dysphagia and breathing difficulty, resulting in acute presentation to our service...

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No abstract text is available yet for this article.