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https://www.readbyqxmd.com/read/28089208/the-reconstructive-options-for-oropharyngeal-defects-in-the-transoral-robotic-surgery-framework
#1
Giuseppe Meccariello, Filippo Montevecchi, Rossella Sgarzani, Andrea De Vito, Giovanni D'Agostino, Riccardo Gobbi, Chiara Bellini, Claudio Vicini
Transoral robotic surgery (TORS) is a fascinating new technique that has been proved to be a safe and feasible for selected oropharyngeal cancers. Furthermore, TORS offers several advantages in the treatment of locoregionally advanced cancers. Nevertheless, the careful selection of patients is the keypoint for a successful application of this therapeutic modality. However, the reconstruction of large oropharyngeal defects is challenging due to the restoration of velopharyngeal competency and swallowing. Moreover, the absence of mandibular splitting increases the difficulties faced by reconstructive surgeons...
January 11, 2017: Oral Oncology
https://www.readbyqxmd.com/read/28048327/su-f-p-58-squamous-cell-and-basal-cell-carcinoma-of-the-skin-treated-with-a-freiburg-flap-applicator
#2
K Dou, B Li, M Jacobs, B Laser
PURPOSE: To treat squamous cell and basal cell carcinoma of the skin with the Freiburg flap applicator using a high dose rate modality of an Elekta Flexitron or MicroSelectron for radiation delivery by compensating the dose deviation resulting from the incomplete scatter environment. METHODS: Patients were selected to have lesions greater than or equal to 2cm. A mask might be needed depending on special locations. The lesions on the eyelid and face presented in this research were, however, treated without a mask...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28045815/reconstruction-of-skin-defects-on-the-mid-and-lower-face-using-expanded-flap-in-the-neck
#3
Xiaogen Hu, Gao Zeng, Yang Zhou, Cheng Sun
BACKGROUND: The reconstruction of major burn and other deformities resulting from significant soft tissue deficits of the face is a continuing challenge for surgeons. In the study, the authors introduce our 5-year experiences using expanded flap in the neck for reconstruction on the mid and lower face. METHODS: From 2008 and 2013, 12 tissue expanders were used in 12 patients for face resurfacing. The operation consisted of 2 steps. In the first step, the expander was placed subcutaneously under the skin of the neck and they were expanded timely to create adequate superfluous skin and soft tissue...
December 30, 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28041765/-the-thin-alt-perforator-flap-for-oropharyngeal-robotic-assisted-reconstruction
#4
Q Qassemyar, P Aguilar, S Temam, F Kolb, P Gorphe
Since a few years, the transoral robotic surgery reduced the morbidity of oropharyngeal tumors excision. Large posterior tumors can now be removed without any scar visible on the face. In this context and to respect the thinness required for reconstructions at the junction of the upper aerodigestive tract, the free radial forearm flap still remains the solution of choice. However, if the transoral robotic surgery respects the anatomy and the aesthetics of patients at the visible and social area that represents the face, the forearm flap provides visible scars on the other region of social interaction that represents the upper limb...
December 29, 2016: Annales de Chirurgie Plastique et Esthétique
https://www.readbyqxmd.com/read/28039499/omega-%C3%AE-advancement-flap-a-circular-flap-design-for-the-aesthetic-closure-of-circular-skin-defect
#5
Enver Arpaci, Serdar Altun, Nilgün Markal Ertas, Ahmet Cagri Uysal, Emre Inozu
BACKGROUND: Most skin defects that require reconstruction with a local skin flap have a circular- or oval-shaped pattern. The majority of the skin flaps are planned in an angled shape. Therefore, it may be necessary to modify the shape of the defect or the distal flap border to minimize tissue distortion. We have designed a circular-shaped advancement flap to be compatible with the circular defect. METHODS: Eighteen cases of reconstruction of skin defects in the face, chest wall, hand and buttock area were performed using the omega advancement flap between 2010 and 2014...
December 30, 2016: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28033633/rhytidoplasty-smas-imbrication-vector-comparison
#6
Fernando Pedroza, Luis Fernando Pedroza, Daniel Correal Gentry, Juan Guillermo Erazo Cordoba, Guillermo Arturo Landinez Cepeda
To determine if there are aesthetic differences in patients who have undergone a SMAS lifting with predominantly oblique-horizontal vectors versus predominantly oblique-vertical vectors. To determine if there are aesthetic differences in the results of the neck using sutures placed in specific areas of the platysmal muscle versus randomly placed sutures for platysmal plication to the mastoid. Comparative, retrospective, blind, and randomized study. Evaluation of preoperative and postoperative photographs of 54 patients who underwent predominantly oblique-horizontal SMAS lifting versus 53 patients who underwent predominantly oblique-vertical traction of the SMAS flap, reviewed by three external, unbiased facial plastic surgeons in a blind study...
December 2016: Facial Plastic Surgery: FPS
https://www.readbyqxmd.com/read/28005812/microcystic-adnexal-carcinoma-of-the-nasal-tip-treated-with-surgical-excision-and-rotational-forehead-skin-flap
#7
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/28005772/correction-of-residual-static-and-dynamic-labial-deviations-in-a-paralyzed-face-after-free-gracilis-muscle-transplantation
#8
Ricardo Horta, Inês Correia-Sá, Ricardo Nascimento, Alvaro Silva, José Amarante
Free muscle flap transfer is currently the procedure of choice for longstanding facial paralysis to restore symmetry both at rest and when smiling. However, movements obtained are generally localized, unidirectional, and philtrum centralization and lower lip movement is not proportionally achieved. The stability of free flap insertion at the lips also interferes with the results, as gradual disinsertion and shifting of the nasolabial fold can be caused by repetitive movements. Asymmetry of smile can also be caused by lip depressor inactivity due to marginal mandibular paralysis, and both dynamic and static procedures are often required after dynamic reanimation...
November 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28005741/two-thirds-lip-defects-a-new-combined-reconstructive-technique-for-patients-with-epithelial-cancer
#9
Tiziana Vitagliano, Lucia Stella Curto, Antonio Greto Ciriaco, Pietro Gareri, Diego Ribuffo, Manfredi Greco
BACKGROUND: The lips are a common site prone to squamous cell carcinomas, which arise in the facial region. There are different techniques to reconstruct the excised lip region, according to dimensions, area, and position of the tumor. The authors describe a new technique of lip reconstruction born from a combination between a nasolabial flap and adipose tissue transplant. METHODS: The study was lead in the Plastic and Reconstructive Surgery Department of the University of Catanzaro...
November 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27991024/-cooperation-between-the-plastic-surgery-and-the-head-neck-surgery-departments-in-the-treatment-of-unusual-cases-veszpr%C3%A3-m-hungary-2010-2015
#10
Zoltán Lóderer, József Piffkó, Károly Somlai, Gábor Bognár, Gábor Sándor
INTRODUCTION: Handling problems in the head and neck region often requires a close cooperation between allied professions, just as in the challenging cases presented by us. Cases and methodology: With the first patient, we performed a radical surgery on the left side of the face due to recidivious basal cell carcinoma, followed by reconstruction using a Type I chimeric anterolateral thigh flap (ALT), while in the case of the second patient, we carried out a radical surgery on the right side of the face due to epithelial carcinoma and reconstruction with a Type I chimeric thoracodorsal flap...
December 2016: Magyar Sebészet
https://www.readbyqxmd.com/read/27975013/free-medial-plantar-flap-connection-with-a-posterior-tibial-artery-flap-in-reconstruction-of-fore-mid-foot-skin-defect
#11
Hao Wu, Jia-Gen Sheng, Chang-Qing Zhang
BACKGROUND: Although there are many surgical treatments for covering the skin defect of the fore-mid foot, how to reconstruct the weight-bearing region remains a challenge. The weight-bearing region of the sole needs to withstand the pressure and shearing stresses of walking, so the plantar skin is anatomically different from other skins in the areas of texture, thickness, subcutaneous tissue, etc. Medial plantar flaps that are harvested from the instep region are regarded as the first choice for weight-bearing region reconstruction because of their excellent functional and aesthetic long-term result...
November 2016: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/27974011/use-of-anteromedial-thigh-perforator-flap-and-immunological-implications-of-gorlin-goltz-syndrome-a-case-study
#12
A Scalise, R Calamita, C Tartaglione, E Bolletta, G Di Benedetto, M Pierangeli
Gorlin-Goltz syndrome is mainly characterised by the development of numerous multicentric and relapsing cutaneous basal cell carcinomas (BCCs). A major problem for patients with Gorlin-Goltz syndrome is the large amount of BCCs that can invade the deep underlying structures, especially the face. Here, we describe the case of a 23-year-old male affected by Gorlin-Goltz syndrome. He had recurrent BCCs on a hairless scalp and dorsum since he was 17 years old and underwent four surgical procedures to excise BCCs, including a reconstruction with anteromedial thigh perforator flap...
December 2, 2016: Journal of Wound Care
https://www.readbyqxmd.com/read/27956720/indication-for-and-limitation-of-the-facial-dismasking-flap-approach-for-skull-base-surgery-to-achieve-the-best-esthetical-and-functional-results
#13
Tomoyuki Yano, Mutsumi Okazaki, Kentaro Tanaka, Atsunobu Tsunoda, Masaru Aoyagi, Seiji Kishimoto
BACKGROUND: The facial dismasking flap (FDF) approach to operations on the deep skull base region consists of a coronal incision and a circumpalpebral incision. This approach provides a wide surgical field for extirpation of deep extended craniofacial tumors without leaving any undesirable scars on the face. Therefore, the FDF approach can provide satisfactory esthetical and functional results. Meanwhile, in some cases, especially in patients with a history of skull base surgery or orbital extension, patients are not fully satisfied even when the FDF approach is used...
January 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/27927508/kyphectomy-in-children-with-severe-myelomeningocele-related-kyphosis
#14
R N Dunn, L N Bomela
STUDY DESIGN: Retrospective review of prospectively maintained database. OBJECTIVES: To review myelomeningocele patients with severe kyphosis undergoing kyphectomy surgery in terms of complications and clinical and radiographic outcomes. SUMMARY OF BACKGROUND DATA: Because of posterior element abnormality in myelomeningocele, the extensor muscles act as perverted flexors, driving progressive kyphosis that resulted in sitting, respiratory, and skin breakdown problems...
May 2016: Spine Deformity
https://www.readbyqxmd.com/read/27920067/injectable-diphenhydramine-used-as-anaesthetic-for-wide-local-excision-with-flap-closure
#15
Laura E Pickett, Jillian Macdonald
BACKGROUND: Lidocaine-allergic patients pose a challenge for cutaneous surgical procedures. We present a case of a successful wide local excision with flap closures on the face using topical tetracaine followed by infiltration with 1% diphenhydramine. CASE SUMMARY: An 84-year-old woman, with a lidocaine intolerance, presented to the Mohs surgery clinic for wide local excision of a nodular basal cell carcinoma on her right medial cheek. Successful anaesthesia was achieved using topical 4% tetracaine followed by intradermal and subcutaneous injection of 1% diphenhydramine...
December 5, 2016: Journal of Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/27896441/pterygium-surgery-using-the-principle-of-contact-inhibition-results-of-13-years-experience
#16
Tsutomu Hara, Takako Hashimoto, Takeshi Hara
PURPOSE: To report a technique to prevent pterygium recurrence using the principle of contact inhibition. METHODS: Two hundred and fifteen patients (232 eyes; average age, 64.1 years) with primary pterygia who underwent pterygium surgery at the Hara Eye Hospital between 1999 and 2012. We retrospectively evaluated the patients who underwent the following procedure to prevent pterygium recurrence. The surface conjunctiva on the pterygium body was not removed. After removing the pterygium body, by placing a narrow pedicle autoconjunctival flap along the corneal limbus and tying it tightly to the front area of the residual conjunctiva, there is no room for the active residual tissue to proliferate, thus preventing a recurrence by contact inhibition...
November 28, 2016: Graefe's Archive for Clinical and Experimental Ophthalmology
https://www.readbyqxmd.com/read/27894585/pre-expanded-intercostal-perforator-super-thin-skin-flap
#17
REVIEW
Yunjun Liao, Yong Luo, Feng Lu, Hiko Hyakusoku, Jianhua Gao, Ping Jiang
This article introduces pre-expanded super-thin intercostal perforator flaps, particularly the flap that has a perforator from the first to second intercostal spaces. The key techniques, advantages and disadvantages, and complications and management of this flap are described. At present, the thinnest possible flap is achieved by thinning the pre-expanded flap that has a perforator from the first to second intercostal spaces. It is used to reconstruct large defects on the face and neck, thus restoring function and cosmetic appearance...
January 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/27894583/pre-expanded-supraclavicular-artery-perforator-flap
#18
REVIEW
Norbert Pallua, Bong-Sung Kim
The supraclavicular artery perforator (SAP) flap is a versatile flap for the reconstruction of head and neck defects. Recently, the authors have modified the SAP flap by using an anterior branch of the transverse cervical artery. The anterior SAP flap allows the harvest of a tissue island in the deltopectoral fossa, which is even thinner, is more pliable, and shows a superior color match to the face and neck compared with the original SAP flap. Pre-expansion increases flap size considerably, enabling the coverage of extended defects without the need of microsurgery...
January 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/27894582/pre-expanded-transverse-cervical-artery-perforator-flap
#19
REVIEW
Huifeng Song, Jiake Chai
The face and neck are important areas for function and appearance. High-quality skin flaps should be used to reconstruct defects in the cervicofacial region. This article introduces the pre-expanded transverse cervical artery perforator flap, which can be used for cervicofacial reconstruction after burns, trauma, and tumor resection with excellent results. This perforator flap is one of the best options for cervicofacial reconstruction in terms of color and texture match, and has fewer flap complications. With regard to the expanded flap, the donor site can be sutured directly leaving only an inconspicuous linear scar...
January 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/27894581/pre-expanded-super-thin-skin-perforator-flaps
#20
REVIEW
Chunmei Wang, Sifen Yang, Lee L Q Pu
Patients with severe postburn scar contractures underwent reconstruction of skin defects after scar excision with pre-expanded super-thin skin perforator flaps supplied primarily by perforators via the "bridging effect" from the branches of the adjacent arteries as 2-stage procedures. Pre-expansion is an innovative technique and may improve the anastomoses between subdermal vascular plexuses and extend the supplying area of these vessels to the flap. Such a flap becomes super thin, but with a prefabricated blood supply it can be used for reconstruction of skin defects of the face, neck, or other body part with improved functional and cosmetic outcomes...
January 2017: Clinics in Plastic Surgery
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