Reconstruction of Orbital Exenteration Defects with Cheek Rotation Flaps: Indications, Technique, Complications, Rehabilitation, and Survival

2021 ◽  
Author(s):  
Sven Holger Baum ◽  
Christopher Mohr
Keyword(s):  
Neck Region ◽  
Major Complication ◽  
Wound Complications ◽  
Orbital Exenteration ◽  
Node Metastasis ◽  
Tumor Relapse ◽  
Facial Prostheses ◽  
Orbital Defects

AbstractThe objective of this study was to examine the role of cheek rotation flaps in the reconstruction of orbital defects after exenteration. From January 2000 to August 2018, patients undergoing orbital exenteration and reconstruction with cheek rotation flaps were enrolled in this retrospective study. All patients were evaluated for wound complications, orbital rehabilitation, tumor relapse, and survival. Thirty patients completed the study. Fourteen complications allocated to 11 patients were assessed. The most common complications were seroma (13%), temporary facial nerve weakness (13%), and partial necrosis of the flap (10%). A major complication occurred in a total of two patients (7%), so that surgical correction was necessary. Eleven patients had a relapse; 15 patients died as part of the follow-up. Fifteen patients were treated with facial prostheses. The overall survival rate was 61% after 1 year and 42% after 5 years. Follow-up periods ranged from 6 to 95 months. Cheek rotation flap reconstruction after exenteration is a reliable method with a low rate of major complications. It is indicated when an approach to the parotid gland or the neck region is necessary because of suspected lymph node metastasis and in elderly patients because of their skin's laxity. It can be performed as primary or secondary reconstruction. Good esthetic results can be achieved, especially after endosseous implantation.

Adenoid cystic carcinoma of trachea: long-term disease control after endoscopic surgery and radiotherapy

2019 ◽  
Author(s):  
Corrado Spatola ◽  
Alessandra Tocco ◽  
Dario Marletta ◽  
Roberto Milazzotto ◽  
Francesco Marletta ◽  
...  
Keyword(s):  
Disease Control ◽  
Adenoid Cystic Carcinoma ◽  
Intensity Modulated Radiotherapy ◽  
Neck Region ◽  
Intensity Modulated ◽  
Adenoid Cystic ◽  
The Impact

Aim: Adenoid cystic carcinoma is a rare tumor of head and neck region and its development in the thoracic region is even less frequent. This implies the absence of guidelines for therapeutic management and a consequent case-by-case approach. The role of radiotherapy is not yet clearly defined, but intensity-modulated radiotherapy allows for improved organ-at-risk sparing. Materials & methods: We have collected the cases of four patients treated at our institutions by the means of intensity-modulated radiotherapy, after endoscopic resection. Results & conclusion: Patients treated achieved long-term disease control of about 5 years, with a minimal acute toxicity. Longer follow-up is needed to drain conclusion on the impact of this treatment on overall survival.

scholarly journals Role of Polidocanol as Sclerosant in Treatment of Hemangiomas of Head and Neck Region

2017 ◽  
Vol 25 (3) ◽  
pp. 148-153 ◽  
Author(s):  
Rupanjita Sangma ◽  
Mukul Patar
Keyword(s):  
Side Effects ◽  
Head And Neck ◽  
Surgical Intervention ◽  
Neck Region ◽  
Complete Regression ◽  
Head And Neck Region ◽  
Common Presentation ◽  
Intralesional Injections

Introduction Haemangiomas are common presentation in head and neck, prevalence being 60% followed by 25% and 15% respectively in trunk and limbs. This report studies the efficacy of Polidocanol as sclerosant in the treatment of heamangiomas in head and neck. Materials and Methods The two year prospective study conducted from January 2015 to December 2016 with Polidocanol as sclerosant on 55 patients attending the department of ENT. Intralesional injections of 3 % polidocanol were given at 2 week intervals. Results Out of 55 patients 15 cases did not follow up after the first dose, so results were calculated out of 40 patients. 12 patients showed complete regression & 15 showed regression to half the size. Thus 67.5 % patients showed acceptable results. There were no side effects except hyperpigmentation in 2 patients. There were no cases of recurrence during our study period. Conclusion Sclerotherapy is a promising method of treatment for haemangiomas of head and neck that may obviate the need for surgical intervention.

Iodoterapia e seus Efeitos Colaterais no Tratamento de Neoplasia de Tireoide

REVISTA FIMCA ◽  
2019 ◽  
Vol 5 (1) ◽  
pp. 15-27
Author(s):  
Abraão Carmo Sussuarana ◽  
Josimar Albuquerque Roque ◽  
Grace Kelly Almeida
Keyword(s):  
Side Effects ◽  
Neck Region ◽  
Laryngeal Edema ◽  
Head And Neck Region ◽  
Oral Infections ◽  
Thyroid Neoplasia ◽  
Increased Sensitivity ◽  
Therapeutic Doses

Introdução: A neoplasia de tireoide é o câncer mais comum na região de cabeça e pescoço. Inicialmente o tratamento é cirúrgico com a retirada do tumor, e após esta intervenção inicia-se a Iodoterapia, tratamento em que o paciente recebe doses terapêuticas de Iodo131 que são absorvidas pela glândula tireoide para extinguir qualquer tecido remanescente de células tumorais. Pouco se sabe sobre os efeitos colaterais do tratamento iodoterápico em paciente com neoplasia de tireoide. Objetivos: Esta pesquisa teve por objetivo realizar um levantamento bibliográfico sobre esses efeitos colaterais, através do método de revisão bibliográfica integrativa. Materiais e Métodos: Foi realizado um levantamento bibliográfico em bancos de dados, de artigos científicos nacionais e internacionais publicados sobre o tema, tendo preferência pelas publicações mais recentes, nos idiomas Espanhol, Português e Inglês. Resultados: Os principais efeitos colaterais abordados pelos trabalhos revisados foram: xerostomia, sialoadenite, hipossalivação, perda de paladar, maior susceptibilidade a infecções bucais, dificuldade de mastigação, deglutição e fonação, maior susceptbilidade ao aparecimento de lesões de cáries, variações na fala, edema da laringe, alterações nas funções dos músculos da face, riscos teratogênicos, obstrução do canal nasolacrimal, náuseas, mialgia, vômitos, epigastralgia, taquicardia, insônia, tremores, calor intenso, fadiga, labilidade emocional, perda de peso, irregularidade menstrual, adinamia, disfagia, exoftalmia, queda de cabelo, cefaleia, câimbras, ganho de peso, sensibilidade ao frio e diminuição de libido. Conclusão: Os efeitos colaterais devem ser relatados ao profissional de saúde responsável pelo acompanhamento do tratamento, para que medidas possam ser tomadas. Além disso, abordou-se a importância do papel do farmacêutico no tratamento da Iodoterapia. Ressalta-se a necessidade do fomento de pesquisas sobre esse assunto no meio científico. Introduction: Thyroid neoplasm is the most common cancer in the head and neck region. Initially, the treatment is surgical with the removal of the tumor, and after this interven+on Iodotherapy begins, a procedure in which the patient receives therapeutic doses of Iodine131 that are absorbed by the thyroid gland to extinguish any remaining tissue of tumor cells. Little is known about the side effects of iodotherapy treatment in patients with thyroid neoplasia. Objectives: This research aimed to perform a bibliographic survey on these side effects, through the method of integrative bibliographic review. Materials and Methods: A bibliographic study was carried out on databases of national and international scientific articles published on the subject, with preference being given to the most recent publications, in Spanish, Portuguese and English. Results: The main side effects were: xerostomia, sialoadenitis, hyposalivation, loss of taste, increased susceptibility to oral infections, difficulty in chewing, swallowing and phonation, increased sensitivity to cavities, speech changes, laryngeal edema, changes in the functions of facial muscles, teratogenic risks, nasolacrimal canal obstruction, nausea, myalgia, vomiting, epigastralgia, tachycardia, insomnia, tremors, intense heat, fatigue, emotional lability, weight loss, menstrual irregularity, adynamia, dysphagia, exophthalmia, hair loss, headache, cramps, weight gain, sensi+vity to cold and decreased libido. Conclusion: Side effects should be reported to the healthcare provider responsible for the follow-up of treatment so that measures can be taken. Also, the role of the pharmacist in the treatment of iodine therapy was discussed. Promo+ng research on this subject in the scientific field is necessary.

scholarly journals Role of Grommets in Otitis Media with Effusion

2016 ◽  
Vol 9 (3) ◽  
Author(s):  
Kashif Iqbal Malik ◽  
Zubair Iqbal Bhutta ◽  
Nadeem Mukhtar ◽  
Mansoor Basir Pal
Keyword(s):  
Otitis Media ◽  
Otitis Media With Effusion ◽  
Major Complication ◽  
Ventilation Tubes ◽  
The Mean ◽  
One Year ◽  
Cigarette Paper ◽  
Paper Method

The outcome of otitis media with effusion (OME) in children is generally good. 54 children with symptomatic otitis media with effusion not responding to medical treatment of four weeks were treated with grommet insertion at Jinnah Hospital. On one year follow-up no major complication was noted. However five patients required retympanostomy due to recurrence of disease. Procedure was accompanied by adenoidectomy in 15 patients and tonsillectomy in 8 patients. Adenotonsillectomy was decided on individual basis. The mean duration of stay for ventilation tubes was ???? and they extruded spontaneously in all except one patient, who required removal under general anesthesia. One patient had persistent residual perforation which was treated by cigarette paper method.

scholarly journals Late dental effects of chemotherapy and radiotherapy in childhood cancer survivor: case report

2021 ◽  
Vol 10 (15) ◽  
pp. e97101522296
Author(s):  
Poliana Gonçalves Miranda ◽  
Rafael Resende de Miranda ◽  
João César Guimaraes Henriques ◽  
Cizelene do Carmo Faleiros Veloso Guedes
Keyword(s):  
Case Report ◽  
Neck Region ◽  
Enamel Hypoplasia ◽  
Chemotherapy Drugs ◽  
Chemotherapy Protocol ◽  
Anticancer Treatment ◽  
Antineoplastic Treatment ◽  
The Right

Chemotherapy drugs and radiotherapy in the head and neck region are considered possible to interfere with odontogenesis. Patients may present alterations such as tooth agenesis, shortening or root malformation, enamel hypoplasia and microdontia. Such effects do not occur in adults, as they already have the dental structures formed. The objective of this study is to describe, through a case report, the dental alterations and implications for the clinical practice of a patient who received chemotherapy and radiotherapy in childhood. A 12- year-old female patient was diagnosed with embryonal rhabdomyosarcoma in the right parotid gland region at 5 years of age. Antineoplastic treatment consisted of IRS IV chemotherapy protocol: ifosfamide (IFO) - doxorubicin (DOXO) - etoposide (VP16) followed by vincristine - dactinomycin - cyclophosphamide (VAC) / vincristine - ifosfamide - etoposide (VIE) alternated, in addition to conventional radiotherapy, with a total dose of 45 Gy. The patient developed important dental alterations, such as root malformation in most teeth, microdontia and enamel hypoplasia, being essential the role of the dentist. Currently, after 6 years of anticancer treatment, she has regular dental follow-up.

Psychological Resilience Provides No Independent Protection From Suicidal Risk

Crisis ◽  
2016 ◽  
Vol 37 (2) ◽  
pp. 130-139 ◽  
Author(s):  
Danica W. Y. Liu ◽  
A. Kate Fairweather-Schmidt ◽  
Richard Burns ◽  
Rachel M. Roberts ◽  
Kaarin J. Anstey
Keyword(s):  
Risk Factors ◽  
Well Being ◽  
Current Status ◽  
Psychological Resilience ◽  
Cross Sectional ◽  
Life Project ◽  
Resilience Factors ◽  
First Time

Abstract. Background: Little is known about the role of resilience in the likelihood of suicidal ideation (SI) over time. Aims: We examined the association between resilience and SI in a young-adult cohort over 4 years. Our objectives were to determine whether resilience was associated with SI at follow-up or, conversely, whether SI was associated with lowered resilience at follow-up. Method: Participants were selected from the Personality and Total Health (PATH) Through Life Project from Canberra and Queanbeyan, Australia, aged 28–32 years at the first time point and 32–36 at the second. Multinomial, linear, and binary regression analyses explored the association between resilience and SI over two time points. Models were adjusted for suicidality risk factors. Results: While unadjusted analyses identified associations between resilience and SI, these effects were fully explained by the inclusion of other suicidality risk factors. Conclusion: Despite strong cross-sectional associations, resilience and SI appear to be unrelated in a longitudinal context, once risk/resilience factors are controlled for. As independent indicators of psychological well-being, suicidality and resilience are essential if current status is to be captured. However, the addition of other factors (e.g., support, mastery) makes this association tenuous. Consequently, resilience per se may not be protective of SI.

Abusive head trauma (AHT) outcome at long-term follow-up and the role of elective neurosurgical approach: A report of 22 cases

2013 ◽  
Author(s):  
Francesca Menegazzo ◽  
Melissa Rosa Rizzotto ◽  
Martina Bua ◽  
Luisa Pinello ◽  
Elisabetta Tono ◽  
...  
Keyword(s):  
Head Trauma ◽  
Abusive Head Trauma ◽  
Long Term Follow Up

Long Term Follow-up after Ovarian Borderline Tumor: Relapse and Survival in a large Patient Cohort

2008 ◽  
Vol 68 (S 01) ◽  
Author(s):  
MS Lenhard ◽  
S Mitterer ◽  
C Kümper ◽  
N Ditsch ◽  
K Friese ◽  
...  
Keyword(s):  
Borderline Tumor ◽  
Patient Cohort ◽  
Tumor Relapse ◽  
Large Patient Cohort ◽  
Large Patient ◽  
Long Term Follow Up

The role of ultrasound examination in early detection and follow-up of arterio-portal shunts

2008 ◽  
Vol 29 (S 1) ◽  
Author(s):  
S Ioanitescu ◽  
L Micu ◽  
A Rampoldi ◽  
N Masala ◽  
V Marcu ◽  
...  
Keyword(s):  
Early Detection ◽  
Ultrasound Examination

Pilonidal sinus disease: Karydakis flap procedure in our patients

2020 ◽  
Vol 99 (8) ◽  
Keyword(s):  
Wound Healing ◽  
Pilonidal Sinus ◽  
Healing Process ◽  
Pilonidal Sinus Disease ◽  
Wound Complications ◽  
Limberg Flap ◽  
New Disease ◽  
Sinus Disease ◽  
Flap Procedure

Introduction: Despite the available guidelines, opinions of many surgeons are quite ambiguous when it comes to the therapy of pilonidal sinus disease. The treatment can be a frustrating problem both for the surgeon and the patient because it is associated with wound complications and high recurrence rate. The objective of this study was to analyze the results of patients with pilonidal sinus disease undergoing the Karydakis flap procedure. Methods: A total of 27 patients treated for primary and recurrent pilonidal disease using the Karydakis flap procedure at our department between October 23, 2018 and November 22, 2019 were analyzed prospectively. We evaluated postoperative wound healing, complications and recurrence of the disease in a short-term follow-up period. Disease recurrence was defined as prolonged healing or as a new disease requiring repeated surgery. Results: In December 2019 all 27 patients came for a follow-up visit. The result was a fully lateralized wound without any signs of a new disease in all patients. In May 2020 a follow-up visit by phone was performed. The median follow-up was 12 months. The healing process was free of any serious complications in 25 patients. Seroma formation cases were managed by puncture in the outpatient setting. Conclusion: According to the available evidence and guidelines, off-midline procedures – the Karydakis flap, Bascom cleft lift, and Limberg flap procedures – are associated with lower recurrence rates and better wound healing. An important goal is to achieve complete wound lateralization and to change the configuration of the gluteal cleft by reshaping it, which results in a nicely flattened gluteal crease.

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