scholarly journals Olfactory and gustatory functions after free flap reconstruction and radiotherapy for oral and pharyngeal cancer: a prospective follow-up study

2018 ◽  
Vol 275 (4) ◽  
pp. 959-966 ◽  
Author(s):  
Markus Lilja ◽  
Mari Markkanen-Leppänen ◽  
Sanna Viitasalo ◽  
Kauko Saarilahti ◽  
Andrew Lindford ◽  
...  
Keyword(s):  
Free Flap ◽  
Flap Reconstruction ◽  
Free Flap Reconstruction ◽  
Pharyngeal Cancer ◽  
Follow Up Study ◽  
Oral And Pharyngeal Cancer

Quality of life after free-flap reconstruction in patients with oral and pharyngeal cancer

Head & Neck ◽  
2006 ◽  
Vol 28 (3) ◽  
pp. 210-216 ◽  
Author(s):  
Mari Markkanen-Leppänen ◽  
Antti A. Mäkitie ◽  
Marja-Leena Haapanen ◽  
Erkki Suominen ◽  
Sirpa Asko-Seljavaara
Keyword(s):  
Quality Of Life ◽  
Free Flap ◽  
Flap Reconstruction ◽  
Free Flap Reconstruction ◽  
Pharyngeal Cancer ◽  
Oral And Pharyngeal Cancer

Swallowing after free-flap reconstruction in patients with oral and pharyngeal cancer

Oral Oncology ◽  
2006 ◽  
Vol 42 (5) ◽  
pp. 501-509 ◽  
Author(s):  
Mari Markkanen-Leppänen ◽  
Elina Isotalo ◽  
Antti A. Mäkitie ◽  
Eija Rorarius ◽  
Sirpa Asko-Seljavaara ◽  
...  
Keyword(s):  
Free Flap ◽  
Flap Reconstruction ◽  
Free Flap Reconstruction ◽  
Pharyngeal Cancer ◽  
Oral And Pharyngeal Cancer

Study of the length of hospital stay for free flap reconstruction of oral and pharyngeal cancer in the context of the new French casemix-based funding

Oral Oncology ◽  
2010 ◽  
Vol 46 (3) ◽  
pp. 190-194 ◽  
Author(s):  
Angélique Girod ◽  
Antonio Brancati ◽  
Véronique Mosseri ◽  
Irène Kriegel ◽  
Thomas Jouffroy ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Free Flap ◽  
Length Of Hospital Stay ◽  
Flap Reconstruction ◽  
Free Flap Reconstruction ◽  
Pharyngeal Cancer ◽  
Oral And Pharyngeal Cancer

Long-term Follow-up Study of Radial Forearm Free Flap Reconstruction After Hemiglossectomy

2015 ◽  
Vol 26 (1) ◽  
pp. 44-47 ◽  
Author(s):  
Masaya Akashi ◽  
Kazunobu Hashikawa ◽  
Akiko Sakakibara ◽  
Takahide Komori ◽  
Hiroto Terashi
Keyword(s):  
Free Flap ◽  
Radial Forearm Free Flap ◽  
Flap Reconstruction ◽  
Free Flap Reconstruction ◽  
Follow Up Study ◽  
Long Term Follow Up ◽  
Radial Forearm

S110 – Free Tissue Transfer Reconstruction of Fistula after ACDF

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P114-P114
Author(s):  
Sarah R. Rossmiller ◽  
Tamer Ghanem ◽  
Mark K Wax
Keyword(s):  
Free Flap ◽  
Free Tissue Transfer ◽  
Fistula Formation ◽  
Flap Reconstruction ◽  
Esophageal Diverticulum ◽  
Free Flap Reconstruction ◽  
Incision And Drainage ◽  
Tissue Transfer ◽  
Radial Forearm

Objectives Pharyngeal injury post-anterior cervical disc fusion (ACDF) repair is a well-recognized postoperative complication. It can lead to abscess formation, pharyngocutaneous fistula, and esophageal diverticulum. Various reconstructive procedures have been proposed, including primary repair or pedicled muscle flaps. In recalcitant cases, free tissue transfer can be used. We review our experience with patients undergoing free tissue transfer for repair of pharyngeal defects. Methods Retrospective data review from January 2002 to February 2008 of patients undergoing pharyngeal repair following ACDF surgery. Results 5 patients were identified for total of 6 reconstruction procedures. Presentation of the pharyngeal leak occurred from 8 days to 3 years after the ACDF procedure. 3 patients presented acutely with cervical abscesses requiring incision and drainage. 2 patients underwent hardware removal at the time of incision and drainage. 2 patients presented with dysphagia and a contained esophageal diverticulum. 4 of the patients underwent radial forearm fasciocutaneous free flap reconstruction, and 1 underwent anterolateral thigh musculocutaneous free flap reconstruction. One patient had a revision surgery for recurrent fistula formation after radial forearm free flap with rectus free flap reconstruction. There were no immediate postoperative leaks; however, on 1–51 months follow-up, 4 out of 6 cases developed a diverticulum, with one of them developing a second fistula. 3 out of 5 patients had no evidence of diverticulum or fistula at last follow-up, for a success rate of 60%. Conclusions Pharyngo-esophageal perforation following an ACDF approach is difficult to repair even with free tissue transfer.

scholarly journals Six-year experience of microvascular free-flap reconstruction of head and neck neoplasms

2021 ◽  
Vol 78 (4) ◽  
pp. 335-339
Author(s):  
Santiago Olguín Joseau ◽  
Ariel Arias ◽  
Juan Carlos Sánchez ◽  
Pablo Valle ◽  
Agustín Garzón Bertola ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Head And Neck ◽  
Free Flap ◽  
Head And Neck Neoplasms ◽  
Site Infection ◽  
Flap Reconstruction ◽  
Free Flap Reconstruction ◽  
Surgical Time ◽  
Microvascular Free Flap

Introduction: Microvascular free-flap reconstruction is one of the treatment options after large resection of head and neck neoplasms. The objectives of this study are to identify short-term outcomes and risk factors for flap complication in patients who underwent neoplasms resection of head and neck with microvascular free-flap reconstruction. Methods: Retrospective study of patients who underwent surgery for head and neck neoplasm with microvascular free-flap reconstruction between January 2014-2020. Complications were studied at 30-days follow-up and divided into medical and flap complications. Factors independently associated with flap complication were analyzed. Results: We included 31 patients (15 men). The mean age was 60 years. Reconstruction was performed with radial-forearm flap in 74% (n=23) and with free-fibula flap in 26% (n=8). Mean surgical time was 420 minutes. Median hospital length of stay was 7 days. Medical complications were of 23%. Minor complications were of 35% and major of 32%. There was no mortality in 30-days follow-up. Flap complications were of 35%. Reintervention was of 29%, surgical site infection of 9%, dehiscence of 29% and flap loss of 9.7%.  Surgical site infection was independently associated with prolonged surgical time (Odds ratio [OR]=1.03, IC95%=0.98-1.04, p=0.02) and body mass index equal to or greater than 30 (OR=1.38, IC95%=0.84-2.26, p=0.04) while flap loss was associated with prolonged surgical time (OR=1.02, IC95%=0.99-1.04, p=0.01). Conclusion: Microsurgical free-flap reconstruction should be considered in our population in patients with large head and neck neoplasms. Preoperative assessment of the risk of postoperative complications is essential before selecting patients for this surgery.

S113 – Facial Suspension & Free Flaps in Composite Parotid Defects

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P115-P115
Author(s):  
Judith M Skoner ◽  
Luke Buchmann ◽  
Joshua Hornig ◽  
Eric J Lentsch ◽  
M. Boyd Gillespie ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Facial Nerve ◽  
Free Flap ◽  
Family Satisfaction ◽  
Microvascular Reconstruction ◽  
Flap Reconstruction ◽  
Free Flap Reconstruction ◽  
Extensive Resection ◽  
Suture Suspension

Objectives 1) Study efficacy of 2 methods of immediate static facial suspension after total composite parotidectomy, facial nerve sacrifice & free flap reconstruction. 2) Compare these regarding outcomes & patient satisfaction. Methods Retrospective review 2005–08 of all patients at academic tertiary referral center with advanced H&N malignancy necessitating extirpation, including parotidectomy, CN-VII sacrifice, and microvascular reconstruction. Ipsilateral face addressed simultaneously with either acellular human dermal allograft (AHDA) ‘sling’ or suture suspension (SS). Follow-up 2–18 months. Outcomes assessed: suspension status (commissure symmetry 1–4 complete ptosis), overall aesthetics (excellent 1–4 unsatisfactory), oral competence (no drooling 1–3 constant drooling) and patient/family satisfaction scores (very satisfied 1–4 very dissatisfied). Results 9 patients underwent extirpation, CNVII sacrifice, fasciocutaneous microvascular reconstruction (forearm, ALT or parascapula) and facial suspension. 8 received postoperative radiation; 1 expired. 2 underwent AHDA facial ‘slings.’ 7 underwent SS using polybutilate-coated braided polyester (Ethibond Excel). Both techniques used 3 distal suspension sites (nasolabial crease, upper/lower commissure) and proximal zygomatic stablization. Suspension grades were 1–3 for AHDA, 1–2 for SS; aesthetic 2–3 for AHDA, 1–3 for SS; competence 2 for AHDA, 1–2 for SS; satisfaction 1–2 for AHDA, 1–2 for SS. Conclusions Facial nerve rehabilitation in post-extirpative oncologic setting remains challenging for optimizing function/aesthetics. In our series of patients undergoing extensive resection with facial nerve sacrifice and free flap reconstruction, suture suspension provided slightly better oral symmetry and overall aesthetics compared to AHDA ‘sling’ suspension. Patient satisfaction was high in both groups. Long-term follow-up and greater sample size are needed to determine if any observed advantage is real and sustained.

Outcome after Free Flap Reconstruction of the Heel

1994 ◽  
Vol 15 (5) ◽  
pp. 250-255 ◽  
Author(s):  
John W. Durham ◽  
Charles L. Saltzman ◽  
Curtis M. Steyers ◽  
Bruce A. Miller
Keyword(s):  
Free Flap ◽  
Plantar Pressure ◽  
Functional Results ◽  
Elevated Pressure ◽  
Flap Reconstruction ◽  
Free Flap Reconstruction ◽  
Flap Coverage ◽  
Plantar Pressures ◽  
Protective Sensation

We reviewed six free flap reconstructions of the weightbearing surface of the heel. Patients were seen for clinical evaluation at a mean follow-up of 4.7 years (range 2.7–6.0 years). Functional results using a modified Boston Children's Hospital Ankle Score were 33% excellent, 33% good, 17% fair, and 17% poor. The excellent functional results were related to the absence of chronic draining flap ulcers. All flaps lacked protective sensation by Semmes-Weinstein monofilament testing. Weightbearing plantar pressures in the flaps were elevated in all patients. Sequential radiographs from the time of flap coverage revealed the development of a bony protuberance (stalactite) projecting from the undersurface of the calcaneus in all patients with injuries to the plantar cortex of the calcaneus. In patients with flap ulceration, these stalactites projected into the ulcer at the site of maximum plantar pressure. A combination of loss of plantar calcaneal integrity, elevated pressure concentrations, and flap insensitivity appear causally related to the development of heel free flap ulceration and outcome.

scholarly journals Is Single-stage Microvascular Reconstruction for Facial Mucormycosis Safe?

2021 ◽  
Vol 54 (02) ◽  
pp. 130-137
Author(s):  
R. Parvati ◽  
M. V. Subbalaxmi ◽  
R. Srikanth ◽  
P. Sajani ◽  
R. V. Koteswara Rao
Keyword(s):  
Free Flap ◽  
Microvascular Reconstruction ◽  
Flap Reconstruction ◽  
Free Flap Reconstruction ◽  
Total Maxillectomy ◽  
Radial Forearm ◽  
Systemic Manifestations ◽  
Group 2 ◽  
Group 1

Abstract Introduction This is a retrospective therapeutic series of eight cases of facial mucormycosis treated over a 15-year period to determine the safety of simultaneous debridement and free-flap reconstruction in facial mucormycosis. Methods Surgical debridement was done for three cases that presented acutely with systemic manifestations (group 1) and five cases that presented in the subacute phase without systemic manifestations (group 2). The debridement involved total maxillectomy with orbital exenteration in three cases, total maxillectomy with orbital preservation in two, and subtotal maxillectomy in three cases. A total of seven out of eight patients underwent reconstruction with free flap for defect closure; in one patient, only primary closure of mucosa was done. Results The mean follow-up was 20.5 months. Two patients with acute disease, where reconstruction was done, died in the postop period (on the 27th and 6th day post reconstruction, respectively) due to continuing infection and septic shock. One of the three (group 1), who presented acutely and underwent debridement alone, survived. Four of five patients in group 2 underwent successful free-flap reconstruction. The patient with free-flap loss was salvaged with an extracorporeal radial forearm flap. All except one patient had a soft-tissue free-flap reconstruction. Three of the six living patients reported for secondary surgery. The inability to achieve clear nonnecrotic surgical margins due to extensive disease was the reason for mortality in two patients in group 1. There was no mortality in any of the group 2 patients, even when debridement and free-flap coverage was done simultaneously. Conclusion Simultaneous debridement and free flap can be successfully implemented in select cases of facial mucormycosis

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