Palatomaxillary Obturation and Facial Prosthetics in Head and Neck Reconstruction

2020 ◽  
Vol 36 (06) ◽  
pp. 715-721
Author(s):  
Weitao Wang ◽  
Tom Shokri ◽  
Aurora Vincent ◽  
Allison Vest ◽  
Fayette Williams ◽  
...  

AbstractRehabilitation of head and neck defects following trauma, oncologic resection, or congenital malformation is a challenging task. Not only is the restoration of three-dimensional form necessary for acceptable cosmesis, but simultaneous restoration of functional speech and swallow is also essential for optimal reconstruction outcomes. While advances in free tissue transfer have allowed surgical reconstruction of head and neck defects once considered inoperable and associated with poor quality of life, not all patients are ideal surgical candidates. As such, nonsurgical solutions to both functional and cosmetic restoration remain a necessary alternative option. Facial prostheses and palatomaxillary obturators have evolved with increasingly biocompatible materials as well as retention systems to address significant defects that challenge the limits of surgical reconstruction.

2013 ◽  
Vol 40 (2) ◽  
pp. 341-349 ◽  
Author(s):  
Claudia R. Albornoz ◽  
Andrea L. Pusic ◽  
Patrick Reavey ◽  
Amie M. Scott ◽  
Anne F. Klassen ◽  
...  

2008 ◽  
Vol 118 (5) ◽  
pp. 874-880 ◽  
Author(s):  
Alexandre Bozec ◽  
Gilles Poissonnet ◽  
Emmanuel Chamorey ◽  
Cédric Casanova ◽  
Jacques Vallicioni ◽  
...  

2019 ◽  
Vol 39 (3) ◽  
pp. 145-149 ◽  
Author(s):  
A. Ferri ◽  
E. Segna ◽  
A. Varazzani ◽  
C. Copelli ◽  
S. Valsecchi ◽  
...  

2018 ◽  
Vol 132 (2) ◽  
pp. 180-183 ◽  
Author(s):  
J Mark ◽  
H Patwa ◽  
M S Costello ◽  
Y Patil

AbstractBackground:The ablation of advanced head and neck cancer often results in large three-dimensional defects that require free tissue transfer to optimally address functional and cosmetic issues. The subscapular system is a highly versatile donor site for flaps used for head and neck reconstruction. Traditional methods of harvesting subscapular flaps require repositioning and re-preparing, which significantly increases the operative time and prevents simultaneous harvesting of the flap.Method:This paper presents our experience of a single-stage ‘sit and tilt’ technique, which provides a convenient method for harvesting subscapular system free flaps without significant repositioning.Results and conclusion:This technique was used for a variety of head and neck defects, and body habitus did not seem to affect free tissue harvesting. It is hoped that utilisation of this preparation and harvesting technique will make head and neck surgeons more willing to take advantage of the subscapular system.


Author(s):  
Mark K. Wax ◽  
Larry L. Myers ◽  
Peter E. Andersen ◽  
James I. Cohen

2021 ◽  
Vol 54 (02) ◽  
pp. 118-123
Author(s):  
Rajan Arora ◽  
Kripa Shanker Mishra ◽  
Hemant T. Bhoye ◽  
Ajay Kumar Dewan ◽  
Ravi K. Singh ◽  
...  

Abstract Background There is a steep learning curve to attain a consistently good result in microvascular surgery. The venous anastomosis is a critical step in free-tissue transfer. The margin of error is less and the outcome depends on the surgeon’s skill and technique. Mechanical anastomotic coupling device (MACD) has been proven to be an effective alternative to hand-sewn (HS) technique for venous anastomosis, as it requires lesser skill. However, its feasibility of application in emerging economy countries is yet to be established. Material and Method We retrospectively analyzed the data of patients who underwent free-tissue transfer for head and neck reconstruction between July 2015 and October 2020. Based on the technique used for the venous anastomosis, the patients were divided into an HS technique and MACD group. Patient characteristics and outcomes were measured. Result A total of 1694 venous anastomoses were performed during the study period. There were 966 patients in the HS technique group and 719 in the MACD group. There was no statistically significant difference between the two groups in terms of age, sex, prior radiotherapy, prior surgery, and comorbidities. Venous thrombosis was noted in 62 (6.4%) patients in the HS technique group and 7 (0.97%) in the MACD group (p = 0.000). The mean time taken for venous anastomosis in the HS group was 17 ± 4 minutes, and in the MACD group, it was 5 ± 2 minutes (p = 0.0001). Twenty-five (2.56%) patients in the HS group and 4 (0.55%) patients in MACD group had flap loss (p = 0.001). Conclusion MACD is an effective alternative for HS technique for venous anastomosis. There is a significant reduction in anastomosis time, flap loss, and return to operation theater due to venous thrombosis. MACD reduces the surgeon’s strain, especially in a high-volume center. Prospective randomized studies including economic analysis are required to prove the cost-effectiveness of coupler devices.


Sign in / Sign up

Export Citation Format

Share Document