scholarly journals Significance of vesicles in flap monitoring in oral cancer surgery: Report of two cases

2021 ◽  
Vol 7 (1) ◽  
pp. 5
Author(s):  
Yuki Sakamoto ◽  
Souichi Yanamoto ◽  
Masahiro Umeda
Keyword(s):  
Oral Cancer ◽  
Head And Neck ◽  
Success Rate ◽  
Free Flap ◽  
Cancer Surgery ◽  
Vesicle Formation ◽  
Flap Necrosis ◽  
Oncologic Surgery ◽  
Flap Monitoring ◽  
Short Time

The success rate of vascularized free flap transplantation in head and neck oncologic surgery is high, ranging from 94% to 98.8%; however, flap necrosis sometimes occurs after surgery. When vessel-related complications occur, flap necrosis proceeds rapidly. Thus, flap monitoring after surgery is especially important. We recently treated two patients with flap-related complications. A vesicle appeared on the surface of the flap and enlarged within a short time; the flap’s color changed to purple, and a reoperation was eventually performed. While there are approaches to monitor flaps, this is the first report suggesting the assessment of vesicle formation for flap monitoring, since the vesicles occur several hours before changes in the flap color.

Review of Flap Monitoring Technology in 2020

2020 ◽  
Vol 36 (06) ◽  
pp. 722-726
Author(s):  
Adam Jacobson ◽  
Oriana Cohen
Keyword(s):  
Head And Neck ◽  
Free Flap ◽  
Loss Rate ◽  
Early Recognition ◽  
Postoperative Patient ◽  
Free Flap Monitoring ◽  
Improved Outcomes ◽  
Vascular Compromise ◽  
Flap Monitoring ◽  
Multiple Levels

AbstractAdvances in free flap reconstruction of complex head and neck defects have allowed for improved outcomes in the management of head and neck cancer. Technical refinements have decreased flap loss rate to less than 4%. However, the potential for flap failure exists at multiple levels, ranging from flap harvest and inset to pedicle lay and postoperative patient and positioning factors. While conventional methods of free flap monitoring (reliant on physical examination) remain the most frequently used, additional adjunctive methods have been developed. Herein we describe the various modalities of both invasive and noninvasive free flap monitoring available to date. Still, further prospective studies are needed to compare the various invasive and noninvasive technologies and to propel innovations to support the early recognition of vascular compromise with the goal of even greater rates of flap salvage.

scholarly journals Optimal Perioperative Care in Major Head and Neck Cancer Surgery With Free Flap Reconstruction

2017 ◽  
Vol 143 (3) ◽  
pp. 292 ◽  
Author(s):  
Joseph C. Dort ◽  
D. Gregory Farwell ◽  
Merran Findlay ◽  
Gerhard F. Huber ◽  
Paul Kerr ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Free Flap ◽  
Perioperative Care ◽  
Cancer Surgery ◽  
Flap Reconstruction ◽  
Free Flap Reconstruction

scholarly journals Reconstruction with free flaps in robotic head-and-neck onco-surgeries

2018 ◽  
Vol 51 (03) ◽  
pp. 283-289 ◽  
Author(s):  
Rajan Arora ◽  
Vinay Kumar Verma ◽  
Kripa Shanker Mishra ◽  
Hemant Bhoye ◽  
Rahul Kapoor
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Dissection ◽  
Neck Cancer ◽  
Free Flap ◽  
Free Flaps ◽  
Cancer Surgery ◽  
Flap Reconstruction ◽  
Free Flap Reconstruction ◽  
Good Outcome

ABSTRACT Aims and Objective: The aim of the present article is to highlight how reconstruction with free flaps is different and difficult in cases with robotic head-and-neck cancer surgery. It also highlights the technical guidelines on how to manage the difficulties. Materials and Methods: Eleven patients with oropharyngeal cancer having undergone tumour excision followed by free-flap reconstruction been reviewed here. Nine patients had tumour excision done robotically through intraoral route while neck dissection done with transverse neck crease incision. There is a problem of difficult flap inset in this group of patient. Two patients had intraoral excision of tumour followed by robotic neck dissection via retroauricular incision. With no incision directly on the neck, microvascular anastomosis is challenging in this set of patients. Free flap was used in all the cases to reconstruct the defect. Results: Successful reconstruction with free flap was done in all the cases with good outcome both functionally and aesthetically. Conclusion: Free-flap reconstruction is possible in robotic head-and-neck cancer surgery despite small and difficult access, but it does need practice and some technical modifications for good outcome.

Implantable Doppler Removal After Free Flap Monitoring Among Head and Neck Microvascular Surgeons

2021 ◽  
Author(s):  
Adrian A. Ong ◽  
Yadranko Ducic ◽  
Patrik Pipkorn ◽  
Mark K. Wax
Keyword(s):  
Head And Neck ◽  
Free Flap ◽  
Free Flap Monitoring ◽  
Flap Monitoring

scholarly journals Pectoralis major myocutaneous flap in salvage reconstruction following free flap failure in head and neck cancer surgery

2018 ◽  
Vol 47 (1) ◽  
pp. 76-83 ◽  
Author(s):  
Wei Wei ◽  
Yongsheng Qiu ◽  
Qigen Fang ◽  
Yingping Jia
Keyword(s):  
Quality Of Life ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Free Flap ◽  
Cancer Surgery ◽  
Pectoralis Major ◽  
Primary Group ◽  
Flap Failure

Objective This study aimed to compare the results of the pectoralis major myocutaneous (PMM) flap in primary and salvage head and neck cancer surgery. Methods A total of 160 patients were enrolled in this study. The salvage group consisted of 30 patients who received immediate PMM flap surgery following free flap failure. In the primary group, the PMM flap was primarily chosen for 130 patients. Related information was collected and analysed. The University of Washington (UW)-Quality of Life questionnaire, version 4, was mailed to every patient. Results Partial necrosis was significantly lower in the primary group (n = 13, 10.0%) than in the salvage group (n = 7, 23.3%). Surgical site infection was found in 10 (7.8%) patients in the primary group and in six (20.0%) patients in the salvage group. The mean composite quality of life scores were 66.8 ± 20.5 and 66.2 ± 22.1 in the two groups, respectively. Differences in scores for domains of activity, mood, and anxiety were significant. Disease-specific survival and recurrence-free survival rates were not different between the two groups. Conclusion PMM flap salvage reconstruction has a higher complication rate and poorer functional results, but similar survival prognosis, compared with primary surgery.

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