Microvascular nose reconstruction after extended tumor resection.

2020 ◽  
Vol 92 (4) ◽  
pp. 1-5
Author(s):  
Łukasz Krakowczyk

Introduction: The nose is the central and probably the most important anatomical region of the face. Reconstructive surgery after tumor resection in this anatomical region requires from the surgeon knowledge of the anatomy, due to the three-dimensional shape and variety of tissues. Materials and methods: In the years 2010-2019, 48 patients were treated in the Oncological and Reconstructive Surgery Clinic for extended nasal tumors , who required the use of free microvascular flaps after resection for functional and aesthetic supply of anatomical structures of the nose. Results: In 48 patients, a total of 92 free microvascular flap were used for nasal reconstruction including: radial forearm free flap in 24 patients, radial forearm free flap with radial bone in 14 patients, auricle free flap in 16 patients, radial forearm free flap in combination with auricle free flap in 7 patients, double auricle free flap in 6 patients, radial forearm free flap in combination with double auricle free flap in 4 patients. Total necrosis of the free flap was noted in 4 cases, partial in 6 patients. Conclusions: Presented surgical techniques using the microvascular free flaps constitute a recognized method of treatment in the world and should be used in everyday surgeon practice. Discussion: In the reconstructive nose surgery after extended tumor resections due to cancer, there are no uniform treatment standards and algorithms . The surgeon is often dependent on his knowledge, skills and creative thinking . Presented results in this article allows to obtain optimal functional and aesthetic effects.

2009 ◽  
Vol 66 (4) ◽  
pp. 290-294
Author(s):  
Jelena Jeremic ◽  
Zivorad Nikolic ◽  
Lazar Drcic ◽  
Aleksandar Petrovic ◽  
Katarina Jeremic ◽  
...  

Background/Aim. Radial forearm free flap, highly regarded in head and neck reconstructive surgery, is known to be one of the most reliable and versatile flaps. The aim of this study was to illustrate the versatility and reliability of a radial forearm flap in reconstruction of a variety of extraoral head and neck defects. Methods. During a period 2001-2007 at the Clinic for Maxillofacial Surgery, Faculty of Dentistry and the Center for Burns, Plastic and Reconstructive Surgery in Belgrade, 19 patients underwent microsurgical reconstructions after extraoral tumor ablation in the head and neck region, using fasciocutaneous radial forearm free flap. Results. The overall flap survival rate was 89,5%. The complications that appeared were one partial necrosis and one venous thrombosis that in spite of reanastomosis resulted in a complete flap failure. The donor site healed uneventfully in all patients, except one, who had a partial skin graft failure, that ended in a secondary skin grafting. Conclusion. For reconstruction in head and neck surgery, with the need for thin, pliable tissues and a long vascular pedicle, radial forearm flap still remains a primary choice. Because of their multiple advantages, free flaps from the radial forearm is a safe method for reconstruction of a variety of extensive extraoral soft tissue defects in the head and neck region.


2014 ◽  
Vol 2014 (nov26 1) ◽  
pp. bcr2014207147-bcr2014207147 ◽  
Author(s):  
A. M. Moore ◽  
J. Montgomery ◽  
J. McMahon ◽  
S. Sheikh

2017 ◽  
Vol 156 (5) ◽  
pp. 822-827 ◽  
Author(s):  
Rémi Foissac ◽  
Marc Benatar ◽  
Olivier Dassonville ◽  
Alexandre Bozec ◽  
Gilles Poissonnet ◽  
...  

Objective This study was designed to assess the effectiveness of an alternative technique using a perforator flap to manage secondary tendon exposure after a radial forearm free flap in head and neck oncologic surgery. Study Design Prospective cohort study. Setting Plastic Reconstructive Surgery Unit, Nice University Hospital, Pasteur 2 Hospital, France. Subjects and Methods Despite its numerous advantages, the radial forearm free flap is associated with significant donor site morbidity and the risk of secondary tendon exposure. Conventional skin grafts for secondary tendon exposure can lead to diminished wrist range of motion and grip strength, with residual pain and cold intolerance. Between 2012 and 2015, we prospectively studied 20 patients with secondary tendon exposure after a forearm radial free flap for head and neck reconstruction. Two techniques of secondary coverage were compared: a reference technique with a secondary full skin graft (10 patients) and a dorsoulnar artery perforator (DUAP) flap (10 patients). Results Maximum wrist extension (100%) was observed for the DUAP group compared with only 87% for the skin graft (SG) group ( P = .001). An improvement in grip strength (+14 kg) ( P = .028) and a decrease in pain or cold intolerance ( P = .002) were also observed in the DUAP group, in addition to a better aesthetic appearance. Conclusion The perforator flap procedure is an interesting tool in reconstructive surgery. The DUAP flap is a reliable, useful flap for secondary tendon exposure coverage after a radial forearm free flap. Level of Evidence III (case-control analytic studies of 1 center).


1994 ◽  
Vol 47 (6) ◽  
pp. 419-421 ◽  
Author(s):  
D.M. Evans ◽  
E.B. Chevretton ◽  
R.P. Cole ◽  
J.A. Pereira ◽  
G.A.J. Morrison

2007 ◽  
Vol 52 (2) ◽  
pp. 547-554 ◽  
Author(s):  
Jörg Dabernig ◽  
Odhran P. Shelley ◽  
Guiseppe Cuccia ◽  
Jürgen Schaff

Head & Neck ◽  
2015 ◽  
Vol 38 (3) ◽  
pp. 434-438 ◽  
Author(s):  
Dustin A. Silverman ◽  
Wojciech H. Przylecki ◽  
Jill M. Arganbright ◽  
Yelizaveta Shnayder ◽  
Kiran Kakarala ◽  
...  

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