selection and review principles of reconstruction and secondary surgery for head and neck defects. In this article, we present an algorithm to guide choice of flap selection and review principles of reconstruction and secondary surgery for head and neck defects. A significant increase in the incidence of oropharyngeal cancer in the U.S. and other countries, especially among men, … Use of locoregional flaps in most cases will, not be sufficient to restore integrity and function for, many defects or may not be aesthetically pleasing. Comorbidities, postoperative complications, speech fluency, and time to speech fluency were evaluated in each patient. Issing PR, Kempf HG, Heppt W, Schönermark M, Lenarz T. Laryngorhinootologie. 3. As, an example, maxillary defects can be reconstructed using, an obturator or a purely soft tissue free flap such as a, scapular flap. Virtual planning and rapid prototype modeling are increasingly used in head and neck reconstruction with the aim of achieving superior surgical outcomes in functionally and aesthetically critical areas of the head and neck compared with conventional reconstruction. 2019 May;52(2):166-170. doi: 10.1055/s-0039-1693504. Key to success of surgery is choosing an appropriate reconstructive option based on the patient's wishes and fitness for major surgery. Key to achieving the, best long-term outcome is an optimal reconstructio. patients without other significant comorbidities. This reconstruction restored. Patient management following microsurgical flap failure includes strategic abandonment of reconstruction in some cases, use of conventional procedures in a majority of cases, and further microsurgical procedures in one-third of cases. Defects were classified according to their depth as unilaminar (type U = mucosa only), bilaminar (type B = mucosa and bone), or trilaminar (type T = mucosa, bone, and skin) and the number and side of mucosal zones involved (from 1 to 5). These have been utilized in the preoperative imaging of two patients undergoing ALT flap reconstruction. Wookey H. The surgical treatment of carcinoma of the, hypopharynx and the oesophagus. centers, this has become the flap of choice for skin and, soft tissue reconstruction in the head and neck, provid-, ing an unparalleled quantity of soft, supple tissue, with, a concealed donor site. Both techniques are technically feasible, highly accurate, and provide more information to the surgeon than ultrasound. In: Melville J., Shum J., Young S., Wong M. (eds) Regenerative Strategies for Maxillary and Mandibular Reconstruction. Patients with head and neck cancer may also have, undergone evaluation with direct laryngoscopy, bron-, choscopy, or esophagoscopy under anesthesia to assess, for spread of the lesion and synchronous lesions. Considerations in head and neck reconstruction recommend the use of a reverse reconstructive ladder, where the microsurgical free flap becomes the first choice for large or composite defects [14]. Post-burn upper, mid-face and nose reconstruction using a … Other options include, distally and transposed for venous drainage when no, flaps may be required, such as the use of a tubed ALT, flap for tracheal reconstruction in parastomal recurrence, Head and neck reconstruction is perhaps one of the most. Plast, flap for reconstruction in the head and neck. We retrospectively analyzed patients who underwent intraoral reconstruction surgery using radial forearm free flaps (RFFF) and anterolateral thigh free flaps (ALT) at a single institution to provide more information supporting the choice of a reconstruction method after removal of head and neck cancer.Methods The charts of 708 patients who underwent head and neck reconstruction between 1998 and 2018 at the Department of Plastic and Reconstructive Surgery at our institution were retrospectively reviewed. Natl Med J China 1981;61:139, circumflex iliac vessels as the supply for free groin flaps. Free jejunal flaps for esophageal, taneous flaps were later described for intraoral recon-, was reconstructed with a radial forearm flap, with neurotization of the lateral antebrachial cutaneous nerve using the, hypoglossal nerve. Define sub-site specific reconstructive aims; Understand criteria for selection of ideal free tissue transfer. Plast Reconstr Surg 1991;88:574–585; dis-, resource costs for head and neck reconstruction with free. Subsequent descriptions of the deltopectoral flap by, pharyngoesophageal reconstruction) were milestones, that allowed single-stage reconstruction of head and, neck defects with much greater success and less morbid-, ity. 2019 Jan;40(1):5-13. doi: 10.3174/ajnr.A5776. Feeding function was evaluated using the Functional Oral Intake Scale (FOIS).
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