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251 results found

A new flap for the perinasal region

Perinasal defects are most commonly caused by tumour extirpation or trauma. There are a number of methods to reconstruct the defect, and the method chosen depends on the size of the defect and other patient considerations. When the defect is...

Identifying early flap failure

The holy grail of flap monitoring is an easy, reliable and predictive method to identify impending compromise. Does this paper provide it? Various methods have been used to improve our ability to monitor the viability of a flap and here...

Anaesthesia for free-flap surgery

Adel Hutchinson is one of those calm and controlled anaesthetists for whom nothing seems too difficult. In this article, she describes the key perioperative factors for one of the highest complexity operations in ENT; free-flap surgery. It makes good reading...

Risk factors in free flap failure

This is a retrospective analysis from China of 881 free flaps over nearly four years, 49 of which were ‘taken back’, 26 of which were lost, giving a 97% success rate. The commonest cause of flap failure was venous thrombosis....

The double-half bilobed flap or traditional bilobed flap: which is better?

Reconstruction of the nasal tip following ablative surgery can be taxing. The nasal tip is a very visible area with largely immovable skin and reconstruction needs an appreciation of the various subunits to achieve best results. The traditional superiorly based...

Nasolabial flap to reconstruct periorbital defects

The authors present a series of 25, mainly geriatric patients that had ablative surgery with complex defects in the paranasal and orbital regions. The paranasal and periorbital regions are extremely important for facial aesthetics and quality of life. The authors...

A new free flap for the head and neck?

Reconstruction of major defects in the head and neck is usually an area where maxillofacial or plastic surgery colleagues come to assist, with consideration of the size and function any repair has to fulfil. Whilst the radial forearm free flap...

A modification of the crescentic flap for nasal skin reconstruction

Non-melanoma skin cancers are the most frequent skin tumours and in over 25% of cases affect the nose. Following excision, the reconstruction may be challenging. Reconstruction aims to preserve the anatomical units, nasal functions and also an aesthetic final outcome....

Submental island flap to reconstruct the lower lip

The lips are necessary for oral competence, cosmesis, speech and feeding. Non-melanoma cancers can affect the lips, and the lower lips are about 80% more likely to be affected. A large number of these cancers are squamous cell carcinomas. Treatment...

Postauricular advancement flap for partial helix defect repair

Ear defects can be the result of trauma, burns or ablative surgery. The three dimensional structure of the pinna presents a difficult reconstructive challenge as successful ear reconstruction requires both similar tissue cover and a supporting framework. Partial ear reconstruction...

5-cm incision for neck dissection and free flap reconstruction

Patients with oral cavity squamous cell carcinoma (SCC) will commonly require neck dissection as it is associated with a higher rate of overall and disease free survival. Free flap reconstruction of the defect following surgical resection is considered the gold...

Endoscopic CSF leak repair using nasoseptal flap

Many of us during training or in established practice will have encountered the complication of anterior skull base CSF leak. This can be a challenging problem to deal with and in this article the authors describe their favoured approach. Cerebrospinal...