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274 results found

Risks of tracheostomy in head and neck cancer

Tracheostomy is associated with several complications, with rates quoted as high as 8-45%, including: bleeding; displacement; obstruction; surgical emphysema; pneumothorax; fistulae and failure to decannulate. There are now many studies that confirm the increased length of stay and complications of...

Facial reconstruction with polyethylene implants

Planning reconstructive surgery for complex craniofacial defects challenges even the most experienced of surgeons. In most cases surgery is undertaken to improve anatomical functioning. However the anatomical structure of these regions is also critical to facial aesthetics and patient satisfaction...

Head and Neck: Dissection and Reconstruction Manual

The ‘Head and Neck Dissection and Reconstruction Manual’ is compiled by the Chinese University of Hong Kong (CUHK) Head and Neck Course faculty and edited by Professor A Van Hasselt and E Wong. The Manual is specifically aimed at ENT...

Patient reported outcomes following total laryngectomy using the Swallowing Outcomes After Laryngectomy (SOAL) questionnaire

Following a total laryngectomy, alterations in the pharyngeal musculature and changes in the pharyngo-oesophageal segment due to reconstruction, results in altered bolus transit. Swallowing dysfunction after total laryngectomy for head and neck squamous cell carcinoma can vary from 10%-90%. There...

Harvesting the flexor hallucis longus: what is the increased morbidity?

The free fibula flap is now widely used in clinical applications for microvascular reconstruction and occasionally, to add bulk, the flexor hallucis longus (FHL) muscle is harvested along with the fibula. The post-operative morbidity is usually described as mild and...

Microvascular surgery - does size matter

Success rates for microvascular free tissue transfer performed for head and neck reconstruction are currently very high. As the recipient vessel diameter decreases, questions of reliability and ease of access are raised. This retrospective analysis looked at 89 flaps in...

Free flap reconstruction in stage three bisphosphonate-related osteonecrosis

There is no widely accepted gold standard for the treatment of bisphosphonate-related osteonecrosis of the jaw (BRONJ). Early BRONJ is managed conservatively but there is controversy regarding the treatment of the later stages. Stage three is defined as exposed bone...

Polydioxanone in septal reconstruction

Septal reconstruction is a challenging problem and is undertaken for functional or cosmetic reasons, or a combination of both. Either autologous cartilage, commonly auricular, or other alloplastic material can be used. The authors describe the use of a Polydioxanone (PDS)...

Speech predictors after glossectomy

This is a cross-sectional study from India where 69 patients were assessed for speech intelligibility and phonetics using an assessment tool in the local language. Volume defects were classified into thirds and the location of this defect noted. Not unsurprisingly,...

Rib grafts for mandibular reconstruction

Reconstruction of the mandible following ablation requires good bone stock to allow optimal function and the placement of dental implants. In the developed world, vascularised bony flaps are accepted as the gold standard but these may not be widely available...

Peripheral nerve reconstruction using cell-enhanced acellular nerve grafts

Autologous nerve grafts are the current gold standard for peripheral nerve reconstruction. This systematic review analyses the role of cell-enhanced acellular nerve (ANA) grafts on the regeneration of peripheral nerve injuries. Several studies have been published to examine alternatives to...

Delirium post-op

This is a retrospective study from Japan analysing 102 patients who underwent oral cancer resection and free flap reconstruction. Postoperative delirium occurred in a third of these patients. An increased risk was identified in those with high preoperative albumin, postoperative...