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Functional considerations in reconstruction after laryngectomy
With a plethora of different reconstructive options and techniques available after laryngectomy, it can be difficult to clearly see which give the lowest complication rates and best functional outcomes. This article aims to summarise the current evidence in swallowing and...
Surgical management of refractory osteoradionecrosis
This is a French single-centre, 10-year experience of 55 surgical resection and reconstruction procedures. They claim an overall effectiveness rate of 92.3%. A total of 36 segmental and 19 marginal mandibulectomies were performed. A variety of free flaps were used,...
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...
Reconstruction with scapular tip following hemimaxillectomy and rehabilitation with dental implants
Post ablative defects in the maxilla can be extremely complex, involve all three dimensions and may result in significant morbidity. Rehabilitation may be difficult with either an obturator or surgical reconstruction with a free fibula, Iliac crest or scapula. This...Partial reconstruction of the pinna
Reconstruction of the pinna is one of the most challenging procedures in facial plastic surgery. Although there has been significant progress since one of the earliest recorded descriptions by Sushruta in 600 BC, the complex three-dimensional structure of the pinna...Global health missions – not just for consultants. A guide for trainees.
Lulu Ritchie is a courageous and driven trainee in London, inspired by humanitarian missions but conscious of the usual requests for consultant level doctors. Lulu didn’t let that hold her back. She found a way and has kindly summarised her...
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...
Promising surgical technique for pulsatile tinnitus caused by sigmoid sinus dehiscence?
Pulsatile tinnitus (PT) can be caused by sigmoid sinus dehiscence (SSD). The authors report the results of 17 patients who underwent sandwich surgical technique for sigmoid sinus (SS) wall reconstruction for the treatment of pulsatile tinnitus caused by sigmoid sinus...
Deglutition in pharyngolaryngectomy patients
Circular defects after total pharyngolaryngectomy present a reconstructive challenge. In this study, the authors compared the swallowing results after three reconstructive techniques: free forearm flap, free jejunal loop and folded pectoralis major flap. Forty-six patients were included and were evaluated...
Multi-layered repair of lateral sphenoid CSF rhinorrhoea
This case series describes the author’s results with repairing lateral sphenoid encephalocoeles in seven patients. Alloderm inlay with abdominal fat onlay and nasoseptal flap onlay repair resulted in a 100% success rate with no recurrence of cerebrospinal fluid (CSF) rhinorrhoea,...
A move away from bony free flaps in reconstruction
Techniques for facial reconstruction have come on in leaps and bounds since the world wars. The use of titanium implants is more recent and the technology for manipulating the metal and how we use it is rapidly developing. Here the...
