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...
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....
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...
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...
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...
This is a systematic review from surgeons in Italy and Florida where, from an initial 799 potentially relevant articles, only six could be included. Efficiency was assessed by the mean ischemia time which, for the virtual group, was 73.8 minutes,...
Microvascular free flaps are commonly used in reconstruction for head and neck defects. Failures of these flaps, however, are associated with a significant morbidity and mortality. Flap failures within the first 72 hours are commonly attributed to technical failure of...
The topic of this systematic review is one which is commonly heard in discussions between microbiologists and head and neck surgeons – what is the evidence for antibiotic prophylaxis in clean-contaminated free-flap cases, and crucially, how long should antibiotics be...
This paper from Beijing looked at 68 patients, 34 in a control group and 34 in an intervention group. Oral exercise training was performed by a specialist swallowing nurse in the intervention group. They found that personalised oral exercises had...
Free flap reconstruction is the gold standard in tongue reconstruction, aiming to restore function such as swallowing, cosmesis and speech. The anterolateral thigh cutaneous flap and the radial forearm free flap are among the most popular free flaps used for...