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Oh MS, Vettikattu NT, Baddour HM, Gross JH, Boyce BJ, Patel MR, Schmitt NC, Arturo Solares C, Vuncannon JR, Kaka AS. Submental Island Flaps for Lateral Reconstruction: Technical Refinements for Optimal Outcomes and Resource Efficiency. OTO Open 2024; 8:e131. [PMID: 38618288 PMCID: PMC11015144 DOI: 10.1002/oto2.131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 01/02/2024] [Accepted: 02/05/2024] [Indexed: 04/16/2024] Open
Abstract
Objective To describe our modifications to the submental island flap (SMIF) in a case series that demonstrates improved reproducibility, shortened length of stay (LOS), and reduced utilization of hospital resources. Study Design This retrospective case series with chart review included adult patients who underwent resection of malignant or benign tumors resulting in lateral facial, parotid, or temporal bone defects, which were reconstructed with SMIF. Setting A tertiary-care academic referral center. Methods Retrospective case series included all adult patients who underwent SMIF reconstruction between March 2020 and August 2021. Patient demographic and clinical data were collected. Primary outcomes were measures of hospital utilization including duration of surgery, LOS, and postoperative outcomes. Results Twenty-eight patients were included with a mean age of 71.7 years. Eighty percent were male. All patients underwent parotidectomy, and the mean operative time was 347 minutes. The median LOS was 2.5 days (range 0-16 days). Seventy-five percent of the flaps drained into the internal jugular vein, and 25% drained into the external jugular vein. No patients required reoperation or readmission. All flaps survived. Conclusion SMIFs are a safe and effective option for reconstruction of lateral facial, parotid, and temporal bone defects. Compared to free flap reconstruction, SMIFs offer reduced length of surgery, decreased use of health care resources, and lower rate of reoperation. As health care resource allocation is increasingly important, the SMIF offers an excellent alternative to free flap reconstruction of lateral defects.
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Affiliation(s)
- Melissa S. Oh
- Department of Otolaryngology–Head and Neck Surgery, Division of Head and Neck Oncology and ReconstructionEmory University School of MedicineAtlantaGeorgiaUSA
| | - Nikhil T. Vettikattu
- Department of Otolaryngology–Head and Neck Surgery, Division of Head and Neck Oncology and ReconstructionEmory University School of MedicineAtlantaGeorgiaUSA
| | - Harry Michael Baddour
- Department of Otolaryngology–Head and Neck Surgery, Division of Head and Neck Oncology and ReconstructionEmory University School of MedicineAtlantaGeorgiaUSA
| | - Jennifer H. Gross
- Department of Otolaryngology–Head and Neck Surgery, Division of Head and Neck Oncology and ReconstructionEmory University School of MedicineAtlantaGeorgiaUSA
| | - Brian J. Boyce
- Department of Otolaryngology–Head and Neck Surgery, Division of Head and Neck Oncology and ReconstructionEmory University School of MedicineAtlantaGeorgiaUSA
| | - Mihir R. Patel
- Department of Otolaryngology–Head and Neck Surgery, Division of Head and Neck Oncology and ReconstructionEmory University School of MedicineAtlantaGeorgiaUSA
| | - Nicole C. Schmitt
- Department of Otolaryngology–Head and Neck Surgery, Division of Head and Neck Oncology and ReconstructionEmory University School of MedicineAtlantaGeorgiaUSA
| | - Clementino Arturo Solares
- Department of Otolaryngology–Head and Neck Surgery, Division of Head and Neck Oncology and ReconstructionEmory University School of MedicineAtlantaGeorgiaUSA
| | - Jackson R. Vuncannon
- Department of Otolaryngology–Head and Neck Surgery, Division of Head and Neck Oncology and ReconstructionEmory University School of MedicineAtlantaGeorgiaUSA
| | - Azeem S. Kaka
- Department of Otolaryngology–Head and Neck Surgery, Division of Head and Neck Oncology and ReconstructionEmory University School of MedicineAtlantaGeorgiaUSA
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Li J, Zhang S, Ouyang D, Zeng L, Qiao Y, Deng W, Liao G, Liang Y. Favorable effects of open surgery on patients with extensive skull base osteoradionecrosis through a personalized sequential approach: A case series. J Craniomaxillofac Surg 2024; 52:302-309. [PMID: 38368207 DOI: 10.1016/j.jcms.2024.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 11/04/2023] [Accepted: 01/16/2024] [Indexed: 02/19/2024] Open
Abstract
The present study aimed to investigate outcomes following open surgery for extensive skull base ORN. Open surgery through a personalized sequential approach was employed to deal with five cases of extensive skull base ORN. Two patients with mild cases underwent regional debridement and sequestrectomy, and three patients with severe cases underwent extensive resection with reconstruction using free anterolateral thigh (ALT) flap. Biological glues and vascularized flaps were used for obturation of the skull base bony defect to prevent postoperative cerebrospinal fluid (CSF) leakage. The infections were controlled by antibiotic administrations which strictly followed the principles of antimicrobial stewardship (AMS). As results, both regional debridement plus sequestrectomy and extensive resection achieved satisfied outcomes in all patients. No severe complications and delayed hospitalization occurred. During the follow-up period (8-19 months), all patients were alive, pain free, without crusting or purulent discharge, and no sequestration or CSF leakage occurred. In conclusion, a personalized sequential approach including open surgery, pedicled/vascularized free flap reconstruction and AMS was advocated for patients with extensive skull base ORN.
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Affiliation(s)
- Jingyuan Li
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China; Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China
| | - Sien Zhang
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China; Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China
| | - Daiqiao Ouyang
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China; Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China
| | - Lijuan Zeng
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China; Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China
| | - Yongjie Qiao
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China; Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China
| | - Wei Deng
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China; Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China
| | - Guiqing Liao
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China; Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China.
| | - Yujie Liang
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China; Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China.
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Kejner AE, Lee BJ, Pipkorn P. Lateral Skull Base and Auricular Reconstruction. Otolaryngol Clin North Am 2023:S0030-6665(23)00073-7. [PMID: 37258407 DOI: 10.1016/j.otc.2023.04.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Reconstruction of the lateral temporal bone with adequate functional and cosmetic outcomes depends on a multidisciplinary approach including the head and neck surgeon, reconstructive surgeon, neurotologist, and anaplastologist. Approaching the defect includes consideration of the location, tissue type, function, and patient/tumor characteristics. Anatomic limitations due to prior therapy also play an important role in reconstructive choices. Here, we review contemporary literature regarding the reconstruction of this complex region.
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Affiliation(s)
- Alexandra E Kejner
- Division of Head & Neck Surgery, Medical University of South Carolina, 135 Rutledge Avenue MSC 550, Charleston, SC 29436, USA.
| | - Byung Joo Lee
- Division of Maxillofacial Prosthodontics, MUSC 135 Rutledge Avenue MSC 550, Charleston, SC 29436, USA
| | - Patrik Pipkorn
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8115, St. Louis, MO 63110, USA
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4
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Hennocq Q, Boccara D. Description of the Pedicled Osteo-Muscular Flap of Split Temporal Muscle. J Maxillofac Oral Surg 2023. [DOI: 10.1007/s12663-023-01910-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2023] Open
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Liu HJ, Li DZ, Li XJ, Qian HP, An CM, Wan JH. Free Flap Transfer, a Safe and Efficient Method for Reconstruction of Composite Skull Base Defects After Salvage Resection of Advanced Intracranial and Extracranial Communicating Tumors. World Neurosurg 2021; 152:e62-e70. [PMID: 33940259 DOI: 10.1016/j.wneu.2021.04.084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 04/21/2021] [Accepted: 04/21/2021] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Surgical treatment of advanced intracranial and extracranial communicating skull base tumors is challenging, especially for the reconstruction of the large composite defect left by tumor resection. The aim of the study is to evaluate the utility of the free flap reconstruction of the defects resulting from radical resection of these tumors in a single institution. METHODS The clinical data of 17 consecutive patients who underwent free flap reconstruction for defect left by salvage resection of advanced intracranial and extracranial communicating tumors from 2013 to 2019 were retrospectively collected and analyzed. RESULTS There were 5 squamous cell carcinomas, 4 adenoid cystic carcinomas, 2 basal cell carcinomas, 2 meningiomas, 1 anaplastic hemangiopericytoma, 1 pleomorphic adenoma, 1 osteosarcoma, and 1 chondrosarcoma. All patients had recurrent neoplasms, 2 of whom had pulmonary metastasis. A modified radical cervical dissection was performed in 6 patients. The anterolateral thigh myocutaneous flap and rectus abdominis myocutaneous flap were used in 15 patients (88.2%) and 2 patients (11.8%), respectively. Complications were seen in 3 of 17 patients (17.6%) with 1 total flap loss. The median progression-free survival duration was 31 months. The 3- and 5-year progression-free survival rates were 0.47 and 0.24, respectively. The mean overall survival duration was 66 months. The 3- and 5-year overall survival rates were 0.85 and 0.68, respectively. CONCLUSIONS Free flap transfer is a safe and effective method with acceptable complications, useful for reconstruction of large composite skull base defects after salvage resection of advanced intracranial and extracranial communicating tumors. The functional and cosmetic results are satisfying.
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Affiliation(s)
- Hou-Jie Liu
- Department of Neurosurgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - De-Zhi Li
- Department of Head and Neck Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Xue-Ji Li
- Department of Neurosurgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Hai-Peng Qian
- Department of Neurosurgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Chang-Ming An
- Department of Head and Neck Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Jing-Hai Wan
- Department of Neurosurgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China.
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Kent SL, Kim Y, Perez H, Frank E, Gentry V, LaTour D, Inman J. Consideration in Microvascular Reconstruction during Times of Social Crises: Perspectives on Resource Utilization. Facial Plast Surg 2020; 36:768-772. [PMID: 33368134 DOI: 10.1055/s-0040-1721811] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
Reconstruction of head and neck surgical defects can be a complicated, costly process. While the era of cost-effective medicine has begun to broadly question the necessity of high-cost care, times of extraordinary sociomedical demand bring increased scrutiny to even routine costs and resource utilization. Within this context, we reviewed the advantages, drawbacks, and financial costs of both regional and free flap reconstructions, namely the decreased costs and hospital resource utilization that may be associated with reconstruction using regional flaps. Although beset by reports of partial necrosis in certain regional flaps-particularly the submental island, cervicofacial advancement, and supraclavicular artery island flaps-many reports have demonstrated complication and flap failure rates equivalent to those of free flaps. Additionally, regional flaps have been associated with decreased costs for hospital stay, most notably in cases of postoperative complications. In cases necessitating free flap reconstruction, cost-savings strategies such as bypassing postoperative intensive care unit admissions have been shown to provide satisfactory, safe outcomes. As the head and neck surgeon continues to adapt to the medical pressures of a global pandemic, resource-sparing approaches to oncologic care will persist in their newfound importance.
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Affiliation(s)
- Sean Lloyd Kent
- Department of Otolaryngology, Loma Linda University, Loma Linda, California
| | - Yohanan Kim
- Department of Otolaryngology, Loma Linda University, Loma Linda, California
| | - Hector Perez
- Department of Otolaryngology, Loma Linda University, Loma Linda, California
| | - Ethan Frank
- Department of Otolaryngology, Loma Linda University, Loma Linda, California
| | - Vance Gentry
- Department of Otolaryngology, Loma Linda University, Loma Linda, California
| | - Donn LaTour
- Department of Otolaryngology, Loma Linda University, Loma Linda, California
| | - Jared Inman
- Department of Otolaryngology, Loma Linda University, Loma Linda, California
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Herr MW, Vincent AG, Skotnicki MA, Ducic Y, Manolidis S. Radiation Necrosis of the Lateral Skull Base and Temporal Bone. Semin Plast Surg 2020; 34:265-271. [PMID: 33380912 DOI: 10.1055/s-0040-1721763] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Radiation therapy plays a critical role in the treatment of malignancies involving the head and neck. Although the therapeutic effects of ionizing radiation are achieved, normal tissues are also susceptible to injury and significant long-term sequelae. Osteoradionecrosis of the temporal bone (ORNTB) is among the many complications that can arise after therapy. ORNTB is a debilitating and potentially lethal condition that continues to challenge patients and treating physicians. Herein, we review the pathophysiology, presentation, work-up, and management of ORNTB.
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Affiliation(s)
- Marc W Herr
- Department of Head and Neck Oncologic Surgery & Microvascular Reconstruction, Madigan Army Medical Center, Tacoma, Washington
| | | | - Meghan A Skotnicki
- Department of Otolaryngology - Head and Neck Surgery, Kettering Health Network, Dayton, Ohio
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[Reconstruction by thoracodorsal perforator flap after petrosectomy]. ANN CHIR PLAST ESTH 2020; 66:100-105. [PMID: 32527620 DOI: 10.1016/j.anplas.2020.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 04/18/2020] [Accepted: 04/22/2020] [Indexed: 11/24/2022]
Abstract
Petrosectomy is a debilitating intervention, consisting of a resection of the bone forming the external auditory canal, the middle ear and sometimes the internal ear as well. The cavity formed after this surgery can lead to infectious complications. Reconstruction is an essential element for patients' rehabilitation. Most cases require local rotation flaps such as temporal muscle flap. However, when the remaining defect is too large or when the structures have been altered by radiotherapy, free flaps are the most adequate solution for repair. Upon review of the literature, there are very few articles providing options regarding reconstruction possibilities post-petrosectomy. Plastic surgeons are often unfamiliar with this indication, therefore, it is essential to call their attention in order to provide the best options of care in these difficult and complicated cases where possibilities are limited. That is why, it is important for us to share our experience in this domain through the example of our patient presenting with a large osteoradionecroses of the petrous bone, requiring resection and immediate reconstruction using a free flap.
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9
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Hanasono MM. Reconstruction after open surgery for skull-base malignancies. J Neurooncol 2020; 150:469-475. [DOI: 10.1007/s11060-019-03370-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Accepted: 12/11/2019] [Indexed: 01/20/2023]
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10
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Radial Forearm Free Flap for Cochlear Implant Coverage in a Post-Irradiated Field. Otol Neurotol 2020; 41:192-195. [DOI: 10.1097/mao.0000000000002468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abstract
The aim of the study is to discuss the current management options for intra- and extra-cranial communication giant cell tumor of the lateral skull base and perform a review of the literature. A total of 6 patients with giant cell tumor of the lateral skull base were retrospectively enrolled in the study. The principal complaints, imaging manifestations, surgical resection and reconstruction of intra- and extra-cranial communication defects for the diseases were discussed. There were 2 males and 4 females. The most of principal complaints were discomfort or pain in the temporomandibular joint in 5 cases (83.3%). Imaging examination showed invasion of the temporal bone alone in 3 cases (50.0%) and both temporal bone and sphenoid bone involvement in 3 cases (50.0%). C-shaped preauricular infratemporal fossa approach was used for tumour removal and gross total resection was done in all 6 cases. The pedicled temporal muscle fascial flap was used to reconstruct the intra- and extra-cranial communication defect of the lateral skull base. The conclusion is that giant cell tumor is a benign tumor but is also locally aggressive. Gross total resection is the most commonly recommended treatment choice for giant cell tumor of the skull and can achieve good treatment outcomes. The temporalis muscle flap is a good alternative choice for reconstruction of the defect.
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Patel AV, Thuener JE, Clancy K, Ascha M, Manzoor NF, Zender CA. Submental artery island flap versus free flap reconstruction of lateral facial soft tissue and parotidectomy defects: Comparison of outcomes and patient factors. Oral Oncol 2018; 78:194-199. [DOI: 10.1016/j.oraloncology.2018.01.027] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Revised: 12/22/2017] [Accepted: 01/28/2018] [Indexed: 10/18/2022]
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Goodarzi A, Ahmadpour A, Toussi A, Shahlaie K. A Multilayered Technique for Repair of the Suboccipital Retrosigmoid Craniotomy. J Neurol Surg B Skull Base 2018; 79:508-514. [PMID: 30210980 DOI: 10.1055/s-0038-1625976] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Accepted: 12/02/2017] [Indexed: 10/17/2022] Open
Abstract
Objective Our primary objective was to retrospectively review our single institution experience using an anatomic multilayered repair of the retrosigmoid suboccipital craniotomy. Our secondary objective was to review the existing body of literature on the repair of this craniotomy and compare our outcomes to previous results. Design Retrospective review of 25 consecutive patients undergoing repair for the retrosigmoid craniotomy. Setting University of California Davis Medical Center (2010-2016). Participants A total of 25 consecutive patients who underwent retrosigmoid craniotomy and repair. Exclusion criteria included patients who were under the age of 18 years. Main Outcome Measures Main outcomes included incidence of postoperative headache, cerebrospinal fluid leak, and wound infections. Results Postoperative headache was reported in two patients in this series (8%). None of the patients in the series developed cerebrospinal fluid leak or wound infections. Mean follow-up period was 16 months. Conclusion Our multilayered anatomic repair after retrosigmoid suboccipital craniotomy results in favorable clinical results and may help reduce the risks associated with this operation.
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Affiliation(s)
- Amir Goodarzi
- Department of Neurological Surgery, University of California, Davis School of Medicine, Sacramento, California, United States
| | - Arjang Ahmadpour
- Department of Neurological Surgery, University of California, Davis School of Medicine, Sacramento, California, United States
| | - Atrin Toussi
- Department of Neurological Surgery, University of California, Davis School of Medicine, Sacramento, California, United States
| | - Kiarash Shahlaie
- Department of Neurological Surgery, University of California, Davis School of Medicine, Sacramento, California, United States
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Kadakia S, Badhey A, Inman J, Mourad M, Ducic Y. Surgical management of temporal bone osteoradionecrosis: Single surgeon experience of 47 cases. Am J Otolaryngol 2017; 38:688-691. [PMID: 28843593 DOI: 10.1016/j.amjoto.2017.07.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Accepted: 07/04/2017] [Indexed: 11/25/2022]
Abstract
PURPOSE To report the outcomes of 47 patients with temporal bone osteoradionecrosis treated primarily with surgical resection in order to analyze whether flap type and hyperbaric oxygen use affect wound breakdown. MATERIALS AND METHODS Between January 1998 and January 2016, 47 patients were treated for temporal bone osteoradionecrosis with surgery. Some patients were also treated with hyperbaric oxygen. Resection of grossly necrotic temporal bone was followed by immediate reconstruction with local, regional, or free flaps. Minimum follow-up was 6months. If patients had breakdown of their initial reconstructions, secondary reconstruction was performed with either a regional or free flap. During the post-operative period, wound breakdown, flap complications, and patient survival were noted. RESULTS 30 patients developed ORN from primary radiotherapy while 17 had post-operative radiation. It was found that wound breakdown was significantly associated with type of flap reconstruction (p=0.02) with local flap reconstruction portending a poorer prognosis. Hyperbaric oxygen was not associated with decreased wound breakdown (p=0.5). CONCLUSIONS Surgical treatment can be an effective treatment for temporal bone osteoradionecrosis, without hyperbaric oxygen providing any additional benefit. Reconstruction with regional or free flaps may be a more reliable method to resurface defects compared to local flaps.
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15
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Reconstruction of parotidectomy and lateral skull base defects. Curr Opin Otolaryngol Head Neck Surg 2017; 25:431-438. [DOI: 10.1097/moo.0000000000000391] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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16
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Patel NS, Modest MC, Brobst TD, Carlson ML, Price DL, Moore EJ, Janus JR. Surgical management of lateral skull base defects. Laryngoscope 2015; 126:1911-7. [DOI: 10.1002/lary.25717] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Revised: 09/01/2015] [Accepted: 09/10/2015] [Indexed: 11/07/2022]
Affiliation(s)
- Neil S. Patel
- Department of Otorhinolaryngology; Mayo Clinic; Rochester Minnesota U.S.A
| | - Mara C. Modest
- Department of Otorhinolaryngology; Mayo Clinic; Rochester Minnesota U.S.A
| | - Tyler D. Brobst
- Department of Otorhinolaryngology; Mayo Clinic; Rochester Minnesota U.S.A
| | - Matthew L. Carlson
- Department of Otorhinolaryngology; Mayo Clinic; Rochester Minnesota U.S.A
| | - Daniel L. Price
- Department of Otorhinolaryngology; Mayo Clinic; Rochester Minnesota U.S.A
| | - Eric J. Moore
- Department of Otorhinolaryngology; Mayo Clinic; Rochester Minnesota U.S.A
| | - Jeffrey R. Janus
- Department of Otorhinolaryngology; Mayo Clinic; Rochester Minnesota U.S.A
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