Buccal fat augmentation for insufficient neoglottal closure after supracricoid laryngectomy with cricohyoidoepiglottopexy

Autologous Fat Grafting for Craniofacial Reconstruction in Oncologic Patients

Due to the anatomical and functional complexity of the region, craniofacial tumor removal requires some of the most challenging surgical approaches, often complemented with advanced chemo-radiotherapy techniques. However, these modern therapies often lead to sequelae that can drastically reduce the quality of life for the surviving patients. Recent advances in the field of regenerative medicine opened new avenues for craniofacial reconstruction following head and neck cancer treatment. One of the most promising recent strategies relies on the use of autologous fat transplant. In this mini review, we briefly present some of the fat’s biological properties that make it an ideal tissue for craniofacial reconstruction following cancer treatment. We then outline the recent advances that led to a better understanding of the detailed anatomy of the craniofacial fat depots. Furthermore, we provide a succinct review of the methods used for fat harvesting, processing and engrafting in the craniofacial area after head and neck tumor removal, discussing their main applications, advantages and limitations.

Thyroid gland flap minimizes mucosal defects at supracricoid partial laryngectomy with cricohyoidoepiglottopexy

Wound infection is a major complication after supracricoid partial laryngectomy with cricohyoidoepiglottopexy (CHEP) for radiation therapy failure. A 60-year-old man received chemoradiotherapy for a glottic carcinoma. CHEP, reusing the thyroid gland flap (TF), was performed because the cancer recurred after a salvage vertical partial laryngectomy following radiation therapy failure. The TF was sutured to the supraglottis and cricoid cartilage mucosa to minimize mucosal defects before the hyoid bone and cricoid cartilage were sutured. Wound healing after CHEP was good without infection. After decannulation, oral food intake was possible without aspiration, and speech function was comparable to that of other patients who had supracricoid partial laryngectomies. Histopathological examination revealed a close connection between the TF and its surrounding tissues without fibrous scarring. TF may improve wound healing after CHEP for radiation failure by minimizing mucosal defects.

Extraoral Uses of Autologous Oral Soft Tissue Grafts: A Different Bridge Between Mouth and Body Health

Focused Clinical Question: Are there any extraoral uses for intraoral soft tissue grafts? Summary: Despite extensive literature on the intraoral uses of soft tissue autografts harvested from oral sites, the periodontal literature is lacking information on the extraoral uses of such grafts. The purpose of this article is to review the autologous use of certain oral soft tissue grafts for extraoral indications. A literature search revealed that several medical specialties, including otolaryngology, ophthalmology, dermatology, plastic surgery, and urology, have a track record of positive outcomes with the use of free gingival, buccal fat pad, and buccal mucosa grafts for a wide variety of reconstructive procedures at diverse body sites. Conclusions: The numerous successful extraoral uses of oral soft tissue autografts underscore the versatility of these tissues in reconstructive surgery and suggest there is potential for collaboration between periodontal and medical specialists for the benefit of patients in need of such reconstructions. Broader awareness of these applications of oral soft tissue grafts could help expand their current uses and would allow practitioners to better answer possible patient inquiries.