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Panda S, Gautam V, Mitra S, Singh CA, Mani S, Palreddy A, Kabilan Y, Konkimalla A, Kondamudi D, Bagchi D, Raveendran S, Sikka K, Kumar R, Singh A, Thakar A. Low-molecular-weight heparin salvage in pedicled flap reconstruction in head and neck: a prospective cohort study. J Laryngol Otol 2024:1-6. [PMID: 38602066 DOI: 10.1017/s0022215124000562] [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: 04/12/2024]
Abstract
OBJECTIVE To determine if systemic administration of low-molecular-weight heparin impacts venous compromise in loco-regional flap reconstruction for head and neck subsites. METHODS This prospective study was conducted on patients who had developed features of venous compromise of the flap. The case group received low-molecular-weight heparin (dalteparin). RESULTS Of the 73 patients who developed venous congestion, low-molecular-weight heparin was administered in 47 patients. In the low-molecular-weight heparin subset, 23 patients had either reversal or non-progression of venous compromise (48.9 per cent). Of the patients who had no response to low-molecular-weight heparin rescue, complete necrosis was seen in 4 and partial flap necrosis was observed in 19. The corresponding numbers in the control group were 13 and 12, respectively (odds ratio 23.9, p = 0.002). Additionally, the low-molecular-weight heparin arm had a lower incidence of partial or complete flap necrosis (p = 0.002). CONCLUSION Low-molecular-weight heparin salvage, when instituted early, is likely to result in a significant reduction in flap-related morbidity.
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Affiliation(s)
- Smriti Panda
- Department of Otorhinolaryngology and Head and Neck Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Vimmi Gautam
- Department of Otorhinolaryngology and Head and Neck Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Sandipta Mitra
- Department of Otorhinolaryngology and Head and Neck Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Chirom Amit Singh
- Department of Otorhinolaryngology and Head and Neck Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Suresh Mani
- Department of Otorhinolaryngology and Head and Neck Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Akshara Palreddy
- Department of Otorhinolaryngology and Head and Neck Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Yuvanesh Kabilan
- Department of Otorhinolaryngology and Head and Neck Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Abhilash Konkimalla
- Department of Otorhinolaryngology and Head and Neck Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Dheeraj Kondamudi
- Department of Otorhinolaryngology and Head and Neck Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Debadeep Bagchi
- Department of Otorhinolaryngology and Head and Neck Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Sarath Raveendran
- Department of Otorhinolaryngology and Head and Neck Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Kapil Sikka
- Department of Otorhinolaryngology and Head and Neck Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Rajeev Kumar
- Department of Otorhinolaryngology and Head and Neck Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Anup Singh
- Department of Otorhinolaryngology and Head and Neck Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Alok Thakar
- Department of Otorhinolaryngology and Head and Neck Surgery, All India Institute of Medical Sciences, New Delhi, India
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Cretu B, Zamfir A, Bucurica S, Scheau AE, Savulescu Fiedler I, Caruntu C, Caruntu A, Scheau C. Role of Cannabinoids in Oral Cancer. Int J Mol Sci 2024; 25:969. [PMID: 38256042 PMCID: PMC10815457 DOI: 10.3390/ijms25020969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 01/03/2024] [Accepted: 01/10/2024] [Indexed: 01/24/2024] Open
Abstract
Cannabinoids have incited scientific interest in different conditions, including malignancy, due to increased exposure to cannabis. Furthermore, cannabinoids are increasingly used to alleviate cancer-related symptoms. This review paper aims to clarify the recent findings on the relationship between cannabinoids and oral cancer, focusing on the molecular mechanisms that could link cannabinoids with oral cancer pathogenesis. In addition, we provide an overview of the current and future perspectives on the management of oral cancer patients using cannabinoid compounds. Epidemiological data on cannabis use and oral cancer development are conflicting. However, in vitro studies assessing the effects of cannabinoids on oral cancer cells have unveiled promising anti-cancer features, including apoptosis and inhibition of cell proliferation. Downregulation of various signaling pathways with anti-cancer effects has been identified in experimental models of oral cancer cells exposed to cannabinoids. Furthermore, in some countries, several synthetic or phytocannabinoids have been approved as medical adjuvants for the management of cancer patients undergoing chemoradiotherapy. Cannabinoids may improve overall well-being by relieving anxiety, depression, pain, and nausea. In conclusion, the link between cannabinoid compounds and oral cancer is complex, and further research is necessary to elucidate the potential risks or their protective impact on oral cancer.
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Affiliation(s)
- Brigitte Cretu
- Department of Oral and Maxillofacial Surgery, “Carol Davila” Central Military Emergency Hospital, 010825 Bucharest, Romania; (B.C.); (A.Z.)
| | - Alexandra Zamfir
- Department of Oral and Maxillofacial Surgery, “Carol Davila” Central Military Emergency Hospital, 010825 Bucharest, Romania; (B.C.); (A.Z.)
| | - Sandica Bucurica
- Department of Gastroenterology, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania;
- Department of Gastroenterology, “Carol Davila” University Central Emergency Military Hospital, 010825 Bucharest, Romania
| | - Andreea Elena Scheau
- Department of Radiology and Medical Imaging, Fundeni Clinical Institute, 022328 Bucharest, Romania;
| | - Ilinca Savulescu Fiedler
- Department of Internal Medicine, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania;
- Department of Internal Medicine and Cardiology, Coltea Clinical Hospital, 030167 Bucharest, Romania
| | - Constantin Caruntu
- Department of Physiology, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (C.C.); (C.S.)
- Department of Dermatology, “Prof. N.C. Paulescu” National Institute of Diabetes, Nutrition and Metabolic Diseases, 011233 Bucharest, Romania
| | - Ana Caruntu
- Department of Oral and Maxillofacial Surgery, “Carol Davila” Central Military Emergency Hospital, 010825 Bucharest, Romania; (B.C.); (A.Z.)
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, “Titu Maiorescu” University, 031593 Bucharest, Romania
| | - Cristian Scheau
- Department of Physiology, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania; (C.C.); (C.S.)
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Liu S, Liao Y, He B, Dai B, Zhu Z, Shi J, Huang Y, Zou G, Du C, Shi B. Mandibular resection and defect reconstruction guided by a contour registration-based augmented reality system: A preclinical trial. J Craniomaxillofac Surg 2023:S1010-5182(23)00077-X. [PMID: 37355367 DOI: 10.1016/j.jcms.2023.05.007] [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: 11/17/2022] [Revised: 02/22/2023] [Accepted: 05/21/2023] [Indexed: 06/26/2023] Open
Abstract
The aim of this study was to verify the feasibility and accuracy of a contour registration-based augmented reality (AR) system in jaw surgery. An AR system was developed to display the interaction between virtual planning and images of the surgical site in real time. Several trials were performed with the guidance of the AR system and the surgical guide. The postoperative cone beam CT (CBCT) data were matched with the preoperatively planned data to evaluate the accuracy of the system by comparing the deviations in distance and angle. All procedures were performed successfully. In nine model trials, distance and angular deviations for the mandible, reconstructed fibula, and fixation screws were 1.62 ± 0.38 mm, 1.86 ± 0.43 mm, 1.67 ± 0.70 mm, and 3.68 ± 0.71°, 5.48 ± 2.06°, 7.50 ± 1.39°, respectively. In twelve animal trials, results of the AR system were compared with the surgical guide. Distance deviations for the bilateral condylar outer poles were 0.93 ± 0.63 mm and 0.81 ± 0.30 mm, respectively (p = 0.68). Distance deviations for the bilateral mandibular posterior angles were 2.01 ± 2.49 mm and 2.89 ± 1.83 mm, respectively (p = 0.50). Distance and angular deviations for the mandible were 1.41 ± 0.61 mm, 1.21 ± 0.18 mm (p = 0.45), and 6.81 ± 2.21°, 6.11 ± 2.93° (p = 0.65), respectively. Distance and angular deviations for the reconstructed tibiofibular bones were 0.88 ± 0.22 mm, 0.84 ± 0.18 mm (p = 0.70), and 6.47 ± 3.03°, 6.90 ± 4.01° (p = 0.84), respectively. This study proposed a contour registration-based AR system to assist surgeons in intuitively observing the surgical plan intraoperatively. The trial results indicated that this system had similar accuracy to the surgical guide.
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Affiliation(s)
- Shaofeng Liu
- Department of Oral and Maxillofacial Surgery, First Affiliated Hospital of Fujian Medical University, Fuzhou, 350005, China; School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350004, China
| | - Yunyang Liao
- Department of Oral and Maxillofacial Surgery, First Affiliated Hospital of Fujian Medical University, Fuzhou, 350005, China; Laboratory of Facial Plastic and Reconstruction, Fujian Medical University, Fuzhou, 350004, China
| | - Bingwei He
- School of Mechanical Engineering and Automation, Fuzhou University, Fuzhou, 350108, China; Fujian Engineering Research Center of Joint Intelligent Medical Engineering, Fuzhou, 350108, China
| | - Bowen Dai
- Department of Oral and Maxillofacial Surgery, Second Xiangya Hospital of Central South University, Changsha, 410000, China
| | - Zhaoju Zhu
- School of Mechanical Engineering and Automation, Fuzhou University, Fuzhou, 350108, China; Fujian Engineering Research Center of Joint Intelligent Medical Engineering, Fuzhou, 350108, China
| | - Jiafeng Shi
- School of Mechanical Engineering and Automation, Fuzhou University, Fuzhou, 350108, China; Fujian Engineering Research Center of Joint Intelligent Medical Engineering, Fuzhou, 350108, China
| | - Yue Huang
- Department of Oral and Maxillofacial Surgery, First Affiliated Hospital of Fujian Medical University, Fuzhou, 350005, China; Laboratory of Facial Plastic and Reconstruction, Fujian Medical University, Fuzhou, 350004, China
| | - Gengsen Zou
- Department of Oral and Maxillofacial Surgery, First Affiliated Hospital of Fujian Medical University, Fuzhou, 350005, China; Laboratory of Facial Plastic and Reconstruction, Fujian Medical University, Fuzhou, 350004, China
| | - Chen Du
- Department of Oral and Maxillofacial Surgery, First Affiliated Hospital of Fujian Medical University, Fuzhou, 350005, China; School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350004, China
| | - Bin Shi
- Department of Oral and Maxillofacial Surgery, First Affiliated Hospital of Fujian Medical University, Fuzhou, 350005, China; Laboratory of Facial Plastic and Reconstruction, Fujian Medical University, Fuzhou, 350004, China.
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McCauley P, Moore M, Duggan E. Anaesthesia for reconstructive free flap surgery for head and neck cancer. Br J Hosp Med (Lond) 2022; 83:1-9. [DOI: 10.12968/hmed.2021.0668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Head and neck cancer surgery presents significant challenges for the anaesthetist. A thorough multidisciplinary preoperative assessment and optimisation of the patient is essential, including nutritional and psychological evaluation. The incidence of a difficult airway is high, and the anaesthetist must be skilled in advanced airway techniques. Surgery is extensive, often requiring reconstructive surgery with either a pedicled or free flap. Detailed knowledge of flap physiology and anatomy is needed, and anaesthesia comprises careful management of mean arterial pressure, fluid administration, temperature control and oxygenation. The Enhanced Recovery after Surgery Society and the Society for Head and Neck Anaesthesia consensus recommendations provide guidance on current best practice. Despite continued debate, it now appears that this constitutes goal-directed fluid therapy, coupled with judicious vasopressor therapy sufficient to achieve an adequate mean arterial pressure. Emerging techniques such as prehabilitation and postoperative near-infrared spectroscopy flap monitoring provide hope of improved outcomes going forward.
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Affiliation(s)
- Peter McCauley
- Department of Anaesthesia, Beaumont Hospital, Dublin, Ireland
| | - Michael Moore
- Department of Anaesthesia, Beaumont Hospital, Dublin, Ireland
| | - Edel Duggan
- Department of Anaesthesia, Beaumont Hospital, Dublin, Ireland
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Sarac BA, Schoenbrunner AR, Wilson SC, Chiu ES, Janis JE. The Impact of COVID-19-based Suspension of Surgeries on Plastic Surgery Practices: A Survey of ACAPS Members. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2020; 8:e3119. [PMID: 32983820 PMCID: PMC7489607 DOI: 10.1097/gox.0000000000003119] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 07/27/2020] [Indexed: 01/06/2023]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic led to a drastic decline in the number of elective surgeries performed in the United States. Many national societies and local governments provided recommendations for surgeons to initially suspend and progressively resume elective surgery. The authors used a survey to the American Council of Academic Plastic Surgeons (ACAPS) to assess the effect on plastic surgeons. METHODS An electronic survey questionnaire was distributed to 532 members of ACAPS. Data on individual and plastic surgery practice demographics, COVID-19 prevention measures, and procedures or services that were being performed or delayed were collected and analyzed. RESULTS An estimated 161 members (30.2%) completed the survey. Changes in hospital policy were cited as the most common reason (89%) for determining which procedures were currently offered. Results vary by specialty. Notably, <10% of respondents who normally offered aesthetic procedures currently offered any procedures during the survey. Subspecialty-specific results and prevention measures when seeing clinic patients are further summarized and discussed. CONCLUSIONS Plastic surgeons have seen a drastic decrease in the variety of procedures and services they are allowed to offer during the COVID-19 pandemic. To help plan a return to normalcy, surgeons should create and implement plans to protect patients and staff from coronavirus transmission, assure financial solvency, and consider the effects of delayed surgeries on both the physical and mental health of their patients. In doing so, surgeons and their patients will be better prepared in the event of a resurgence of the virus.
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Affiliation(s)
| | - Anna R. Schoenbrunner
- Department of Plastic and Reconstructive Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Stelios C. Wilson
- New York University Medical Center, Hansjörg Wyss Department of Plastic Surgery, New York, N.Y
| | - Ernest S. Chiu
- New York University Medical Center, Hansjörg Wyss Department of Plastic Surgery, New York, N.Y
| | - Jeffrey E. Janis
- Department of Plastic and Reconstructive Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio
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Reconstruction for Complex Oromandibular Facial Defects: The Fibula Free Flap and Pectoralis Major Flap Combination. Case Rep Surg 2019; 2019:8451213. [PMID: 31049242 PMCID: PMC6458920 DOI: 10.1155/2019/8451213] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Revised: 11/09/2018] [Accepted: 02/18/2019] [Indexed: 11/30/2022] Open
Abstract
Background Extensive through-and-through oromandibular defects after advanced oral carcinoma excision pose a reconstructive challenge for the head and neck surgeon. These complex oromandibular wounds often involve the mandible, oral and/or aerodigestive mucosa, and the external skin. As a result, these defects are often not amenable to reconstruction with a single flap due to the volume of soft tissue needed and the three-dimensional reconstructive requirement. The use of two free flaps has often been suggested to overcome this reconstructive challenge. A simpler and less technically demanding way to deal with this may involve the use of a free flap in combination with a pedicled regional flap. We present our experience of the use of a simultaneous microvascular fibula free flap (FFF) with a pectoralis major myocutaneous flap (PMMC) for addressing these defects. Methods A retrospective chart review was performed of patients treated with a FFF and PMMC combination for the reconstruction of oromandibular defects at the University of Mississippi Medical Center (Jackson, MS) between October 2013 and February 2016. A minimum follow-up of 12 months was required. Data collected included the extent and location of tumor involvement, size of the postablative defect, tumor histology, clinical and pathological staging, length of follow-up, functional outcomes, and associated complications. Results A total of three patients were identified to have been treated with the above technique. Defects repaired involved through-and-through mandibular defects with associated oral mucosa and external skin defects. In all cases, the FFF was used for restoring bony continuity with the skin paddle used to reconstruct the intraoral lining. The PMMC was used for reconstruction of the external skin defect and for providing soft tissue bulk. The average size of the fibula skin paddle used for intraoral reconstruction was 7.7 cm × 11.7 cm. The average size of the PMMC paddle was 7.3 × 9 cm. The mean follow-up was 21.7 months. Both the FFF and PMMC survived in all cases, although postoperative wound healing complications occurred in two of the three patients. There was one partial flap loss. Two patients regained good oral intake while one patient tolerated oral intake but was PEG tube-dependent. Conclusions The combination of pectoralis major myocutaneous flap and a vascularized free fibular flap is a viable option for the reconstruction of complex through-and-through oromandibular defects. This technique may be useful when a single microvascular free flap is not sufficient for reconstruction of such defects.
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Alfouzan AF. Review of surgical resection and reconstruction in head and neck cancer. Traditional versus current concepts. Saudi Med J 2019; 39:971-980. [PMID: 30284578 PMCID: PMC6201028 DOI: 10.15537/smj.2018.10.22887] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
This review summarizes the development of head and neck cancer resection and reconstruction. The developments in the treatment of cancer patients are reflected in their surgical outcomes, in addition to functional and aesthetic improvements. New technologies, such as surgical simulation and planning, minimally invasive surgery, and microsurgery have been added to the field to improve surgical resection of the tumor and reconstruction. The field is still growing to optimize the management of head and neck cancer.
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Affiliation(s)
- Afnan F Alfouzan
- Department of Prosthodontics, College of Dentistry, King Saud University, Riyadh, Kingdom of Saudi Arabia. E-mail.
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Reiter M, Baumeister P. Reconstruction of laryngopharyngectomy defects: Comparison between the supraclavicular artery island flap, the radial forearm flap, and the anterolateral thigh flap. Microsurgery 2018; 39:310-315. [DOI: 10.1002/micr.30406] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2018] [Revised: 10/07/2018] [Accepted: 11/06/2018] [Indexed: 11/06/2022]
Affiliation(s)
- Maximilian Reiter
- Department of Otolaryngology and Head and Neck SurgeryLudwig Maximilians University Munich Germany
| | - Philipp Baumeister
- Department of Otolaryngology and Head and Neck SurgeryLudwig Maximilians University Munich Germany
- Clinical Cooperation Group Personalized Radiotherapy in Head and Neck CancerHelmholtz Center Munich Germany
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Fukushima H, Kanazawa T, Kawabata K, Mitani H, Yonekawa H, Sasaki T, Shimbashi W, Seto A, Kamiyama R, Misawa K, Asakage T. Indwelling voice prosthesis insertion after total pharyngolaryngectomy with free jejunal reconstruction. Laryngoscope Investig Otolaryngol 2017; 2:30-35. [PMID: 28894820 PMCID: PMC5510280 DOI: 10.1002/lio2.63] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Accepted: 12/01/2016] [Indexed: 11/25/2022] Open
Abstract
Objectives Total pharyngolaryngectomy with free jejunal reconstruction is often performed in patients with hypopharyngeal carcinoma. However, postoperative speechlessness significantly decreases patient quality of life. We investigated whether Provox® insertion could preserve speech after total pharyngolaryngectomy with free jejunal reconstruction. Study Design Retrospective chart review. Methods A total of 130 cases of secondary Provox® insertions after total pharyngolaryngectomy with free jejunal reconstruction were analyzed. Communication outcomes were compared using the Head and Neck Cancer Understandability of Speech Subscale. Outcomes and complications associated with insertion site (jejunal insertion vs. esophageal insertion) and adjuvant irradiation therapy were also evaluated. Results Provox® insertion had favorable communication outcomes in 102 cases (78.4%). Neither the insertion site nor irradiation affected the communication outcome. Complications were observed in 20 cases (15.4%). Local infection was the most common complication. Free jejunal insertion, in which the resection range was enlarged, had a lower complication rate than did esophageal insertion, and its complication rate was unaffected by previous irradiation. For all patients, the hospitalization duration and duration of speechlessness were 13.4 days and 14.6 months, respectively. Patients receiving jejunal insertions had a significantly shorter hospitalization duration than did those receiving esophageal insertions. Unlike Provox®2, Provox®Vega significantly reduced the complication rate to zero. Conclusion For jejunal inserson of a Provox® prosthetic, a sufficient margin can be maintained during total pharyngolaryngectomy and irradiation can be performed, and satisfactory communication outcomes were observed. Provox® insertion after total pharyngolaryngectomy with free jejunal reconstruction should be considered the standard therapy for voice restoration. Level of Evidence 4.
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Affiliation(s)
- Hirofumi Fukushima
- Department of Head and Neck Surgery.,Tokyo Medical and Dental University Graduate School of Medicine, Division of Head and Neck Tokyo Japan
| | - Takeharu Kanazawa
- Cancer Institute Hospital, Japanese Foundation of Cancer Research, Department of Otolaryngology-Head and Neck Surgery Tokyo Japan
| | - Kazuyoshi Kawabata
- Tokyo Medical and Dental University Graduate School of Medicine, Division of Head and Neck Tokyo Japan
| | - Hiroki Mitani
- Tokyo Medical and Dental University Graduate School of Medicine, Division of Head and Neck Tokyo Japan
| | - Hiroyuki Yonekawa
- Tokyo Medical and Dental University Graduate School of Medicine, Division of Head and Neck Tokyo Japan
| | - Toru Sasaki
- Tokyo Medical and Dental University Graduate School of Medicine, Division of Head and Neck Tokyo Japan
| | - Wataru Shimbashi
- Tokyo Medical and Dental University Graduate School of Medicine, Division of Head and Neck Tokyo Japan
| | - Akira Seto
- Tokyo Medical and Dental University Graduate School of Medicine, Division of Head and Neck Tokyo Japan
| | - Ryousuke Kamiyama
- Tokyo Medical and Dental University Graduate School of Medicine, Division of Head and Neck Tokyo Japan
| | - Kiyoshi Misawa
- Jichi Medical University, Shimotsuke, Japan, Department of Otolaryngology/Head and Neck Surgery Hamamatsu University School of Medicine Hamamatsu Japan
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Reiter M, Baumeister P. Venous anastomosis in free flap reconstruction after radical neck dissection: is the external jugular vein a feasible option? Eur Arch Otorhinolaryngol 2017; 274:2239-2244. [DOI: 10.1007/s00405-016-4443-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Accepted: 12/22/2016] [Indexed: 10/20/2022]
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Gobbo M, Bullo F, Perinetti G, Gatto A, Ottaviani G, Biasotto M, Tirelli G. Diagnostic and therapeutic features associated with modification of quality-of-life's outcomes between one and six months after major surgery for head and neck cancer. Braz J Otorhinolaryngol 2016; 82:548-57. [PMID: 26878840 PMCID: PMC9444670 DOI: 10.1016/j.bjorl.2015.10.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Accepted: 10/02/2015] [Indexed: 12/13/2022] Open
Abstract
Introduction Treatments used in head and neck cancer greatly impact the physical, psychological and functional state of patients. Evaluation of quality of life has become an integral part of the treatment. Objective This retrospective study evaluates features involved in changes in quality of life after major surgery for head and neck cancer within six months, according to self-reported outcomes. Methods One hundred and thirty patients completed the University of Washington Quality of Life questionnaire one and six months after major surgery for head and neck cancer. A multivariate model was used to evaluate which diagnostic and therapeutic features were related to improvement of quality of life within a six-month period. Results Significant improvement in most features related to quality of life was already recognizable at six months. Patients submitted to more invasive treatment had the biggest improvement in quality of life between time-points, as well as those patients with bigger tumors. Conclusion After major surgery, patients may undergo fast recovery, with overall quality of life likely to improve in the short-term. Clinicians must be aware of the importance of dealing with treatment-related issues immediately after surgery, with hopeful possibility of on-the-upgrade results.
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Affiliation(s)
- Margherita Gobbo
- Dental Science Department, Division of Oral Medicine and Pathology, Trieste, Italy.
| | - Federica Bullo
- University of Trieste, Hospital of Cattinara, ENT Clinic, Head and Neck Department, Trieste, Italy
| | - Giuseppe Perinetti
- Dental Science Department, Division of Oral Medicine and Pathology, Trieste, Italy
| | - Annalisa Gatto
- University of Trieste, Hospital of Cattinara, ENT Clinic, Head and Neck Department, Trieste, Italy
| | - Giulia Ottaviani
- Dental Science Department, Division of Oral Medicine and Pathology, Trieste, Italy
| | - Matteo Biasotto
- Dental Science Department, Division of Oral Medicine and Pathology, Trieste, Italy
| | - Giancarlo Tirelli
- University of Trieste, Hospital of Cattinara, ENT Clinic, Head and Neck Department, Trieste, Italy
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