• 제목/요약/키워드: Reconstruction of the head and neck

검색결과 256건 처리시간 0.022초

설근부에서 시작된 인후두협착과 식도협착 1례 (Complete laryngopharyngoesophageal stricture due to lye ingestion)

  • 최환;백승국;권순영;정광윤;김광택
    • 대한기관식도과학회지
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    • 제13권1호
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    • pp.55-58
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    • 2007
  • Caustic bums of the upper aerodigestive tract continue to be a significant clinical problem. Wide -field pharyngoesophagectomy is commonly performed as treatment for malignancies of the hypopharynx. A total laryngectomy is often necessary at the time of this procedure because of the anatomical proximity of the cancer or because of the likely compromise of swallowing postoperatively. When preservation of the larynx is attempted, aspirations after surgery frequently require a second-stage laryngectomy. And various flaps are using for reconstruction of esophageal defect. The choice of reconstruction is depended to the patient's status. A 54-year-old women whose symptom was severe dysphagia and X-ray revealed laryngopharyngeal stricuture. She had attempted suicide by swallowing lye liquids 32 years ago. She has entire laryngopharyngeal and esophageal stricutures. Total laryngectomy was performed and reconstruction of theesophagus was carried out with unusual reversed-gastric tube formation. Hence, we report this case with the review of literaturefor proper management in the future.

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혀의 재건을 위한 부피 및 표면적의 측정 (Estimation of Volume and Surface Area for Reconstruction of Tongue)

  • 박하나로;김희진;정우진;안순현
    • 대한두경부종양학회지
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    • 제27권1호
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    • pp.27-31
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    • 2011
  • Purpose : Anterolateral thigh and radial forearm flap is the most important fasciocutaneous flap widely used for reconstruction of tongue. One important purpose of flap is replacing the volume of tongue but still there is no data about the surface area and volume to be reconstructed after glossectomy. In this paper, surface area and volume is estimated from the 3-dimensionally reconstructed MRI images to see which flap is more ideal and to give the reference value for reconstruction. Materials and Methods : With coronal MRI image, tongue including only the intrinsic muscle is delineated in every section and reconstructed 3-dimensionally and calculated the volume and surface area to be reconstructed according to the degree of glossectomy. This volume and surface area was compared with the volume of anterolateral thigh and radial forearm flap. Results : The volume and surface area to be reconstructed in hemiglossectomy was $39.0{\pm}4.0cm^3$ and $31.8{\pm}2.7cm^2$ respectively. The average thickness of anterolateral thigh flap is $9.4{\pm}2.8mm$ and that of radial forearm is $3.8{\pm}1.0mm$. Comparing the curve of tongue surface area and volume with the volume of flap, the anterolateral thigh flap has more ideal volume to replace the defect. Conclusions : The surface area and volume requested for reconstruction could be suggested and the anterolateral thigh flap has more ideal volume for reconstruction of glossectomy defect.

The supraclavicular artery island flap: a salvage option for head and neck reconstruction

  • Lee, Sanghoon;Cho, Hye-Min;Kim, Jin-kyu;Nam, Woong
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제40권
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    • pp.25.1-25.4
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    • 2018
  • Background: Some of head and neck cancer patients are in compromised general condition after ablation surgery and chemoradiation therapy, which makes secondary free tissue transfer quite challenging. Elderly cancer patients also have some risk for microvascular surgery with lengthened general anesthesia. In those cases, the pedicled flap vascularized by supraclavicular artery could be considered as an alternative to free flap. Despite several authors have demonstrated the clinical reliability of supraclavicular artery island flap (SCAIF), to date, SCAIF has not been widely used among reconstructive surgeon. In this article, we clarified vascular flow pattern and introduce simple surgical technique of SCAIF with a literature review. Case presentation: Three patients who had underwent previous neck surgery and adjuvant therapy received maxillofacial reconstruction using SCAIF. It required only a few landmarks, flap harvesting was carried out, and the elapsed time gradually decreased to 15 min with experiences. There were no remarkable morbidities in both donor and recipient sites. Conclusion: SCAIF exhibited minimal anatomic variations and short learning curve of surgical techniques, which might be valuable reconstruction modality for beginning surgeon. And it can be beneficial option for the patients with vessel-depleted neck, medically compromised status for lengthened general anesthesia and failed free tissue transfer.

두경부 영역의 종양 절세후 광배근피판을 이용한 재건술 (EXPERIENCE WITH 6 LATISSIMUS DORSI MYOCUTANEOUS FLAPS ON HEAD AND NECK AREA RECONSTRUCTION)

  • 이종호;박광;서구종;박기덕
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제14권1_2호
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    • pp.105-116
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    • 1992
  • 저자들은 악안면부에 발생한 종양 절제 후 광배근피판(유정 피판, 5례 : 유리 피판, 1례)으로 재건하여 5례에서 성공하였다. 큰 피판 형성의 잠재성은 두경부에서 충분한 종물제거와 재건을 가능하게 하였으며, 피판 형성이 빠르고 용이하며 긴 혈판경(약 45cm)을 채득할 수 있었다. 공여부 합병증과 기능 상실이 적어 두경부의 커다란 결손부 재건에 매우 유용한 피판으로 판단되었으며, 경부곽청술 후 노출되는 심부 조직에 대해 심미적이며 기능적인 보호를 제공할 수 있었다.

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Radial forearm free flap in a patient with an unusual radial artery variation: a case report

  • Menichini, Giulio;Calabrese, Sara;Alfonsi, Nicola;Innocenti, Marco
    • Archives of Plastic Surgery
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    • 제48권6호
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    • pp.646-650
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    • 2021
  • Head and neck reconstruction poses unique challenges in rehabilitating surgical defects in terms of integrity, function, and form. The radial forearm free flap (RFFF) has been widely used for defect coverage, especially in the head and neck area, but its versatility allows it to be used for soft-tissue reconstruction in various parts of the body. The vascular features of the flap are quite constant and reliable. Nevertheless, abnormalities of the forearm vascular tree have been described over the decades. We report a case of intraoral reconstruction after verrucous carcinoma recurrence in a 74-year-old woman with an unusual forearm flap, which we called the median forearm free flap, based on a median branch of the radial artery that was preoperatively detected using handheld Doppler ultrasonography. The distally located skin paddle was predominantly supplied by the aberrant median vessel with its perforators. The flap was thus safely harvested with this atypical pedicle. Successful reconstruction of the intraoral defect was achieved, with an uneventful postoperative course.

측두근막피판을 이용한 구강내 결손부 재건에 관한 증례 2례 (Two Cases of Reconstruction of Oral Cavity Defect with Temporoparietal Flap)

  • 김민식;박경호;박동선;조승호
    • 대한두경부종양학회지
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    • 제18권1호
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    • pp.76-79
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    • 2002
  • Temporoparietal fascial flap (TPFF) has been used in the reconstruction of a broad spectrum of complex defect of head & neck it can be used as pedicled flap or free flap. TPFF is extensively is good for reconstruction of auricular defects because it is fascial flap with ease of covering irregular surface. TPFF is supplied by the superficial temporal artery & vein and innervated by zygomatico-temporal branch of facial nerve and auriculotemporal nerve. The flap ranges from 2-4mm in thickness and can be harvested up to 17x14cm wide, it can include calvarian bone and enables primary closure of donor site. We carried out reconstruction of oral cavity defects by means of TPFF with a satisfactory result in two cases of oral cavity cancer.

방사선 치료 유무 및 수술 범위에 따른 후두전절제술 후 인두피부누공 발생률 분석 (Pharyngocutaneous Fistula Formation Rate after Total Laryngectomy, Related with Previous Radiotherapy and Extent of Surgery)

  • 김성동;이여진;김민수;정우진;안순현
    • 대한두경부종양학회지
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    • 제30권2호
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    • pp.39-42
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    • 2014
  • Background and Objectives : Pharyngocutaneous fistula is the most common complication after total laryngectomy. The objective of this study was to determine the incidence of pharyngocutaneous fistula after total laryngectomy in patients operated on in our department and to establish whether specific factors predispose to fistula formation. Materials and Methods : For 10 years(2003-2014), 49 cases of patients who were diagnosed with laryngeal cancer and underwent total laryngectomy in our department. Patients who underwent radiotherapy before the surgery was 24 cases(48.9%) of all total laryngectomy patients. And those who were needed flap reconstruction because of extensive tumor involvement to hypopharynx were also 24 cases(48.9%), whereas primary closure were performed in 25 cases(51%). Results : The postoperative pharyngocutaneous fistula was found in 12 of the 49 patients(24.5%). The radiotherapy before surgery was a statistically significant factor that increase the incidence of postoperative fistulas(p=0.037). Large extent of surgery including flap reconstruction was almost statistically significant factor of raising postoperative fistula rates(p=0.051). Conclusion : According to this study, the presence of postoperative fistula seems to be influenced by previous radiotherapy and the extent of surgery. These could be the risk factors of pharyngocutaneous fistula after total laryngectomy.

식도암이 동시에 발견된 구강저부의 편평세포암 환자 1예 (A Case of Simultaneous Squamous Cell Carcinomas in Mouth Floor and Esophagus)

  • 김태민;송인식;주재우;김민수;오경호;이주한;권순영
    • 대한두경부종양학회지
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    • 제32권2호
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    • pp.73-77
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    • 2016
  • Simultaneous second primary tumors are not uncommon in patients with oral cavity squamous cell carcinoma. Many studies have previously shown that oral cavity squamous cell carcinoma patients with simultaneous second primary tumor generally have a poor prognosis. Additionally, the choice of the optimal therapeutic modality for oral cavity squamous cell carcinoma patients who present with simultaneous second primary tumor remains problematic. We reported a case of simultaneous squamous cell carcinomas in mouth floor and esophagus, that multidisciplinary team performed resection and reconstruction simultaneously.