• Title/Summary/Keyword: Reconstruction of the head and neck

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Unplanned change from double free flap to a chimeric anterolateral thigh flap in recurrent laryngeal cancer

  • Ki, Sae Hwi;Ma, Sung Hwan;Sim, Seung Hyun;Choi, Matthew Seung Suk
    • Archives of Craniofacial Surgery
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    • v.20 no.6
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    • pp.416-420
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    • 2019
  • Reconstruction method choice in recurrent head and neck cancer depends on surgical history, radiation therapy dosage, conditions of recipient vessels, and general patient condition. Furthermore, when defects are multiple or three dimensional in nature, reconstruction and flap choice aimed at rebuilding the functional structure of the head and neck are difficult. We experienced successful reconstruction of recurrent laryngeal cancer requiring reconstruction of esophageal and tracheostomy stroma defects using a chimeric two-skin anterolateral thigh flap with a single pedicle.

Unexpected Pulmonary Embolism Following Microvascular Head and Neck Reconstruction : Report of Two Cases and Review of the Literature (유리피판을 이용한 두경부 재건 후 발생한 폐색전증 2예 및 문헌고찰)

  • Choi, Eun Chang
    • Korean Journal of Head & Neck Oncology
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    • v.30 no.1
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    • pp.20-22
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    • 2014
  • 유리피판을 이용한 두경부 재건후 폐색전은 드물게 발생한다. 수술후 예상하기 힘들고 갑작스럽게 발생하기 때문에 환자가 아주 위험한 상황에 빠질 수 있다. 즉각적인 발견과 적절한 치료만이 환자의 생명을 구할 수 있다. 유리피판을 이용한 두경부 재건후 발생한 폐색전증 2예를 문헌고찰과 함께 보고하는 바이다.

Giant Thyroid Mass Excision Using Energy Device and Pectoralis Major Myocutaneous Flap Reconstruction

  • Song, Min Seok;Lee, Sang Joon;Woo, Seung Hoon
    • Medical Lasers
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    • v.10 no.2
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    • pp.115-119
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    • 2021
  • A giant thyroid mass can be associated with severe compressive symptoms, requiring surgery for treatment. This paper reports the case of an 82-year-old man who presented with a giant thyroid mass that was suspected of being a metastatic papillary thyroid carcinoma on fine-needle aspiration cytology. A harmonic scalpel was used to excise the giant thyroid mass. A pectoralis major myocutaneous flap was used for reconstruction. The histopathology assessment confirmed the metastases in the lymph node and papillary thyroid carcinoma in the resected gland.

Pectoralis Major Myocutaneous Island Flaps for Reconstruction of Facial Defects (대흉근 근피판으로 큰 안면결손을 치료한 경험)

  • Song Joong-Won;Lee Dong-Hoon;Kang Jin-Sung
    • Korean Journal of Head & Neck Oncology
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    • v.2 no.1
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    • pp.49-59
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    • 1986
  • The surgical reconstruction of major defects of the head and neck such as those following accidental injuries or resection of tumors has been facilitated and advanced by the development of myocutaneous flaps which provide both muscle bulk and skin coverage. Of the many available myocutaneous flaps, the pectoralis major myocutaneous flap has many advantages such as abundant tissue with an excellent vascularity, anatomic proximity, long arc of rotation, reliability and versatility, so it is used most frequently in head and neck reconstruction. It is the purpose of this paper to present our experiences with two cases of pectoralis major myocutaneous island flaps used in reconstruction of major defects of face; one is after resection of very large basal cell carcinoma of the left oral commissure and the other is after resection of a huge fibrous mass and destructed facial bones caused by chronic osteomyelitis.

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Clinical analysis of factors affecting the failure of free flaps used in head and neck reconstruction

  • Beom Jin Lim;Jin Yong Shin;Si-Gyun Roh;Nae-Ho Lee;Yoon Kyu Chung
    • Archives of Craniofacial Surgery
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    • v.24 no.4
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    • pp.159-166
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    • 2023
  • Background: Free tissue transfer is the preferred method of reconstructing head and neck defects, with a success rate of approximately 95%. Although flap failure is uncommon, it has a major impact on patient morbidity and diminishes quality of life, making it is important to investigate the causes of flap failure. Methods: This retrospective chart review analyzed patients who underwent free tissue transfer during head and neck reconstruction at a single institution between 2016 and 2021. Results: During the study period, 58 patients underwent 60 free flap procedures. Revision surgery was needed in 14 patients. Subsequent free flap surgery was performed in one patient, and three free flaps (5%) could not be salvaged. Cardiovascular disease was significantly associated with flap failure, and venous congestion (thrombosis) was the most common reason for revision surgery. Conclusion: Cardiovascular disease clearly emerged as a factor related to the failure of free flap surgery, and this issue warrants particular attention in patients for whom free tissue transfer is planned.

A Case of Mandibulectomy with Partial Preservation of Mandible in Mucoepidermoid Carcinoma Invading Mandible (하악골을 침범한 점액표피양 암종에서 하악 일부를 보전한 변형적 하악 절제술 치험 1예)

  • Hwang Joon-Sik;Lim Young-Chang;Kim Jin-Hwan;Park Il-Suk;Rho Young-Su
    • Korean Journal of Head & Neck Oncology
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    • v.18 no.2
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    • pp.223-226
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    • 2002
  • The segmental mandibulectomy should be performed, if mandiblie invasion is suspected clinically and radiologically. And if tumor is located to mandible very closely or when microinvasion to mandible is suspected, marginal mandibulectomy is recommended. But in segmental mandibulectomy, reconstruction is difficult and cosmetic problem remains. In this case, we performed modified segmental resection of mandible, preserving the inferior margin of mandible, and maintains the continuity of the bone, in mucoepidermoid carcinoma of parapharynx, invading mandible. We reviewed the diagnosis, pathology, and treatment, and report the case with reviews of literature.

Emergent Exploration after Free Tissue Transfer in Head and Neck Cancer (두경부 악성종양 환자에서 유리조직이식 후 시행한 혈류장애 구제술)

  • Chang, Yong-Joon;Chung, Chul-Hoon;Lee, Jong-Wook;Joe, Woo-Sung;Kim, Jin-Hwan;Rho, Young-Soo
    • Archives of Reconstructive Microsurgery
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    • v.17 no.1
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    • pp.19-27
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    • 2008
  • Purpose: Microvascular reconstructive surgery has become an integral part of the treatment of head and neck cancer patients. This review of 121 free flaps for head and neck cancer patients performed over the last 11 years was done to evaluate circulatory crisis, salvage, and secondary reconstruction and to investigate which factors may contribute to these rates. Method: Nine emergent explorations among 121 head and neck reconstruction with free flaps were reviewed to analyze detection of vascular crisis, the time interval from detection of circulatory crisis to exploration, operation procedures and results, and secondary reconstructions. Emergent exploration was done with our protocol. Result: Nine free flaps exhibited signs of vascular problems between 1 day and 6 days postoperatively. The emergent exploration rate of this series was 7.4% (9/121). The salvage rate was 55.6% (5/9), giving an overall flap viability of 96.7% (117/121). In our study, preoperative radiation therapy, positive smoking history, alcohol consumption history, combined disease such as diabetes mellitus and hypertension, recipient vessels and types of vascular anastomosis were not related to the causes of circulatory crisis. The mean time interval between the onset of clinical recognition of impaired flap perfusion and re-exploration of the salvaged 5 flaps was 3.2 hours, that of failed 4 flaps was 11.25 hours. Conclusion: Despite high overall success rate, relatively low salvage rate may be attributed to late detection of circulatory crisis and in long time interval between detection and exploration. We conclude that early detection of circulatory crisis and expeditious re-exploration are a matter of great importance for the success of salvage operation.

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The Changes of External Ear Resonance after Surgery for Repair of the Postauricular Meato-Mastoid Cutaneous Fistula (외이도-유양동-귀뒤바퀴피부 누공환자에서 수술 전, 후의 외이도 공명의 변화)

  • Kim, Sangjun;Kang, Myung Koo;Jeong, Sung Wook;Lee, Dong Kun
    • Journal of Clinical Otolaryngology Head and Neck Surgery
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    • v.29 no.2
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    • pp.235-239
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    • 2018
  • Due to the structure with one end closed, the external ear resonance effect in which the high frequency is amplified can be generated, and the sound can be perceived well. The external ear resonance normally has a first peak and a second peak. On average, the first peak has a gain of 18.6 dB at 2620 Hz and the second peak has a gain of 18.2 dB at 4210 Hz. The resonance of the external auditory canal changes with the state of the tympanic membrane, the presence of the ventilation tube, and the structure (length, diameter, shape) of the external auditory canal. A patient with a postauricular meatomastoid cutaneous fistula was admitted to the hospital with a foreign body which is the molding of the hearing aid. After removal of the foreign body, the resonance of the external auditory canal was lost and the subjective sound cognitive ability decreased. In the case of postauricular meatomastoid cutaneous fistula, we confirmed the improvement of sound cognitive ability, the change of pure tone hearing threshold, and the change of the external ear resonance after reconstruction of the ear canal without middle ear reconstruction.

3D Reconstructed Image of Neck Mass to Improve Patient's Understanding (경부 종물 환자의 이해도 개선을 위한 3차원 재건 영상의 활용)

  • Yoo, Young-Sam
    • Korean Journal of Head & Neck Oncology
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    • v.26 no.2
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    • pp.193-197
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    • 2010
  • Objectives : Patients with neck tumor and their family need every information about the disease. Especially, the size and location are confusing with verbal information. With the aid of CT, the problem had some answer, but it needs some medical education. We would like to know the usefullness of 3D reconstructed images in patient education about the disease. Material and Methods : Neck CT data were collected from 10 patients with various neck tumors and converted to 3D reconstructed images. Understanding of the patients about the size and location of tumors were rated from questionaires using axial CT images and 3D images. Results : Understanding score about 3D images were greater than that of CT images(p<0.006). Conclusion : 3D reconstructed images of CT could give the patients more real visual information about the disease.