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Primary Reconstruction (primary + reconstruction)
Selected AbstractsReverse facial artery,submental artery mandibular osteomuscular flap for the reconstruction of maxillary defects following the removal of benign tumorsHEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 6 2009Wei-Liang Chen DDS Abstract Background. Functional and aesthetic restoration in maxillary reconstruction remains a challenge. Although many free flap procedures have become popular in maxillary reconstruction, these microsurgical methods have certain limitations and risks. This study assessed the reliability of the reverse facial artery,submental artery mandibular osteomuscular flap for reconstructing maxillary defects. Methods. Eight maxillary defects following benign tumor ablation were repaired with reverse facial artery,submental artery mandibular osteomuscular flaps. The patients ranged in age from 16 to 33 years; 5 were male and 3 were female. Maxillary odontogenic myxoma was present in 3 cases, maxillary fibrous dysplasia and ameloblastoma in 2 cases each, and chondromyxoid fibroma in 1 case. The defects were classified as class 2a. Results. Primary reconstruction of the maxilla was carried out using a pedicled mandibular osteomuscular flap. No flap failures occurred. Dental reconstruction was successful in all patients. Proper aesthetics and complete functionality were obtained, and there were no donor-site problems. The patients were followed for 12 to 24 months, with an average of 18.6 months, and no recurrence was encountered. Conclusion. The reverse facial artery,submental artery mandibular osteomuscular flap is safe, quick, and simple to elevate. The flap can be used reliably for reconstructing maxillary defects. © 2009 Wiley Periodicals, Inc. Head Neck, 2009 [source] Primary reconstruction of small mandibular defects by using mandibular remnant,JOURNAL OF SURGICAL ONCOLOGY, Issue 7 2006FRCS(Glasg), FRCSEd, Kumar Alok Pathak MS, MNAMS No abstract is available for this article. [source] Mandibular reconstruction after resection of benign tumours using non-vascularised methods in a series of patients that did not undergo radiotherapyORAL SURGERY, Issue 1 2009D. Mehrotra Abstract Aim:, A case series analysis of 52 consequent subjects of immediate mandibular reconstruction after tumour resection using non-vascularised methods, undertaken at U.P. King George's University of Dental Sciences and King George's Medical University, is being reported. To assess the success of reconstruction on subjective and objective evaluation based upon Mandibular Reconstruction Assessment Scale (MRAS) questionnaire. Methods:, Patients with benign mandibular tumours irrespective of age, sex, site and socio-economic status were included. Primary reconstruction was carried out after resection in two surgical units on surgeon's choice using stainless steel wire (6/52; 12%), stainless steel reconstruction plate (10/52; 19%) or titanium reconstruction plate (36/52; 69%) without bone graft (23/52; 44%) or with bone graft (29/52; 56%). Bone grafts were harvested from iliac crest (21/52; 40%), rib (2/52; 4%) and an additional pectoralis major myocutaneous flap with iliac crest bone graft (6/52; 12%) to provide cover to the reconstruction plate was also used. Results:, The primary outcome measurements were wound healing, mouth opening, chewing efficiency, jaw movements, cosmetic achievement and speech on a five-point scale, all of which improved significantly after surgery. The overall complication rate was 17%. Three patients (6%) had loosening of the screw, two (4%) showed dehiscence of the plate, two (4%) showed tumour recurrence and one (2%) had infection of the graft that was subsequently removed. Conclusion:, Titanium reconstruction plates with iliac crest graft provided good result in the absence of microvascular reconstruction because of unavailable long operating time and lack of expertise. Long-term satisfactory rehabilitation can be achieved using removable dentures or prosthesis on dental implants on the contraption provided by the non-vascularised tissue despite non-calcified bone visible on the skiagram. [source] A Rational Approach to the Use of Tracheotomy in Surgery of the Anterior Skull BaseTHE LARYNGOSCOPE, Issue 2 2008FRCS(C), Yadranko Ducic MD Abstract Objective: To offer an algorithm for airway management in anterior skull base surgery. Methods: This is a retrospective review of 109 patients undergoing major anterior skull base surgery from a single senior surgeon's experience from September 1997 to May 2006. Results: We report only one (1%) postoperative mortality in this series and only seven major complications in six patients, including two cases of stroke, one case of cerebrospinal fluid (CSF) leak, and four cases of delayed osteoradionecrosis. No patients in this series developed tension pneumocephalus. The total major complication rate is 6%. Fifty-one (47%) patients received prophylactic tracheotomy, and 58 (53%) patients did not receive prophylactic tracheotomy. Eighty-eight (81%) patients received anterior skull base reconstruction with local flaps. Six (5.5%) patients required primary reconstruction with a free flap. Conclusion: We attribute the very low rate of major complications in this series and, in particular, no cases of tension pneumocephalus and rarity of CSF leaks primarily to prophylactic tracheotomy in selected patients and to a reconstructive strategy that emphasizes use of local vascularized tissue to reconstruct the anterior skull base. [source] | ||||||||||