54 results match your criteria Ear Reconstruction and Salvage


Successful prosthetic salvage of a suboptimal autogenous auricular reconstruction with digital technologies: A report of 3 challenging treatments.

J Prosthet Dent 2021 Mar 29. Epub 2021 Mar 29.

Associate Professor, ENT department, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan.

The surgical reconstruction of congenitally missing or malformed ears is challenging and involves complicated surgeries. Ear shape, position, and skin color will likely be compromised in patients with relative anatomic symmetry, and it is easier to reproduce these features with a prosthesis. This article describes the prosthetic reconstruction of 3 patients who had received failed or suboptimal surgical reconstruction of their missing or deformed ears. Read More

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Transoral robotic salvage oropharyngectomy with submental artery island flap reconstruction.

Head Neck 2021 Feb 19;43(2):E13-E19. Epub 2020 Nov 19.

Department of Otolaryngology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, USA.

Background: Transoral robotic surgery (TORS) is an effective approach for select salvage oropharyngeal resections. Reconstruction in these scenarios is often necessary for vascular coverage and optimal functional outcomes but can be challenging. The submental artery island flap (SAIF) is well-suited to this reconstruction. Read More

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February 2021

Feasibility of Free Flap Reconstruction Following Salvage Robotic-Assisted Resection of Recurrent and Residual Oropharyngeal Cancer in 3 Patients.

Ear Nose Throat J 2020 Jul 1:145561320937627. Epub 2020 Jul 1.

Department of Otolaryngology, Head and Neck Surgery, Charing Cross Hospital, Imperial College Healthcare, London, United Kingdom.

Introduction: Human papilloma virus (HPV)-positive oropharyngeal cancer carries a good prognosis when managed with primary chemoradiotherapy. However, the dramatically increasing rate of this disease means more patients are now developing recurrence, with surgery remaining the mainstay of treatment. Despite this, there is no agreed technique for excision of recurrent oropharyngeal cancer. Read More

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Secondary Salvage of the Unsatisfactory Microtia Reconstruction.

Plast Reconstr Surg 2020 05;145(5):1252-1261

From the Division of Plastic and Reconstructive Surgery, Keck School of Medicine of the University of Southern California; Cedars Sinai Medical Center; and the Department of Pediatric Plastic Surgery, Wilhelmina Children's Hospital.

Background: Because auricular reconstruction is a complex and relatively uncommon procedure, there are many patients that have had disappointing reconstructions. This study describes the authors' large experience with secondary procedures in patients with unsatisfactory or failed initial ear reconstruction.

Methods: A prospectively maintained database of all consecutive patients who underwent secondary total ear reconstruction from March of 1991 to December of 2017 was reviewed. Read More

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Relationship of the lobular branch of the great auricular nerve to the tympanoparotid fascia: Spatial anatomy for salvage during face and neck lift.

PLoS One 2019 10;14(10):e0222324. Epub 2019 Oct 10.

Department of Anatomy, College of Medicine, Chung-Ang University, Seoul, Republic of Korea.

To enable selection of a safer suspension site to use in face and neck lifting procedures, the spatial relationship between the tympanoparotid fascia and the great auricular nerve should be clarified. In this study, we aimed to elucidate the position of the tympanoparotid fascia and the pathway of the lobular branch of the great auricular nerve traversing the tympanoparotid fascia. Twenty hemifaces from non-preserved bequeathed Korean cadavers (5 males, 7 females; mean age, 77. Read More

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Clinical applications of ear reconstruction with Medpor.

Zhong Nan Da Xue Xue Bao Yi Xue Ban 2019 May;44(5):562-570

Department of Plastic Surgery, Xiangya Hospital, Central South University, Changsha 410008, China.

Objective: To discuss clinical practice, efficacy and surgical techniques for ear reconstruction with Medpor.
 Methods: Medpor ear reconstructions were used to treat 19 microtia in 17 patients (including 2 bilateral patients) in Xiangya Hospital, Central South University from January 2011 to December 2015. Reconstructions included 2 patients with one-stage ear reconstruction with temporoparietal fascial flap, 2 patients with one-stage operation implanting Medpor directly into skin pocket, and 13 patients with two-stage ear reconstruction. Read More

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Hyperbaric Oxygen Therapy: An Effective and Noninvasive Therapy for Complications of Ear Reconstruction.

J Craniofac Surg 2019 Jun;30(4):e382-e385

Department of Plastic and Reconstructive Surgery, Shanghai 9th People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China.

Objectives: Although complications of ear reconstruction are rare, common salvage procedures involve invasive surgery, and final outcomes can be uncertain. In this study, the authors have successfully applied noninvasive hyperbaric oxygen therapy (HBOT) as an adjunct treatment for the complications of ear reconstruction.

Methods: During a 2-year period, 42 patients with complications of ear reconstruction were included in the study. Read More

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Secondary free tissue transfer in head and neck reconstruction.

J Plast Reconstr Aesthet Surg 2019 Jul 9;72(7):1129-1134. Epub 2019 Mar 9.

Department of Plastic and Reconstructive Surgery, Charing Cross Hospital Campus, Imperial College Healthcare, Fulham Palace Road, London W6 8RF, UK.

Background: The incidence of head and neck cancer (H&N) continues to increase together with the need for reconstructive surgery. Head and Neck microsurgeons are likely to encounter challenging secondary free flap surgery on the background of failed primary flaps, radiotherapy treatment or recurrence. The aim of this study was to review our experience of treating such cases in a tertiary referral centre in the United Kingdom. Read More

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Leeching as Salvage Venous Drainage in Ear Reconstruction: Clinical Case and Review of Literature.

Plast Reconstr Surg Glob Open 2018 Nov 5;6(11):e1820. Epub 2018 Nov 5.

Clinic of Plastic and Reconstructive Surgery, University of Padova, Padua, Italy.

Background: Ear avulsion is a rare complication of different traumas, such as car accidents, human or animal bites and stab wounds, and can result in dramatic cosmetic consequences for the patient. Ear replantation, revascularization, and reattachment are the options offering best aesthetic results. But venous outflow insufficiency is responsible for a high rate of failures. Read More

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November 2018

Salvage of Exposed Microtia Cartilage Framework in a Pediatric Patient With a Preauricular Perforator Cutaneous Flap.

J Craniofac Surg 2019 May/Jun;30(3):e255-e257

Division of Plastic and Reconstructive Surgery, Department of Surgery, Mayo Clinic, Rochester, MN.

An 8-year-old boy with oculo-auriculo-vertebral syndrome presented to the authors' clinic for multidisciplinary management of his condition. His congenital ear deformity included bilateral protrusion as well as atypical Microtia affecting the left side. He underwent bilateral otoplasty combined with left canaloplasty at the first stage to address prominent ears and canal atresia and. Read More

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Salvage or Solution: Alloplastic Reconstruction in Hemifacial Microsomia.

Cleft Palate Craniofac J 2019 08 13;56(7):896-901. Epub 2018 Dec 13.

4 American Craniofacial Associates, Athens, Greece.

Introduction: Skeletal reconstruction in severe grades of hemifacial microsomia (HFM) continues to be challenging. Traditional techniques of autografts and osseous distraction for reconstruction of the glenoid fossa, condyle, and ramus can fall short of expectations and can create new problems. This intercontinental study analyzes the role of alloplastic skeletal rehabilitation in severe HFM. Read More

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The Occipital Artery-Based Fascial Flap for Ear Reconstruction.

Plast Reconstr Surg 2019 03;143(3):592e-601e

From the Division of Plastic and Reconstructive Surgery, Keck School of Medicine of the University of Southern California; Cedars Sinai Hospital; and the Department of Pediatric Plastic Surgery, Wilhelmina Children's Hospital, University Medical Center Utrecht.

Background: The temporoparietal fascia flap is frequently used in ear reconstruction. When the temporoparietal fascia flap is unavailable, options for primary or secondary salvage reconstruction are limited. In these patients, an inferiorly based occipital artery fascia transpositional flap is a good alternative for soft-tissue coverage over a framework. Read More

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Salvage of a cartilage framework exposure in total ear reconstruction using a retro-auricular fascia flap with double axial irrigation.

JPRAS Open 2018 Dec 27;18:104-107. Epub 2018 Jul 27.

Plastic Surgery Department, Hotel Dieu de France Hospital, Achrafieh, Beirut, Lebanon.

Cartilage framework exposure during total ear reconstruction requires an early salvage procedure and a secure coverage. We present a case that has been successfully covered by a retro-auricular fascia flap and a skin graft. Because we were dealing with a post-traumatic ear amputation with extensive scarring, the flap was designed to include both the retro-auricular artery and the occipital artery for an enhanced vascular security. Read More

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December 2018

Supraclavicular Artery Island Flap in Patients With Ports or Pacemakers.

JAMA Facial Plast Surg 2018 May;20(3):256-257

Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston.

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Salvage of Unilateral Complete Ear Amputation with Continuous Local Hyperbaric Oxygen, Platelet-Rich Plasma and Polydeoxyribonucleotide without Micro-Revascularization.

Arch Plast Surg 2017 Nov 27;44(6):554-558. Epub 2017 Oct 27.

Institute for Human Tissue Restoration, Department of Plastic and Reconstructive Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.

In many cases of complete ear amputation, microvascular surgery is required for tissue perfusion and organ survival. However, microvascular reconstruction is not always feasible in the absence of suitable vessels. Here, we present the case of a 76-year-old man who underwent complete amputation of the left ear after a collapse at home because of cardiogenic syncope. Read More

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November 2017

Outcomes and reliability of the flow coupler in postoperative monitoring of head and neck free flaps.

Laryngoscope 2018 04 8;128(4):812-817. Epub 2017 Oct 8.

Department of Surgery (Otolaryngology), Yale University School of Medicine, New Haven, Connecticut.

Objectives/hypothesis: To assess the accuracy and reliability of the flow coupler relative to the implantable arterial Doppler probe in postoperative monitoring of head and neck free flaps.

Study Design: Retrospective single-institution study, April 2015 to March 2017.

Methods: Both the venous flow coupler and arterial Doppler were employed in 120 consecutive head and neck free flap cases. Read More

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Repair of complex pharyngocutaneous fistula using a staged temporoparietal fascial flap.

Am J Otolaryngol 2017 Mar - Apr;38(2):254-256. Epub 2016 Nov 25.

Department of Otolaryngology-Head and Neck Surgery, Harvard Medical School, Massachusetts Eye and Ear Infirmary, Boston, MA, USA.

Introduction: PCF is the most common major complication after salvage total laryngectomy (TL), especially for previously irradiated patients with laryngeal or hypopharyngeal cancer.

Methods/results: A 65-year-old woman presented with recurrent bilateral supraglottic SCC requiring salvage TL 5.5years after initial T1N0M0 epiglottic SCC resection. Read More

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December 2017

Salvage arterial anastomosis using a microvascular coupler in head and neck free flap reconstruction.

Laryngoscope 2017 03 18;127(3):642-644. Epub 2016 Oct 18.

Department of Otolaryngology, Massachussetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA.

Microvascular free tissue transfer is essential in complex head and neck reconstruction. The mainstay of microvascular anastomosis has classically been the suture technique, but the coupling device has emerged as a valuable alternative. Couplers are commonly used for venous anastomoses, but most head and neck reconstructive surgeons do not routinely couple arteries. Read More

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Management of sarcomas possibly involving the knee joint when to perform extra-articular resection of the knee joint and is it safe?

Eur J Surg Oncol 2017 Jan 27;43(1):175-180. Epub 2016 May 27.

Bone Tumour Unit, Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, UK.

We reviewed the oncological and functional outcomes of patients treated for a primary sarcoma possibly involving the knee joint and present an algorithm to guide treatment. The records of 76 patients who had a primary bone or soft tissue sarcoma possibly invading the knee between 1996 and 2012 were identified. Mean age and follow-up was 32 years (9-74) and 64 months (12-195), respectively. Read More

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January 2017

Salvage of Ear Framework Exposure in Total Auricular Reconstruction.

Ann Plast Surg 2017 Feb;78(2):178-183

From the *Bona Microtia and Aesthetic Ear Surgery Clinic; †Department of Plastic and Reconstructive Surgery, Gangnam Severance Hospital, Yonsei University, College of Medicine, Seoul; and ‡Department of Plastic and Reconstructive Surgery, National Health Insurance Service Ilsan Hospital, Ilsan, South Korea.

Background: One of the most common complications of total auricular reconstruction is delayed wound healing, which results in skin necrosis and exposure of the ear framework. Various options exist for salvage of the exposed ear framework.

Methods: From January 2009 to May 2014, 149 patients underwent total auricular reconstruction using an autogenous cartilage framework or porous polyethylene framework (Medpor; Stryker, USA). Read More

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February 2017

Long-term Functional Outcomes of Total Glossectomy With or Without Total Laryngectomy.

JAMA Otolaryngol Head Neck Surg 2015 Sep;141(9):797-803

Department of Otolaryngology-Head and Neck Surgery, The Johns Hopkins University, Baltimore, Maryland.

Importance: The optimal reconstruction of total glossectomy defects with or without total laryngectomy is controversial. Various pedicled and free tissue flaps have been advocated, but long-term data on functional outcomes are not available to date.

Objectives: To compare various total glossectomy defect reconstructive techniques used by multiple institutions and to identify factors that may lead to improved long-term speech and swallowing function. Read More

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September 2015

Conservative reconstruction using stents as salvage therapy for disruption of esophago-gastric anastomosis.

World J Gastroenterol 2015 Jul;21(28):8723-9

Taro Oshikiri, Yasuhiro Fujino, Masahiro Tominaga, Department of Gastroenterological Surgery, Hyogo Cancer Center, Akashi, Hyogo 673-8558, Japan.

Esophagectomy with extended lymphadenectomy and gastric conduit reconstruction is a radical procedure for the treatment of esophageal cancer that is associated with a high morbidity rate. Gastric conduit necrosis is a fatal complication that occurs in 2% of patients. Conventionally, two-stage salvage surgery consisting of removal of the necrotic gastric conduit followed by reconstruction has been performed; however, this procedure has a high morbidity rate. Read More

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Carotid Artery Sacrifice and Reconstruction in the Setting of Advanced Head and Neck Cancer.

Otolaryngol Head Neck Surg 2015 Aug 2;153(2):225-30. Epub 2015 Jun 2.

Otolaryngology and Facial Plastic Surgery Associates, Fort Worth, Texas, USA

Objective: To determine oncological and neuromorbidity outcomes in patients with advanced head and neck cancer (stage IVB) requiring sacrifice and reconstruction of the carotid artery.

Study Design: Case series with chart review.

Setting: Tertiary care referral center. Read More

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Pediatric airway reconstruction with a prefabricated auricular cartilage and radial forearm free flap.

Laryngoscope 2015 Aug 30;125(8):1979-82. Epub 2015 Jan 30.

Department of Otolaryngology-Head & Neck Surgery, Oregon Health & Science University, Portland, Oregon, U.S.A.

Prefabricated composite free flaps for complex airway reconstruction have been described for an adult series at our institution. We extended this approach to a pediatric patient with lifelong subglottic stenosis who had failed previous open airway reconstructions. A staged procedure was utilized in which a composite graft was created using conchal cartilages and a radial forearm free flap. Read More

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Is a preoperative group and save necessary for enhanced recovery joint replacement patients?

Br J Hosp Med (Lond) 2014 Dec;75(12):708-10

FY1 in the Department of Ear, Nose and Throat Surgery, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham B18 7QH.

Aim: To consider the financial benefit to the authors' trust of omitting a preoperative group and save in enhanced recovery arthroplasty patients, and to estimate the scope for national savings. Patient safety was considered to determine acceptability for routine practice.

Methods: A total of 121 patients receiving a total knee replacement or total hip replacement on the authors' enhanced recovery protocol were selected. Read More

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December 2014

Common postburn deformities and their management.

Surg Clin North Am 2014 Aug 16;94(4):817-37. Epub 2014 Jun 16.

Plastic Surgery Transplantation, Burn Center, Division of Plastic Surgery, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA.

This article describes a practical, clinically based approach to classification of postburn deformities. Burn scar contractures are of either the broad diffuse type or linear band-like type. The former generally respond well to release and insertion of a skin graft or substitute, whereas the latter are generally repaired using a simple or modified Z-plasty or a transpositional flap technique. Read More

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Supraclavicular flap reconstruction following total laryngectomy.

Laryngoscope 2014 Aug 15;124(8):1777-82. Epub 2014 Jan 15.

Massachusetts Eye and Ear Infirmary, Head and Neck Division; Harvard Medical School, Department of Otology and Laryngology, Boston, Massachusetts, U.S.A.

Objectives/hypothesis: Report on the successful use of the supraclavicular flap for reconstruction following total laryngectomy and highlight the utility and versatility of the supraclavicular flap for reconstruction after total laryngectomy.

Study Design: Retrospective review of a single institution experience.

Methods: A single institution database was reviewed to identify patients undergoing total laryngectomy and supraclavicular flap reconstruction. Read More

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Evolving considerations in the surgical management of cholesteatoma in the only hearing ear.

Otol Neurotol 2014 Jan;35(1):84-90

Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University, Nashville, Tennessee, U.S.A.

Objective: To describe a contemporary, pragmatic approach to managing cholesteatoma in the only hearing ear.

Study Design: Retrospective case series.

Setting: Single tertiary referral center. Read More

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January 2014

Microvascular salvage of a thrombosed total ear replant.

Microsurgery 2013 Jul 2;33(5):396-400. Epub 2013 May 2.

Division of Plastic and Reconstructive Surgery, Department of Surgery, Mayo Clinic, Rochester, MN, USA.

Microvascular replantation, when possible, is the treatment of choice for total ear amputations. Both arterial and venous reconstruction should be attempted. The present case report describes a successful total ear replantation in a 45-year-old woman whose ear was amputated due to a horse accident. Read More

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Salvage of a costochondral graft for microtia after postoperative infection.

Ann Plast Surg 2014 Jan;72(1):56-8

From the *Shriner's Hospital for Children, Boston, MA; †Harvard Medical School, Boston, MA; and ‡Tufts Medical Center, Boston, MA.

Costochondral grafts have been the gold standard for ear reconstruction in cases of microtia repair for decades. Microtia repair has been traditionally associated with a low complication rate, yet little exists in the literature regarding the management of complications when they do occur. Postoperative infections of costochondral grafts have traditionally resulted in complete graft loss, necessitating additional surgery or leaving the patient with continued physical disfigurement and the accompanying psychological and emotional distress. Read More

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January 2014