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Laryngoscope 2022 Jun 2. Epub 2022 Jun 2.

Department of Otolaryngology-Head and Neck Surgery, Columbia University, New York, New York, USA.

Educational Objective: Assess outcomes of pediatric facial reconstruction with fibula free flaps.

Objectives: Free flap reconstruction of complex maxillofacial defects in pediatric patients is rare. Post-operative complications, donor site morbidity, impact on craniofacial growth, and oro-dental rehabilitation are unknown. Read More

Plast Reconstr Surg 2022 May 17. Epub 2022 May 17.

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

Background: Effective handling of auricular complications after the first stage of autologous cartilage microtia reconstruction remains one of the most demanding challenges for plastic surgeons. Here, the authors discuss relevant details for treatment of such complications in various conditions.

Methods: A total of 1739 microtia patients underwent the first stage of auricular reconstruction with autogenous costal cartilage between 2007 and 2019. Read More

Cleft Palate Craniofac J 2022 Apr 21:10556656221095389. Epub 2022 Apr 21.

Department of Plastic and Reconstructive Surgery, 13753Yamaguchi Prefectural Grand Medical Center, Hofu, Japan.

One of the most common complications of total auricular reconstruction is exposure of the ear framework. Various reconstruction methods have been reported depending on the location and size of exposed cartilage. This report describes a safe reconstruction method for each exposed part of the grafted ear framework. Read More

Acta Otolaryngol 2022 Mar-Apr;142(3-4):241-247. Epub 2022 Mar 18.

Department of Otorhinolaryngology-Head and Neck Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, China.

Background: Three-dimensional fluid-attenuated inversion-recovery (3 D-FLAIR) and real inversion-recovery (3 D-real IR) sequences are used to detect endolymphatic hydrops (EH), but medium inversion-time inversion-recovery imaging with magnitude reconstruction (MIIRMR) may be more sensitive.

Aims: We investigated the inner-ear visualisation success rate and EH detection rates of 3 D-FLAIR and 3 D-real IR, and whether salvage MIIRMR could improve EH detection.

Materials And Methods: Fifty-one patients (102 ears) with episodic or chronic vestibular syndrome were injected intra-tympanically with 8-fold diluted gadolinium, and 3 D-FLAIR and 3 D-real IR images obtained 24-h post-injection. Read More

J Bone Oncol 2021 Dec 1;31:100401. Epub 2021 Nov 1.

Oncology Service, The Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, United Kingdom.

Background: While extra-articular resection (EAR) of the knee and shoulder joint is associated with poorer clinical outcomes, the oncological and functional risks of EAR of the hip joint are unknown. We aimed to compare these risks between EAR of the hip joint and intra-articular resection (IAR).

Methods: We conducted a comparative study of 75 patients who underwent tumour resection and limb-salvage reconstruction for bone sarcomas of the -acetabulum between 1996 and 2016. Read More

Plast Reconstr Surg Glob Open 2021 Oct 28;9(10):e3899. Epub 2021 Oct 28.

Division of Plastic Surgery, Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia.

The cochlear implant (CI) procedure is one of the most efficient surgical options for the management of patients suffering from severe bilateral sensorineural hearing loss. Notably, CI exposure is one of the most commonly reported complications. Herein, we report our experience in the management of three patients with CIs complicated by implant exposure. Read More

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

Head Neck 2021 02 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

Ear Nose Throat J 2021 Dec 1;100(10_suppl):1113S-1118S. 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

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

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

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

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

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

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

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

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

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

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

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.

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

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

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

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

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

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

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

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

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

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