Microvascular free tissue transfer has gained world-wide acceptance as a means of reconstructing post-oncologic surgical defects in the head and neck region. Since 1977, authors have introduced this reconstructive procedure to reconstruction after cancer ablation, total 2372 flaps were transferred 2301 patients during period over 23 years. The most frequently used flap was rectus abdominis (784 flaps: 33.1 percent), followed by jejunum (644 27.2 percent) forearm (384 16.2 percent). In...

Abstract To seek a suitable scaffold for cartilage tissue engineering, we compared various hydrogel materials originating from animals, plants, or synthetic peptides. Human auricular chondrocytes were embedded in atelopeptide collagen, alginate, PuraMatrix™, all of which are will soon be clinically available. The the collagen proliferated well, while others showed no proliferation. A high‐cell density culture within each enhanced expression type II mRNA, when with that without hydrogel. By...

The two-stage method combining neurovascular free-muscle transfer with cross-face nerve grafting is now a widely accepted procedure for dynamic smile reconstruction in cases long established unilateral facial paralysis. Although the results are promising, two operations, about 1 year apart, exert an economic burden on patients and require lengthy period before obtaining results. Sequelae such as hypoesthesia, paresthesia, conspicuous scar donor leg harvesting sural graft also cannot be...

For this article, 178 consecutive cases of mandibular reconstruction using microvascular free flaps and performed from 1979 to 1997 were studied. The purpose report is compare flap success rates, complications, aesthetic functional results. ages the 131 men 47 women ranged 13 85 years, with an average 55 years. Donor sites included rib (11 cases), radius (one case), ilium (36 scapula (51 fibula (34 soft-tissue implant (45 cases). Complications total necrosis, partial major fistula formation,...

The two-stage method combining neurovascular freemuscle transfer with cross-face nerve grafting is now a widely accepted procedure for dynamic smile reconstruction in cases long established unilateral facial paralysis. Although the results are promising, two operations, about 1 year apart, exert an economic burden on patients and require lengthy period before obtaining results. Sequelae such as hypoesthesia, paresthesia, conspicuous scar donor leg harvesting sural graft also cannot be...

AbstractWe reviewed 109 consecutive patients with cancer of the hypopharynx or cervical oesophagus who underwent free flap transfer for immediate reconstruction after total pharyngolaryngo-oesophag-ectomy. The flaps used were either jejunal (n = 70) radial forearm 39). Significantly more fistulas (3/70 compared 15/39, p < 0.0001) and strictures (6/64 13/33, 0.0008) developed in than group. However, functional donor site morbidity was minimal there no cases necrosis We consider that should be...

Koshima, Isao M.D.; Urushibara, Katsuyuki Fukuda, Norio Ohkochi, Masayuki Nagase, Takashi Gonda, Koichi Asato, Hirotaka Yoshimura, Kotaro M.D. Author Information

Since permanent cartilage has poor self-regenerative capacity, its regeneration from autologous human chondrocytes using a tissue engineering technique may greatly benefit the treatment of various skeletal disorders. However, conventional chondrocyte implantation is insufficient both in quantity and quality due to two major limitations: dedifferentiation during long term culture for multiplication hypertrophic differentiation by stimulation redifferentiation. To overcome limitations, this...

Background: Few authors have reported the subsequent treatment for patients in whom free tissue transfers head and neck failed as a result of vascular thrombosis. Methods: Between 1993 May 2005, 502 flaps were transferred after cancer ablation authors' hospital, 19 which resulted total necrosis caused by The categorized these cases into four groups analyzed salvage treatment. Results: For jejunal transfer, early initiation oral intake was obtained when another jejunum transferred....

Patients sustaining a peripheral nerve injury will frequently experience residual muscle weakness after reinnervation, even if the repair is performed under optimal circumstances to allow rapid reinnervation. The mechanisms responsible for this contractile dysfunction remain unclear. It hypothesized that and repair, reduced number of axons are available skeletal reinnervation results in whole force specific deficits. A rat model peroneal was designed so could be systematically reduced. In...

Chondrocyte preparation with the safety and efficiency is first step in cartilage regenerative medicine. To prepare a chondrocyte proliferation medium that does not contain fetal bovine serum (FBS) provides more than 1000-fold increase cell numbers within approximately 1 month, we attempted to use containing 5% human (HS), but it exerted no twofold 2 weeks. compensate for limited ability HS, investigated combinational effects of 12 factors [i.e., fibroblast growth factor (FGF)-2,...

A comparative study was conducted of the results venous end-to-end and end-to-side anastomosis in 948 clinical cases microvascular free-tissue transfers for head neck reconstruction following tumor resection. End-to-side to internal jugular vein achieved uneventfully present series, while a variety recipient veins used anastomosis. The incidence thrombosis 1.8% (15/835) group 2.7% (3/113) No statistical difference observed between two groups. One may hesitate perform because unfamiliarity,...

A wide variety of modalities, including surgery, radiation therapy, and chemotherapy, alone or in combination, have been used for the treatment squamous cell carcinoma (SCC) maxillary sinus to obtain better local control maintain functions. However, there is still much controversy with regard optimum treatment.From 1987 1999, 33 patients SCC were treated at Department Otolaryngology-Head Neck Surgery, University Tokyo Hospital. The consisted 30-40 grays (Gy) preoperative radiotherapy...

Microneurovascular free muscle transfer is fast becoming a standardized procedure in the treatment of established or long-standing facial paralysis. However, there no general agreement as to whether should be employed for children who still are growing. A patient's natural growth may influence disturb reproduction smile, child not able collaborate with postoperative rehabilitation sufficiently well obtain satisfactory result. One hesitate employ aged under 10 out fear its technical...

The tissue expansion technique is advantageous in facial reconstruction because it makes possible to resurface even wider defects with neighboring skin similar color and texture superior obtained elsewhere, thereby surpassing conventional methods. However, there still remain some problems relating procedural details, such as the selection of expanders sites their insertion; design, elevation, suturing, fixation expanded flap; management free margins lower lip eyelid. In each case,...

Neurovascular free-muscle transfer for facial reanimation was performed as a secondary reconstructive procedure 45 patients with paralysis resulting from ablative surgery in the parotid region. This intervention differs neurovascular treatment of established conditions such congenital dysfunction, unresolved Bell palsy, Hunt syndrome, or intracranial morbidity, difficulties including selection recipient vessels and nerves, requirements soft-tissue augmentation. article describes authors'...

Many techniques for reconstruction of an absent umbilicus have been described; however, none has achieved a perfect result. We report new alternative constructing using conical flap and present two representative clinical cases. Our technique creates with sufficient depth good results, including maintenance after more than 1 year.

Abstract In living-donor liver transplantation (LDLT), reconstruction of the hepatic artery is challenging because recipient located deep in abdominal cavity and operating field limited. Also, graft short occasionally damaged. To overcome these difficulties, we developed a double-needle microsuture technique for reconstruction. A total 161 adult patients received 163 LDLTs using this new technique. The first suture was placed at most difficult point to be visualized through microscope. Each...

The pathogenesis of holoprosencephaly is multifactorial, and blockage Sonic hedgehog signaling one the most important causative factors in animal models human cases. In this study, authors analyzed facial anomalies mouse embryos, which were cultured vitro exposed to cyclopamine, an alkaloid blocker signaling. When with cyclopamine for embryonic day 8.5 10.5, whole body size was smaller than normal, distance angle between nasal placodes remarkably reduced. Extension cranial surface vessels...

Summary: Recent advances in endoscopic surgery have allowed laparoscopic harvesting of the omental flap with reduced donor-site morbidity and deformity. Between August 2004 May 2010, authors performed immediate breast reconstruction free 10 cancer patients, employing it either as a pedicle or for volume replacement. Only one complication occurred during follow-up. Cosmetic results were mostly satisfactory. The is safe procedure minimal deformity can be an additional option partial after...

Congenital macrostomia (transverse facial cleft) is a relatively rare anomaly. Surgical methods used to correct this anomaly include commissuroplasty, muscle-plasty of the orbicularis oris, and closure cleft cheek. The authors report new vermilion square flap surgical technique that combines lower lip mucocutaneous border with lazy W-plasty ensure natural commissure cheek skin closure. This was in 8 patients satisfactory results.