To investigate causes of failure free flap reconstructions in patients undergoing reconstruction head and neck defects.Case series with chart review.Single tertiary care center.Patients underwent between January 2007 June 2017 (n = 892). Variables included were clinical characteristics, social history, defect site, donor tissue, ischemia time, postoperative complications. Statistical methods used include univariable multivariable analysis failure.The overall rate was 4.8% 43). Intraoperative...

Autologous skin grafting to the donor site in patients who undergo radial forearm free flap reconstruction (RFFF) is associated with cosmetic and functional morbidity. Integra artificial dermis (Integra Lifesciences, Plainsboro, NJ) a bovine collagen based dermal substitute that can be used as an alternative primary autologous transplantation of site. We describe staged using followed by ultrathin results highly aesthetic outcomes for these defects. A retrospective review 29 undergoing...

Objective Analyze the cause and significance of a shift in timing free flap failures head neck reconstruction. Study Design Retrospective multi‐institutional review prospectively collected databases at tertiary care centers. Methods Included consecutive patients undergoing reconstructions defects between 2007 2017. Selected variables: demographics, defect location, donor site, failure cause, social radiation therapy history. Results Overall rate was 4.6% (n = 133). Distribution tissue by...

Background: Defects following Mohs micrographic surgery often require complex facial reconstruction, with timing varying between immediate (<24 h) and staged (>24 reconstruction. Objective: To compare the risk of postoperative complications reconstruction defects for nonmelanoma skin cancer (NMSC). Methods: Patients NMSC who underwent were identified using a health network database (TriNetX). Complications including flap loss, necrosis, hyperpigmentation, hypertrophic scarring, infection,...

This study aims to explore outcomes among 2-stage paramedian forehead flaps (PFFs), 3-stage PFFs, and PFFs undergoing accelerated pedicle takedown. A retrospective review. tertiary care institution. Patients who underwent for nasal defects between 2017 2022 were identified. Demographic, clinical, surgical characteristics compared groups. Surgical cosmetic revision procedures evaluated. Among 52 patients analyzed, 39 13 PFFs. There no significant differences in demographics, comorbidities, or...

Parotidectomy is a common treatment option for parotid neoplasms and the complications associated with this procedure can cause significant morbidity. Reconstruction following parotidectomy utilized to address contour deformity facial nerve paralysis. This study aims demonstrate national trends in patients identify factors adverse postoperative outcomes. includes largest patient database date determining epidemiologic trends, reconstructive prevalence of events parotidectomy.A retrospective...

To determine the frequency at which patients with osteocutaneous free flap reconstruction of head and neck develop long-term complications identify predisposing perioperative factors.A prospectively maintained database flaps performed a single institution over 10-year period was queried.Single tertiary care referral center.In total, 250 osseous or (OCFFs) for mandibular maxillary were analyzed. Data collected on demographics, preoperative therapy, resection location, adjuvant treatment,...

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Objective To describe the natural history of bone segment union in head and neck free flap procedures detail association poor with postoperative complications. Study Design Case series chart review. Setting Single tertiary care referral center. Subjects Method Patients mandibular or maxillary defects reconstructed osseous osteocutaneous flaps were analyzed (n = 104). Postoperative computed tomography positron emission tomography/computed scans reviewed for signs osseointegration nonunion....

Abstract Background Understanding factors impacting successful salvage of a compromised free flap. Methods Multi‐institutional review flap reconstructions for head and neck defects (n = 1764). Results Free compromise rate: 9% 162); 46% salvaged 74). Higher rates in initial 48 hours (64%) vs after (30%; P &lt; .001). Greater (14%) failure (8%) if inset challenging straightforward (6% compromise, 4% failure; .035). (23%) (17%) following intraoperative anastomosis revision no (7% .0001)....

The cholinergic pedunculopontine tegmental area of the anesthetized rat was explored for single units responsive to somatosensory stimulation. Units projecting intralaminar thalamus were identified by antidromic Approximately one half consisted low threshold light tapping and stroking; others high mechanoreceptive units. Most receptive fields tri- geminal contralateral. These results suggest that information is an important element in a subcortical system linking this with basal ganglia,...

Parotid trauma can lead to both short and long-term complications such as bleeding, infection, facial nerve injury, sialocele, salivary fistula, resulting in pain disfigurement. Facial injuries inferior a line extended from the tragus upper lip should raise concern for parotid injury. These be stratified into three regions they relate masseter muscle. Injuries posing greatest risk of damage Stensen's duct include those anterior posterior border necessitate exploration. When is disrupted,...

Objective To review a single institution’s outcomes of free flap reconstruction the head and neck in patients aged ≥80 years as compared with those &lt;80 years. Study Design Retrospective cohort study. Setting Tertiary academic hospital. Subjects Methods Patients ≥ 80 who underwent between 2007 2013 were identified matched by type younger patients. Outcome measures included success, length stay, discharge disposition, complications, 2‐year mortality. Associations complications comorbidities...

IMPORTANCE Much has been published regarding rejuvenation of the upper face with botulinum toxin A injection; however, optimal target tissue layer not specifically examined. OBJECTIVE To seek a difference between subcutaneous (SC) and intramuscular (IM) administration. DESIGN, SETTING, AND PARTICIPANTS Prospective, randomized study at tertiary care university facial plastic surgery practice. Nineteen patients who underwent treatment to forehead were so that each patient received IM injection...

Objective Naso- or orbitocutaneous fistula (NOF) is a challenging complication of orbital exenteration, and it often requires surgical repair. We sought to identify the incidence risk factors for NOF after exenteration. Study Design Retrospective chart review, systematic meta-analysis. Setting Tertiary care center. Participants Patients undergoing free flap reconstruction following Records were reviewed clinicopathologic data, operative details, outcomes. Main Outcome Measures Univariate...

For difficult or rare procedures, simulation offers an opportunity to provide education and training. In developing adequate model utilize in simulation, 3D printing has emerged as a useful technology detailed, accessible, high-fidelity models. Nasal osteotomy is essential step many rhinoplasty surgeries, yet it can be challenging perform receive exposure this nuanced portion of the procedure. As currently stands, there are limited opportunities practice nasal due reliance on cadaveric...

Nasal septal perforations (NSPs) are relatively common. They can be problematic for both patients and head neck reconstructive surgeons who attempt to repair them. Often, this is made using an interpositional graft sandwiched between bilateral mucoperichondrial advancement flaps. The ideal nasal cartilage. However, many with NSP lack sufficient cartilage harvest. Harvesting other sources of autologous grafts, such as auricular cartilage, adds morbidity the surgical case results in a that...

Nasal osteotomy is a commonly performed procedure during rhinoplasty for both functional and cosmetic reasons. Teaching learning this proves difficult due to the reliance on nuanced tactile feedback. For surgical simulation, trainees are traditionally limited cadaveric bones, which can be costly obtain.This study aimed design print low-cost midface model nasal simulation.A 3D reconstruction of was modified using free open-source software Meshmixer (Autodesk Inc). The pyriform aperture...

To assess risk factors for cerebrospinal fluid (CSF) leak and complications after microvascular reconstruction of cranio-orbitofacial resection with orbital exenteration (CFOE).Retrospective case series.Seventy consecutive patients at a tertiary hospital underwent 76 procedures CFOE defects. Patients were stratified by extent skull base exposure presence or absence dural resection. the apex roof alone classified as minimal (MS) (n = 32). Those beyond significant (SS) 38) subdivided into...