Microfil injections in 8 cadavers and clinical experience with 26 patients have demonstrated a reliable blood supply to the lateral border of scapula based on branches circumflex scapular artery. This tissue has been used successfully for reconstruction variety defects resulting from maxillectomy mandibular cancer benign tumor excisions. Advantages this over previous reconstructive methods include ability design multiple cutaneous panels separate vascular pedicle bone flap allowing...

✓ A subtemporal-preauricular infratemporal fossa approach to remove 22 large neoplasms involving the lateral and posterior cranial base is detailed. The areas from which a neoplasm could be removed by this included sphenoid clival bone; medial half of petrous temporal fossa; nasopharynx; retro- parapharyngeal area; ethmoid, sphenoid, maxillary sinuses; intradural clivus-foramen magnum area. pathology benign tumors such as meningioma, malignant cartilaginous chordoma, other lesions...

Jones, Neil Ford F.R.C.S.; Swartz, William M. M.D.; Mears, Dana C. Jupiter, Jesse B. Grossman, Allen B.S. Author Information

The use of stem cells for cell-based tissue-engineering strategies represents a promising alternative the repair cartilaginous defects. multilineage potential population putative mesodermal obtained from human lipoaspirates, termed processed lipoaspirate cells, was previously characterized. chondrogenic those confirmed with combination histological and molecular approaches. Processed under high-density micromass culture conditions, supplemented transforming growth factor-beta1, insulin,...

Three hundred five microsurgical free flaps have been performed for defects of the head and neck by a team two surgeons plastic over 9-year period, with success rate 91.2%. The most common used were jejunum (89), radial forearm (57), rectus abdominis (48), latissimus dorsi (40), scapular (32), fibula (15), iliac crest (11). Thirty-three required reexploration anastomotic thrombosis or hematoma (10.8%), which 18 salvaged (54.5%). Thirteen flap failures occurred in 113 patients who had...

The 20-MHz ultrasonic Doppler probe was used to determine its efficacy as a continuous monitoring technique for microvascular anastomoses. A 1-mm2 piezoelectric crystal embedded in soft silicone sleeve sutured directly the blood vessel distal anastomosis. Using dog femoral artery, simultaneous measurement of velocity and flow with an electromagnetic flowmeter established direct correlation between 14 percent error at maximum 18 minimum conditions. then implanted rabbit artery 1 week (n = 3)...

Abstract The exposure and operative management of the petrous upper cervical internal carotid artery (ICA) in 29 patients is detailed. Twenty-seven these had extensive cranial base neoplasms (benign or malignant), 1 an inflammatory cholesteatoma, aneurysm ICA immediately proximal to canal. Preoperative studies useful evaluation included computed tomography, magnetic resonance imaging, cerebral angiography, a balloon occlusion test with neurological status blood flow. was obtain control...

Background: Immediate reconstruction of composite head and neck defects using free tissue transfer is an accepted treatment standard. There remains, however, ongoing debate on whether the costs associated with this reconstructive approach merit its selection, especially considering poor patient prognoses high cost care. Methods: A retrospective review last 100 consecutive patients undergoing microsurgical for cancer by two senior surgeons was performed to determine complications or...

Background: Carpal tunnel release is one of the most frequently performed hand operations. However, persistent, recurrent, or completely new symptoms following carpal remain a difficult problem. Methods: A retrospective review surgical findings and outcomes 50 consecutive patients who had undergone 55 revision operations was performed. Results: The initial an endoscopic technique in 34 hands open 21 hands. Thirty-four continued to have persistent symptoms, 18 recurrent three symptoms....

Use of enteric grafts is a popular method for reconstruction the cervical esophagus and hypopharynx. Free jejunal transfer (FJT) gastric pull-up (GP) are most methods used. This discussion retrospective review our experience with 50 cases free 15 pull-up. The graft survival rate was 94 percent (47 50) 87 (13 15) Successful swallowing achieved in 88 (44 transfers pull-ups. Patients were able to swallow leave hospital sooner: 10.6 versus 16.0 days 22.3 29.0 days, respectively. Fistulas...

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One-hundred and fourteen limb transplantations have been performed across a major histoincompatibility barrier between donor ACI (RT1a) recipient Lewis (RT11) rats immunosuppressed with various dosages of FK-506 cyclosporine. Three-hundred thirty biopsy specimens from 64 animals evaluated histologically for signs rejection. A new histologic grading system is introduced to classify the process rejection in component tissues (skin, muscle, bone, articular cartilage) allograft. The results...

There is ongoing controversy regarding the reliability of skin island associated with fibular osteocutaneous flap for mandibular reconstruction. Anatomical dissections and a clinical series reconstructions using have demonstrated unequivocally that can be reliably harvested fibula based purely on septal perforators, without needing to incorporate portions soleus or flexor hallucis longus muscles perform any intramuscular dissection anastomosis muscle perforators. However, should designed...

During the 5-year period from July of 1984 to 1989, we performed 94 free-tissue transfers in 92 patients over age 50 whom arbitrarily defined as "elderly." There were 32 range between and 59 years, 40 aged 60 69 20 70 79 years. Seventy-one flaps utilized for head neck reconstruction, 23 used reconstruction trunk extremities. was 1 total flap loss, a viability rate 99 percent (93 94). Postoperative complications classified into surgical (technical) medical categories. 14 major (15 percent) 13...

A multidisciplinary approach by the neurosurgeon, ENT surgeon, and plastic surgeon has been used in seven patients with extensive tumors involving middle posterior skull base. Wide resection of these was accomplished, resultant defect cranial base reconstructed using free rectus abdominis muscle flaps. The flap to reconstruct defects lateral walls nasopharynx, obliterate exposed paranasal sinuses, cover tenuous dural repairs or grafts overlying temporal lobe fossa prevent cerebrospinal fluid...

Twenty patients with microvascular fibula flap reconstruction of oromandibular defects were selected for implant-retained prosthodontic rehabilitation. A total 71 osseointegrated implants placed within the grafted fibulas. Four had immediate implant placement at time their reconstructive surgery, and remaining 16 secondarily. One patient received postoperative radiation therapy (5940 cGy) 6 weeks following placement. No in previously irradiated flaps. minimum 6-month period osseointegration...

The purpose of this study was to evaluate the osseous healing a critical-sized femoral defect in rat model with use recombinant human bone morphogenetic protein-2 (rhBMP-2), matrix fabricated D,D-L,L-polylactic and hyaluronan acid (OPLA-HY), vascularized periosteal flap.The carrier OPLA-HY or without rhBMP-2 implanted 1-cm-long secured plate screws. In some groups, flap harvested from medial surface tibia. group 1, defects animals were filled alone; 2, covered by flap; 3, 20 mug added...

Abstract During the 5‐year period from July 1984 to 1988, 72 patients over age of 50 underwent microvascular free tissue transfers for head and neck reconstruction. There were 22 aged 50‐59 years, 31 60‐69 19 70‐79 years. Seventy these procedures (97%) done at time ablative surgery utilizing a two‐team approach. was 1 total flap loss viability rate 99% (73/74). 46 complications in 40 patients: 21 surgical 25 medical. Twelve required reoperation major complication 16%. Major medical developed...

Background: A single surgeon's experience with 67 pedicled and free radial forearm flaps for reconstruction of the elbow, wrist, hand was analyzed retrospectively. Methods: Fifty-seven (43 reverse 14 antegrade flow) 10 were performed in 66 patients, including seven fascial one osteocutaneous flap. Indications involved soft-tissue coverage elbow (n = 11), dorsal wrist 24), palmar 12), thumb amputations 5); after release thumb-index finger web space contractures 6) radioulnar synostosis 2);...