Staged Head and Neck Reconstruction: Heresy or a Reasoned Approach in a Select Group of Patients?

IF 0.8 Q4 DENTISTRY, ORAL SURGERY & MEDICINE Craniomaxillofacial Trauma & Reconstruction Pub Date : 2022-09-01 DOI:10.1177/19433875211031361
Mark L Urken, Quinn O'Malley, Mykayla Sandler, Monica H Xing, Edward Ansari, Neil Mundi, Daniel Buchbinder, Eran Alon, Devin Okay
{"title":"Staged Head and Neck Reconstruction: Heresy or a Reasoned Approach in a Select Group of Patients?","authors":"Mark L Urken,&nbsp;Quinn O'Malley,&nbsp;Mykayla Sandler,&nbsp;Monica H Xing,&nbsp;Edward Ansari,&nbsp;Neil Mundi,&nbsp;Daniel Buchbinder,&nbsp;Eran Alon,&nbsp;Devin Okay","doi":"10.1177/19433875211031361","DOIUrl":null,"url":null,"abstract":"<p><strong>Study design: </strong>case series.</p><p><strong>Objective: </strong>The restoration of defects in a single procedure with microvascular free flap reconstruction has become a mainstay of head and neck surgery. Yet in patients with complex defects and pre-existing comorbid medical conditions, a staged-reconstructive approach can enhance the safety of the procedure and improve the patient's outcome.</p><p><strong>Methods: </strong>We present 3 representative case examples of a larger series of patients who underwent reconstruction of major defects and discuss the usefulness of a staged-reconstructive approach in the management of complex patients.</p><p><strong>Results: </strong>All 3 patients, with an existing composite defect in the setting of prior radiation therapy, underwent successful staged-reconstructive surgery using a variety of free tissue and regional flap transfers.</p><p><strong>Conclusions: </strong>A staged approach facilitates the reconstruction of complex composite defects, increases vessel availability, and mitigates the risk of flap failure. Although this approach commits the patient to multiple procedures and a more prolonged plan of care, it is preferable to 1 operation in specific complex situations with adverse, high-risk clinical features.</p>","PeriodicalId":46447,"journal":{"name":"Craniomaxillofacial Trauma & Reconstruction","volume":"15 3","pages":"253-263"},"PeriodicalIF":0.8000,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/19433875211031361","citationCount":"1","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Craniomaxillofacial Trauma & Reconstruction","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1177/19433875211031361","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"DENTISTRY, ORAL SURGERY & MEDICINE","Score":null,"Total":0}
引用次数: 1

Abstract

Study design: case series.

Objective: The restoration of defects in a single procedure with microvascular free flap reconstruction has become a mainstay of head and neck surgery. Yet in patients with complex defects and pre-existing comorbid medical conditions, a staged-reconstructive approach can enhance the safety of the procedure and improve the patient's outcome.

Methods: We present 3 representative case examples of a larger series of patients who underwent reconstruction of major defects and discuss the usefulness of a staged-reconstructive approach in the management of complex patients.

Results: All 3 patients, with an existing composite defect in the setting of prior radiation therapy, underwent successful staged-reconstructive surgery using a variety of free tissue and regional flap transfers.

Conclusions: A staged approach facilitates the reconstruction of complex composite defects, increases vessel availability, and mitigates the risk of flap failure. Although this approach commits the patient to multiple procedures and a more prolonged plan of care, it is preferable to 1 operation in specific complex situations with adverse, high-risk clinical features.

查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
分阶段头颈部重建术:对特定患者来说是异端还是合理的方法?
研究设计:病例系列。目的:微血管游离皮瓣单次修复头颈部缺损已成为头颈部外科的主流。然而,对于有复杂缺陷和先前存在的合并症的患者,分阶段重建方法可以提高手术的安全性并改善患者的预后。方法:我们提出了3例具有代表性的病例,这些患者接受了重大缺陷的重建,并讨论了分期重建方法在复杂患者管理中的有效性。结果:所有3例患者均存在先前放射治疗的复合缺损,均通过各种游离组织和区域皮瓣转移成功地进行了分阶段重建手术。结论:分阶段的方法有助于重建复杂的复合缺损,增加血管的可用性,并降低皮瓣失败的风险。虽然这种方法需要患者进行多次手术和更长时间的护理计划,但在具有不良和高风险临床特征的特定复杂情况下,它优于一次手术。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 去求助
来源期刊
Craniomaxillofacial Trauma & Reconstruction
Craniomaxillofacial Trauma & Reconstruction DENTISTRY, ORAL SURGERY & MEDICINE-
自引率
0.00%
发文量
39
期刊最新文献
Guidelines for Orbital Defect Assessment and Patient-Specific Implant Design: Introducing OA2 (Orbital Assessment Algorithm). Moving Forward: The Last Subscription Issue and the Dawn of Open Access. Opportunity Cost of Surgical Management of Craniomaxillofacial Trauma: A Longitudinal Study. Does More Invasive Surgery Result in Higher Patient Satisfaction? A Long-Term Follow-Up of 136 Zygomaticomaxillary Complex Fractures. Microvascular Reconstructions in Elderly Patients With Oral Squamous Cell Carcinoma - Too Old for Surgical Treatment?
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1