Pub Date : 2020-07-01DOI: 10.4103/jhnps.jhnps_56_20
Nageswara R. Noothanapati, Krishnakumar Thankappan, N. Akali, T. Patel, D. Balasubramanian, S. Iyer
Facial artery is a branch of the external carotid system extending from the upper neck to the nasion. Various flaps are described in the literature based on the facial artery and vein in the neck and face to reconstruct the head-and-neck cancer defects, either superiorly based or inferiorly based. This article summarizes the flaps and their variations based on the facial arteriovenous system. The flap harvest techniques, the indications, advantages and the limitations of the nasolabial flap, facial artery myomucosal flap, and submental flap are described, with appropriate case demonstrations. Variations of the flaps are also discussed.
{"title":"Flaps based on facial arteriovenous system for the reconstruction of head-and-neck cancer defects","authors":"Nageswara R. Noothanapati, Krishnakumar Thankappan, N. Akali, T. Patel, D. Balasubramanian, S. Iyer","doi":"10.4103/jhnps.jhnps_56_20","DOIUrl":"https://doi.org/10.4103/jhnps.jhnps_56_20","url":null,"abstract":"Facial artery is a branch of the external carotid system extending from the upper neck to the nasion. Various flaps are described in the literature based on the facial artery and vein in the neck and face to reconstruct the head-and-neck cancer defects, either superiorly based or inferiorly based. This article summarizes the flaps and their variations based on the facial arteriovenous system. The flap harvest techniques, the indications, advantages and the limitations of the nasolabial flap, facial artery myomucosal flap, and submental flap are described, with appropriate case demonstrations. Variations of the flaps are also discussed.","PeriodicalId":41774,"journal":{"name":"Journal of Head & Neck Physicians and Surgeons","volume":"8 1","pages":"80 - 86"},"PeriodicalIF":0.1,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41768869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-07-01DOI: 10.4103/jhnps.jhnps_50_20
A. Thakar
{"title":"Transoral surgery: The developing paradigm of minimally invasive organ and function preserving surgery","authors":"A. Thakar","doi":"10.4103/jhnps.jhnps_50_20","DOIUrl":"https://doi.org/10.4103/jhnps.jhnps_50_20","url":null,"abstract":"","PeriodicalId":41774,"journal":{"name":"Journal of Head & Neck Physicians and Surgeons","volume":"8 1","pages":"47 - 49"},"PeriodicalIF":0.1,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47977660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-07-01DOI: 10.4103/jhnps.jhnps_18_20
M. Garcia, S. Vallejo, Natalia Haro, Rogelio Martínez-Wagner
Needlefish (Strongylura Notata) are known to cause painful injuries in humans. There are several reports of serious puncture wounds to the chest, abdomen, neck, and extremities. In this report, we describe an impressive puncture lesion to the face that resulted in unilateral partial loss of vision with perforation of the cranial vault secondary to an encounter with a fish while diving. A 39-year-old female presented to the emergency department 1 week after a diving trip to Cancun with pain and swelling in the right orbital region. She had associated right-sided partial vision loss and a puncture wound on the right malar region. Computed tomography scan of the head showed two foreign bodies; one which crossed the orbit from the inferior lateral side displacing medially the optic nerve and into the cranial cavity. The second foreign body was located in the inferolateral side of the malar bone. Multidisciplinary surgical removal of the objects resulted in complete resolution of visual acuity deficits as well as total recovery of her diplopia. Fortunately, minimal limitation in the abduction of the right eye persisted.
{"title":"Multidisciplinary Approach for Vision Recovery after a Diving Accident with a Needlefish in Cancun","authors":"M. Garcia, S. Vallejo, Natalia Haro, Rogelio Martínez-Wagner","doi":"10.4103/jhnps.jhnps_18_20","DOIUrl":"https://doi.org/10.4103/jhnps.jhnps_18_20","url":null,"abstract":"Needlefish (Strongylura Notata) are known to cause painful injuries in humans. There are several reports of serious puncture wounds to the chest, abdomen, neck, and extremities. In this report, we describe an impressive puncture lesion to the face that resulted in unilateral partial loss of vision with perforation of the cranial vault secondary to an encounter with a fish while diving. A 39-year-old female presented to the emergency department 1 week after a diving trip to Cancun with pain and swelling in the right orbital region. She had associated right-sided partial vision loss and a puncture wound on the right malar region. Computed tomography scan of the head showed two foreign bodies; one which crossed the orbit from the inferior lateral side displacing medially the optic nerve and into the cranial cavity. The second foreign body was located in the inferolateral side of the malar bone. Multidisciplinary surgical removal of the objects resulted in complete resolution of visual acuity deficits as well as total recovery of her diplopia. Fortunately, minimal limitation in the abduction of the right eye persisted.","PeriodicalId":41774,"journal":{"name":"Journal of Head & Neck Physicians and Surgeons","volume":"8 1","pages":"137 - 140"},"PeriodicalIF":0.1,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48532403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-07-01DOI: 10.4103/jhnps.jhnps_10_20
Sankalp Singh, N. Bisht, A. Sarin, P. Mishra, A. Kapoor
Metastases to the parotid gland as first presentation of lung cancer are extremely rare and occur in <1% cases most of which are small cell carcinomas. We present such a case of squamous cell carcinoma of the lung who presented with swellings of the parotid gland and over the scalp. He was diagnosed on the basis of fine needle aspiration cytology followed by investigative imaging to search for the primary. He was treated with palliative radiotherapy and chemotherapy but succumbed to his disease at 9 months from the diagnosis. Parotid and skin metastases in lung cancer can occur by both lymphatic and hematogenous spread. Metastases to such visible and accessible parts of the body can help in the early detection of disease, though in most cases, it occurs as a sign of progression in preexisting cancer. Management options are limited in such patients, and overall, the prognosis is poor.
{"title":"Non-small Cell Lung Cancer Presenting as Parotid and Scalp Swellings: A Rare Clinical Presentation","authors":"Sankalp Singh, N. Bisht, A. Sarin, P. Mishra, A. Kapoor","doi":"10.4103/jhnps.jhnps_10_20","DOIUrl":"https://doi.org/10.4103/jhnps.jhnps_10_20","url":null,"abstract":"Metastases to the parotid gland as first presentation of lung cancer are extremely rare and occur in <1% cases most of which are small cell carcinomas. We present such a case of squamous cell carcinoma of the lung who presented with swellings of the parotid gland and over the scalp. He was diagnosed on the basis of fine needle aspiration cytology followed by investigative imaging to search for the primary. He was treated with palliative radiotherapy and chemotherapy but succumbed to his disease at 9 months from the diagnosis. Parotid and skin metastases in lung cancer can occur by both lymphatic and hematogenous spread. Metastases to such visible and accessible parts of the body can help in the early detection of disease, though in most cases, it occurs as a sign of progression in preexisting cancer. Management options are limited in such patients, and overall, the prognosis is poor.","PeriodicalId":41774,"journal":{"name":"Journal of Head & Neck Physicians and Surgeons","volume":"8 1","pages":"141 - 145"},"PeriodicalIF":0.1,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48747440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-07-01DOI: 10.4103/jhnps.jhnps_31_20
S. Sanyal, R. Raychowdhury
Background: Tracheostomy is a common surgical procedure which otolaryngology-head and neck surgery (ORL-HNS) trainees are expected to perform in both emergency and elective settings. Few papers deal specifically with resident training in this procedure. we surveyed the standard of training in the Indian context. Materials and Methods: A questionnaire-based survey was conducted among residents attending the annual national conference of the Association of Otolaryngologists of India. The results of the survey were tabulated using Microsoft Excel. Results: Ninety questionnaires were circulated among postgraduate trainees in their 1st, 2nd, or 3rd year of training (P-1, P-2, and P-3) as well as senior residents (SR). The response rate was 47%. The majority of the respondents (51%) were P-2. The distribution between elective and emergency tracheostomy was variable. The most common indication for tracheostomy in our survey was prolonged Intensive Therapy Unit (ITU) ventilation (42%). In elective tracheostomy, the primary surgeon was either an SR or P-3 (60%) and used a horizontal incision (52%). In emergencies, the primary surgeon was either an SR or P-3 and preferred a vertical incision (65%). Most trainees exposed the trachea by layer dissection; only 6% used monopolar diathermy. Entry through vertical incision and dilator was the preferred method (51%). The first tube change was performed at 72 h by 49% of the respondents. Eighty-four percent of the trainees were confident of performing emergency tracheostomies independently. Conclusions: ORL-HNS trainees should be competent in tracheostomy. The lack of supervision by faculty, variation in steps, and postoperative management all impact the outcome. A standardized technique and faculty supervision are vital for optimum training.
{"title":"Tracheostomy Experience among Indian Otolaryngology-Head and Neck Surgery Residents – A Survey","authors":"S. Sanyal, R. Raychowdhury","doi":"10.4103/jhnps.jhnps_31_20","DOIUrl":"https://doi.org/10.4103/jhnps.jhnps_31_20","url":null,"abstract":"Background: Tracheostomy is a common surgical procedure which otolaryngology-head and neck surgery (ORL-HNS) trainees are expected to perform in both emergency and elective settings. Few papers deal specifically with resident training in this procedure. we surveyed the standard of training in the Indian context. Materials and Methods: A questionnaire-based survey was conducted among residents attending the annual national conference of the Association of Otolaryngologists of India. The results of the survey were tabulated using Microsoft Excel. Results: Ninety questionnaires were circulated among postgraduate trainees in their 1st, 2nd, or 3rd year of training (P-1, P-2, and P-3) as well as senior residents (SR). The response rate was 47%. The majority of the respondents (51%) were P-2. The distribution between elective and emergency tracheostomy was variable. The most common indication for tracheostomy in our survey was prolonged Intensive Therapy Unit (ITU) ventilation (42%). In elective tracheostomy, the primary surgeon was either an SR or P-3 (60%) and used a horizontal incision (52%). In emergencies, the primary surgeon was either an SR or P-3 and preferred a vertical incision (65%). Most trainees exposed the trachea by layer dissection; only 6% used monopolar diathermy. Entry through vertical incision and dilator was the preferred method (51%). The first tube change was performed at 72 h by 49% of the respondents. Eighty-four percent of the trainees were confident of performing emergency tracheostomies independently. Conclusions: ORL-HNS trainees should be competent in tracheostomy. The lack of supervision by faculty, variation in steps, and postoperative management all impact the outcome. A standardized technique and faculty supervision are vital for optimum training.","PeriodicalId":41774,"journal":{"name":"Journal of Head & Neck Physicians and Surgeons","volume":"8 1","pages":"102 - 108"},"PeriodicalIF":0.1,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43010680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.4103/jhnps.jhnps_36_17
Nitin Khunteta, S. Tewari
Primary Squamous Cell Carcinoma of Thyroid gland is a very rare disease. It forms less than 1% of all Thyroid cancers. Due to rarity, It is generally diagnosis of exclusion.
{"title":"Primary squamous cell carcinoma thyroid: A rare case","authors":"Nitin Khunteta, S. Tewari","doi":"10.4103/jhnps.jhnps_36_17","DOIUrl":"https://doi.org/10.4103/jhnps.jhnps_36_17","url":null,"abstract":"Primary Squamous Cell Carcinoma of Thyroid gland is a very rare disease. It forms less than 1% of all Thyroid cancers. Due to rarity, It is generally diagnosis of exclusion.","PeriodicalId":41774,"journal":{"name":"Journal of Head & Neck Physicians and Surgeons","volume":"8 1","pages":"39 - 41"},"PeriodicalIF":0.1,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42541679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.4103/jhnps.jhnps_7_20
P. Chakraborty, P. Arun, K. Manikantan, Jain Vijay, R. Sharan
Introduction: The conventional approach for surgery of the thyroid and neck is performed through an open transcervical incision. Endoscopic and robotic neck surgery via retroauricular approach is a viable cosmetic alternative with improved functional outcomes. Materials and Methods: This is a retrospective analysis of patients who underwent endoscopic or robotic assisted neck surgeries from September 2016 to December 2019 at a tertiary cancer center in Eastern India. Results: A total of 54 patients were operated by the retroauricular approach. We encountered minimal complications and better cosmetic results compared to the standard open approach. A significant reduction in operative time over the course of the study was observed, signifying an easier learning curve. Conclusion: Retroauricular approach is a feasible cosmetic minimally invasive approach to neck surgeries with satisfactory functional outcomes, which may be implemented in developing country like ours where cosmesis is rapidly gaining popularity.
{"title":"Minimally invasive retroauricular approaches to the neck: A paradigm shift","authors":"P. Chakraborty, P. Arun, K. Manikantan, Jain Vijay, R. Sharan","doi":"10.4103/jhnps.jhnps_7_20","DOIUrl":"https://doi.org/10.4103/jhnps.jhnps_7_20","url":null,"abstract":"Introduction: The conventional approach for surgery of the thyroid and neck is performed through an open transcervical incision. Endoscopic and robotic neck surgery via retroauricular approach is a viable cosmetic alternative with improved functional outcomes. Materials and Methods: This is a retrospective analysis of patients who underwent endoscopic or robotic assisted neck surgeries from September 2016 to December 2019 at a tertiary cancer center in Eastern India. Results: A total of 54 patients were operated by the retroauricular approach. We encountered minimal complications and better cosmetic results compared to the standard open approach. A significant reduction in operative time over the course of the study was observed, signifying an easier learning curve. Conclusion: Retroauricular approach is a feasible cosmetic minimally invasive approach to neck surgeries with satisfactory functional outcomes, which may be implemented in developing country like ours where cosmesis is rapidly gaining popularity.","PeriodicalId":41774,"journal":{"name":"Journal of Head & Neck Physicians and Surgeons","volume":"8 1","pages":"8 - 11"},"PeriodicalIF":0.1,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49558858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.4103/jhnps.jhnps_16_20
S. Nabil, R. Nordin, F. Hariri, Ahmad Mohamad Bustaman, Sharifah Syed Zainal, Divya Panicker, A. Nazimi
Introduction: Hyperbaric oxygen therapy (HBOT) has been suggested to be beneficial in managing compromised acute and chronic wounds. To shed some light on its effectiveness in head-and-neck wounds, a retrospective review on the use of HBOT was done. Materials and Methods: The medical records of patients receiving HBOT for head-and-neck conditions were reviewed. The demographics and clinical data were collected. Results: Seventeen patients were identified. Four major indications for therapy were identified being osteoradionecrosis (ORN) treatment, ORN prophylaxis, treatment of compromised flaps/grafts, and treatment of medication-related osteonecrosis of the jaw. Favorable outcome following HBOT was seen in 77% of patients. In the treatment of ORN, 56% cases treated were successful. In the remaining groups, 100% success rates were obtained. The majority of patients had HBOT as an adjunctive treatment. HBOT as an adjunct was successful in 71% of patients, while prophylactic HBOT were successful in all patients. Complications including ear barotrauma and sinus squeeze were seen in 24% of patients. Conclusions: HBOT can be successfully used in various head-and-neck conditions, especially when used in cases with compromised flaps/graft or ORN prophylaxis. It is well tolerated and thus provides a valid adjunctive therapy in the management of tissue with compromised healing capability in the head-and-neck region.
{"title":"The use of hyperbaric oxygen therapy in head-and-neck conditions","authors":"S. Nabil, R. Nordin, F. Hariri, Ahmad Mohamad Bustaman, Sharifah Syed Zainal, Divya Panicker, A. Nazimi","doi":"10.4103/jhnps.jhnps_16_20","DOIUrl":"https://doi.org/10.4103/jhnps.jhnps_16_20","url":null,"abstract":"Introduction: Hyperbaric oxygen therapy (HBOT) has been suggested to be beneficial in managing compromised acute and chronic wounds. To shed some light on its effectiveness in head-and-neck wounds, a retrospective review on the use of HBOT was done. Materials and Methods: The medical records of patients receiving HBOT for head-and-neck conditions were reviewed. The demographics and clinical data were collected. Results: Seventeen patients were identified. Four major indications for therapy were identified being osteoradionecrosis (ORN) treatment, ORN prophylaxis, treatment of compromised flaps/grafts, and treatment of medication-related osteonecrosis of the jaw. Favorable outcome following HBOT was seen in 77% of patients. In the treatment of ORN, 56% cases treated were successful. In the remaining groups, 100% success rates were obtained. The majority of patients had HBOT as an adjunctive treatment. HBOT as an adjunct was successful in 71% of patients, while prophylactic HBOT were successful in all patients. Complications including ear barotrauma and sinus squeeze were seen in 24% of patients. Conclusions: HBOT can be successfully used in various head-and-neck conditions, especially when used in cases with compromised flaps/graft or ORN prophylaxis. It is well tolerated and thus provides a valid adjunctive therapy in the management of tissue with compromised healing capability in the head-and-neck region.","PeriodicalId":41774,"journal":{"name":"Journal of Head & Neck Physicians and Surgeons","volume":"8 1","pages":"27 - 33"},"PeriodicalIF":0.1,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49087411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.4103/jhnps.jhnps_22_20
H. Saluja, Shivani Sachdeva, Seemit Shah, A. Dadhich, Mukund Singh, Sumeet Mishra
Objective: The purpose of this study was to review the incidence and characteristics of maxillofacial fractures in Loni (rural population) and compare them with the existing literature. Materials and Methods: A retrospective study of patients' records and radiographs was reviewed during the 10-year period between 2007 and 2017. Statistical analysis was carried out according to age, gender, cause of accident, and fracture site. Results: A total of 1943 cases with 2470 injuries were reviewed during the 10-year period. The age of patients ranged from 0 to 70 years. The ratio of men to women was 3.5:1. Most fractures were caused by road traffic accident (44.12%), followed by fall (26.76%), assault (25.06%), and animal injuries (4.06%). The prevalent anatomic regions of isolated fractures were the mandible (50.64%), followed by Zygomatic complex (ZMC) (9.26%), Le Fort II (4.07%), Le Fort I (3.50%), orbital floor (3.07%), Le Fort III (2.23%), dentoalveolar (1.39%), zygomatic arch (1.13%), and nasal bone (0.77%). In combination fractures, the most common were the midface combinations (12.55%), followed by mandibular and midface combinations (6.13%), mandibular combination fractures (3.25%), and midface and frontal bone fractures (1.444%). Conclusion: The findings of this study compared with similar studies reported in literature support the view that the cause and incidence of maxillofacial injuries vary from one country to another. Animal injury was one of the causes for maxillofacial trauma because of rural location of our center.
目的：本研究旨在回顾Loni（农村人口）颌面部骨折的发生率和特点，并与现有文献进行比较。材料和方法：回顾性研究了2007年至2017年10年间的患者记录和射线照片。根据年龄、性别、事故原因和骨折部位进行统计分析。结果：在10年的时间里，共回顾了1943例2470人受伤的病例。患者年龄0～70岁。男女比例为3.5:1。大多数骨折是由道路交通事故引起的（44.12%），其次是跌倒（26.76%）、袭击（25.06%）和动物损伤（4.06%）。孤立性骨折的常见解剖区域是下颌骨（50.64%），其次为颧骨复合体（ZMC）（9.26%）、Le Fort II（4.07%）、，在组合骨折中，最常见的是面中部组合骨折（12.55%），其次是下颌和面中部组合（6.13%），下颌组合骨折（3.25%），以及面中部和额骨骨折（1.444%）。结论：与文献中报道的类似研究相比，本研究的结果支持了颌面部损伤的原因和发生率因国家而异的观点。动物损伤是颌面部创伤的原因之一，因为我们中心位于农村。
{"title":"Ten-year review of facial bone fractures in rural population at a teaching institute in Central India (Maharashtra)","authors":"H. Saluja, Shivani Sachdeva, Seemit Shah, A. Dadhich, Mukund Singh, Sumeet Mishra","doi":"10.4103/jhnps.jhnps_22_20","DOIUrl":"https://doi.org/10.4103/jhnps.jhnps_22_20","url":null,"abstract":"Objective: The purpose of this study was to review the incidence and characteristics of maxillofacial fractures in Loni (rural population) and compare them with the existing literature. Materials and Methods: A retrospective study of patients' records and radiographs was reviewed during the 10-year period between 2007 and 2017. Statistical analysis was carried out according to age, gender, cause of accident, and fracture site. Results: A total of 1943 cases with 2470 injuries were reviewed during the 10-year period. The age of patients ranged from 0 to 70 years. The ratio of men to women was 3.5:1. Most fractures were caused by road traffic accident (44.12%), followed by fall (26.76%), assault (25.06%), and animal injuries (4.06%). The prevalent anatomic regions of isolated fractures were the mandible (50.64%), followed by Zygomatic complex (ZMC) (9.26%), Le Fort II (4.07%), Le Fort I (3.50%), orbital floor (3.07%), Le Fort III (2.23%), dentoalveolar (1.39%), zygomatic arch (1.13%), and nasal bone (0.77%). In combination fractures, the most common were the midface combinations (12.55%), followed by mandibular and midface combinations (6.13%), mandibular combination fractures (3.25%), and midface and frontal bone fractures (1.444%). Conclusion: The findings of this study compared with similar studies reported in literature support the view that the cause and incidence of maxillofacial injuries vary from one country to another. Animal injury was one of the causes for maxillofacial trauma because of rural location of our center.","PeriodicalId":41774,"journal":{"name":"Journal of Head & Neck Physicians and Surgeons","volume":"8 1","pages":"23 - 26"},"PeriodicalIF":0.1,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47817536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.4103/jhnps.jhnps_37_19
D. Balasubramanian, N. Subramaniam, Janarthanan Ramu, R. Sood, Mohit Sharma, Jimmy Mathew, Krishnakumar Thankappan, Pramod Subhash, A. Krishnadas, S. Iyer
Introduction: Microsurgical tissue transfer in the pediatric population is challenging for several reasons– small vessel diameter, flap size, difficulties with postoperative flap monitoring, and difficulty in anticipating tissue growth and remodeling. In addition, head-and-neck reconstruction is uniquely difficult due to the functional deficits after ablative surgery. We present our series of microvascular reconstruction for tumors of the head and neck in the pediatric population. Materials and Methods: Retrospective review of microvascular reconstruction performed in our institution for benign and malignant tumors of the head and neck for patients aged <10 years of age between 2004 and 2016. Demographic and treatment details were analyzed, and descriptive statistics were performed. Results: The flaps used for reconstruction were anterolateral thigh flap (n = 5), fibula free flap (n = 4), scapular free flap (n = 2), radial forearm free flap (n = 1), and sixth rib with serratus anterior and latissimus dorsi (growth center transfer) (n = 1). Rapid prototyping models and inverse planning were used for bony reconstruction in seven cases. The flap success rate was 100%. The average operating time was 130 min. There were no major intraoperative or postoperative complications. Conclusion: Microvascular reconstruction for head-and-neck tumors in the pediatric age group is safe and is associated with good functional and esthetic outcomes. The anterolateral thigh flap and the fibula flap are the flaps of choice in a majority of cases. Preoperative planning, especially in complex bony reconstruction, is important to maximize outcomes and minimize the operative time. Multidisciplinary care is essential to ensure rapid rehabilitation in the postoperative period.
{"title":"Microvascular reconstruction for tumors of the head and neck in the pediatric population","authors":"D. Balasubramanian, N. Subramaniam, Janarthanan Ramu, R. Sood, Mohit Sharma, Jimmy Mathew, Krishnakumar Thankappan, Pramod Subhash, A. Krishnadas, S. Iyer","doi":"10.4103/jhnps.jhnps_37_19","DOIUrl":"https://doi.org/10.4103/jhnps.jhnps_37_19","url":null,"abstract":"Introduction: Microsurgical tissue transfer in the pediatric population is challenging for several reasons– small vessel diameter, flap size, difficulties with postoperative flap monitoring, and difficulty in anticipating tissue growth and remodeling. In addition, head-and-neck reconstruction is uniquely difficult due to the functional deficits after ablative surgery. We present our series of microvascular reconstruction for tumors of the head and neck in the pediatric population. Materials and Methods: Retrospective review of microvascular reconstruction performed in our institution for benign and malignant tumors of the head and neck for patients aged <10 years of age between 2004 and 2016. Demographic and treatment details were analyzed, and descriptive statistics were performed. Results: The flaps used for reconstruction were anterolateral thigh flap (n = 5), fibula free flap (n = 4), scapular free flap (n = 2), radial forearm free flap (n = 1), and sixth rib with serratus anterior and latissimus dorsi (growth center transfer) (n = 1). Rapid prototyping models and inverse planning were used for bony reconstruction in seven cases. The flap success rate was 100%. The average operating time was 130 min. There were no major intraoperative or postoperative complications. Conclusion: Microvascular reconstruction for head-and-neck tumors in the pediatric age group is safe and is associated with good functional and esthetic outcomes. The anterolateral thigh flap and the fibula flap are the flaps of choice in a majority of cases. Preoperative planning, especially in complex bony reconstruction, is important to maximize outcomes and minimize the operative time. Multidisciplinary care is essential to ensure rapid rehabilitation in the postoperative period.","PeriodicalId":41774,"journal":{"name":"Journal of Head & Neck Physicians and Surgeons","volume":"8 1","pages":"12 - 16"},"PeriodicalIF":0.1,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42295736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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