Medial sural artery perforator flap following orbital exenteration.

An extended orbital exenteration defect in a male in his mid-80s was successfully reconstructed with a medial sural artery perforator flap. To our knowledge, this flap has not been described in the literature for such defects until now. While it may require meticulous intramuscular perforator dissection, it provides several advantages; it is thin, pliable, has a long pedicle of large calibre facilitating microanastomosis and provides adequate coverage where the amount of chimeric muscle can easily be tailored to the defect's surface area and volume.

Systematic Review of the Profunda Artery Perforator Free Flap for Head and Neck Reconstruction.

Objective: The profunda artery perforator (PAP) flap has gained popularity in head and neck reconstruction with a favorable donor site providing a relatively hidden scar and the ability to harvest a large amount of pliable tissue with consistent vascular anatomy. The primary aim of this study is to evaluate the safety and efficacy of this PAP flap in head and neck reconstruction.

Data Sources: PUBMED, EMBASE, Web of Science, Google Scholar (January 1948-February 2022).

First Bite Syndrome in Transoral Surgery for Oropharyngeal Cancer.

Objective: First bite syndrome (FBS) is a rare complication of transoral surgery (TOS) for oropharyngeal cancer (oropharyngeal squamous cell carcinoma [OPSCC]). Risk factors for developing this complication are not well described. In this study, we attempt to identify risks for developing FBS in TOS.

Effect of palatine tonsil tumor resection on postoperative velopharyngeal insufficiency in transoral surgery.

Background: Velopharyngeal insufficiency (VPI) is a known complication of transoral surgery (TOS) for oropharyngeal HPV-mediated squamous cell carcinoma. Controversy exists regarding adequate resection margins for balancing functional and oncologic outcomes.

Methods: This retrospective study was exempted by the IRB.

A Multisource Process Evaluation of a Community-Based Healthy Lifestyle Programme for Child and Adolescent Obesity.

Whānau Pakari is a healthy lifestyle assessment and intervention programme for children and adolescents with obesity in Taranaki (Aotearoa/New Zealand), which, in this region, replaced the nationally funded Green Prescription Active Families (GRxAF) programme. We compared national referral rates from the GRxAF programme (age 5-15 years) and the B4 School Check (B4SC, a national preschool health and development assessment) with referral rates in Taranaki from Whānau Pakari. We retrospectively analysed 5 years of clinical data (2010-2015), comparing referral rates before, during, and after the Whānau Pakari clinical trial, which was embedded within the programme.

Effect of adenotonsillectomy on central sleep apnea: A scoping review.

Objective: The purpose of this study was to assess the effects of adenotonsillectomy (A&T) on reducing central sleep apnea (CSA) in children and adolescents with obstructive sleep apnea (OSA).

Methods: A review of the PubMed database was conducted. Two researchers independently reviewed the articles from the literature search and selected papers for further review if they met inclusion criteria.

From Nasolabial Folds to Pan-facial Rejuvenation-The Evolution of Fillers in my Career.

This is a comprehensive review of facial fillers including landmark studies and expert commentary spanning the years from 2003 (when the first hyaluronic acid [HA] dermal filler underwent Food and Drug Administration approval in United States) to present.

Development of the Preferred Components for Co-Design in Research Guideline and Checklist: Protocol for a Scoping Review and a Modified Delphi Process.

Background: There is increasing evidence that co-design can lead to more engaging, acceptable, relevant, feasible, and even effective interventions. However, no guidance is provided on the specific designs and associated methods or methodologies involved in the process. We propose the development of the Preferred Components for Co-design in Research (PRECISE) guideline to enhance the consistency, transparency, and quality of reporting co-design studies used to develop complex health interventions.

Microvascular Free Flap Outcomes in Maxillectomy Defects from Invasive Fungal Sinusitis.

Objectives: Microvascular free tissue transfer is routinely used for reconstructing midface defects in patients with malignancy, however, studies regarding reconstructive outcomes in invasive fungal sinusitis (IFS) are lacking. We aim to describe outcomes of free flap reconstruction for IFS defects, determine the optimal time to perform reconstruction, and if anti-fungal medications or other risk factors of an immunocompromised patient population affect reconstructive outcomes.

Methods: Retrospective review of reconstruction for IFS (2010-2022).

Changes in referral patterns for weight in association with the preschool Raising Healthy Kids target.

Introduction The 'Raising Healthy Kids (RHK) health target ' recommended that children identified as having obesity [body mass index (BMI) ≥98th centile] through growth screening at the B4 School Check (B4SC) be offered referral for subsequent assessment and intervention. Aim To determine the impact of the 'RHK health target ' on referral rates for obesity in Aotearoa New Zealand (NZ). Methods A retrospective audit was undertaken of 4-year-olds identified to have obesity in the B4SC programme in Taranaki and nationally in 2015-19.

Comparison of percentile tables and algorithm-based calculators for classification of blood pressures in children and adolescents with obesity: A secondary analysis of a clinical trial.

Aim: Obesity as a major risk factor for childhood hypertension necessitates careful blood pressure (BP) monitoring of those affected. This study aimed to compare BP classification in a cohort of children affected by obesity using tables versus digital calculations in two sets of guidelines.

Methods: This study was a secondary analysis of data collected from a randomised clinical trial of a multidisciplinary life-style assessment and intervention program.

Caregiver survey of preschool children with obesity referred to Whānau Pakari-a multidisciplinary healthy lifestyle intervention programme.

Aim: To examine caregiver perceptions relating to the acceptability of weight screening at New Zealand's B4 School Check (B4SC), and the accessibility and acceptability of a healthy lifestyle programme (Whānau Pakari) for preschool children (Whānau Pakari preschool programme) identified with weight issues.

Method: An online survey was designed to assess agreement with statements relating to the B4SC healthy weight check and Whānau Pakari programme. Eligible participants (n=125) were caregivers of preschool children identified with obesity (BMI ≥98th centile), or overweight (BMI >91st centile) with weight-related co-morbidities, at the B4SC and referred to Whānau Pakari over the period July 2016 to March 2019.

Associations between changes in caregiver's and child's weight status in a community-based obesity intervention programme.

Objectives: We examined whether caregivers of children/adolescents enroled in a randomised controlled trial (RCT) of a family-centred intervention indirectly achieved reductions in body mass index (BMI), and if these were associated with changes in their children's BMI.

Methods: RCT participants were New Zealand children/adolescents aged 4.8-16.

The cost of investigating weight-related comorbidities in children and adolescents in Aotearoa/New Zealand.

Aim: Expert recommendations for child/adolescent obesity include extensive investigation for weight-related comorbidities, based on body mass index (BMI) percentile cut-offs. This study aimed to estimate the cost of initial investigations for weight-related comorbidities in children/adolescents with obesity, according to international expert guidelines.

Methods: The annual mean cost of investigations for weight-related comorbidities in children/adolescents was calculated from a health-funder perspective using 2019 cost data obtained from three New Zealand District Health Boards.

Participants' and caregivers' experiences of a multidisciplinary programme for healthy lifestyle change in Aotearoa/New Zealand: a qualitative, focus group study.

Objective: Child and adolescent obesity continues to be a major health issue internationally. This study aims to understand the views and experiences of caregivers and participants in a child and adolescent multidisciplinary programme for healthy lifestyle change.

Design: Qualitative focus group study.

Caregiver perceptions of weight in preschool children, and determinants of engagement in a multidisciplinary intervention service for weight issues.

Aims: To explore the perceptions and experiences of caregivers of preschool children with weight issues referred from New Zealand's preschool check (the B4 School Check) to a healthy lifestyle programme. Second, to understand determinants of engagement with the programme for families post referral.

Methods: Semi-structured focus groups and interviews were conducted with caregivers of preschool children referred from the national preschool check (the B4 School Check) to the Whānau Pakari healthy lifestyle programme.

Correspondence: systematic reviews do not always capture context of real-world intervention programmes for childhood obesity (response to Littlewood, et al., 2020 in BMC Public Health).

In a recent issue of the BMC Public Health journal, Littlewood et al. described the results of a systematic review of interventions to prevent or treat childhood obesity in Māori or Pacific Island peoples. They found that studies to date have had limited impact on improving health outcomes for Māori and Pacific Island peoples, and suggest this may be due to a lack of co-design principles in the conception of the various studies.

Two-year outcomes of Whānau Pakari, a multi-disciplinary assessment and intervention for children and adolescents with weight issues: A randomized clinical trial.

Objective: To determine whether 12-month BMI SDS reductions persisted at 24 months in a multi-disciplinary assessment and intervention program for children and adolescents with obesity, and whether secondary outcomes improved.

Methods: This was a community-based 12-month RCT in Aotearoa/New Zealand. Eligible participants were aged 5 to 16 years with BMI ≥98th centile or BMI >91st centile with weight-related comorbidities.

Factors impacting successful salvage of the failing free flap.

Background: Understanding factors impacting successful salvage of a compromised free flap.

Methods: Multi-institutional review of free flap reconstructions for head and neck defects (n = 1764).

Results: Free flap compromise rate: 9% (n = 162); 46% salvaged (n = 74).

Management of the Acute Loss of a Free Flap to the Head and Neck-A Multi-institutional Review.

Objectives/hypothesis: To review the management of failed free tissue transfers among four large institutions over a 13-year period to provide data and analysis for a logical, algorithmic, experience-based approach to the management of failed free flaps.

Study Design: Retrospective case series.

Methods: A multi-institutional retrospective chart review of free tissue transfers to the head and neck region between 2006 and 2019 was performed.

Hair nicotine concentration of cats with gastrointestinal lymphoma and unaffected control cases.

Background: A previous study showed an association between owner-reported exposure to environmental tobacco smoke (ETS) and lymphoma in cats. This study aimed to investigate the association between ETS exposure and gastrointestinal lymphoma in cats, using hair nicotine concentration (HNC) as a biomarker.

Methods: This was a prospective, multi-centre, case-control study.

Survey of Barriers and Facilitators to Engagement in a Multidisciplinary Healthy Lifestyles Program for Children.

Objective: To understand facilitators and barriers to engagement in a multidisciplinary assessment and intervention program for children and adolescents with obesity, particularly for Māori, the Indigenous people of New Zealand.

Methods: Whānau Pakari participants and caregivers (n = 71, 21% response rate) referred to the family-based healthy lifestyles program in Taranaki, New Zealand, were asked to participate in a confidential survey, which collected self-reported attendance levels and agreement with statements around service accessibility and appropriateness and open-text comments identifying barriers and facilitators to attendance.

Results: Self-reported attendance levels were higher when respondents reported sessions to be conveniently located (P = .

Complications, Mortality, and Functional Decline in Patients 80 Years or Older Undergoing Major Head and Neck Ablation and Reconstruction.

Importance: Data regarding outcomes after major head and neck ablation and reconstruction in the growing geriatric population (specifically ≥80 years of age) are limited. Such information would be extremely valuable in preoperative discussions with elderly patients about their surgical risks and expected functional outcomes.

Objectives: To identify patient and surgical factors associated with 30-day postoperative complications, 90-day mortality, and 90-day functional decline; to explore whether an association exists between the type of reconstructive procedure and outcome; and to create a preoperative risk stratification system for these outcomes.

Incidence of inadequate perforators and salvage options for the anterior lateral thigh free flap.

Objective: The anterolateral thigh (ALT) free flap is a soft tissue flap used in head and neck reconstruction. Occasionally, its perforators to the skin paddle are absent or too small to support the flap. Salvage options in this scenario have not been well described for head and neck reconstruction.