Artery first and declamp it: A temporary revascularization method during microvascular anastomosis: A retrospective case series study.

Background: The optimal sequence of microvascular clamping during free flap transfer is yet to be established. Many surgeons are reluctant to perform temporary declamping and subsequent reclamping during microvascular anastomosis; however, we generally anastomose the artery first and temporarily declamp it before performing venous anastomosis to confirm arterial patency and ensure proper alignment of the flap veins. Herein, we aimed to retrospectively investigate the efficacy and safety of this temporary revascularization method in 126 patients who underwent microvascular head and neck reconstruction.

Negative Pressure Wound Therapy with Instillation and Dwell Time for Pharyngocutaneous Fistula.

Pharyngocutaneous fistula is a critical complication of head and neck cancer reconstruction and it is often difficult to manage. We herein report two cases of pharyngocutaneous fistulas that developed after oropharyngeal reconstruction and were successfully treated with negative pressure wound therapy with instillation and dwell time (NPWTi-d), an advanced form of traditional NPWT. NPWTi-d may be a useful nonsurgical treatment for pharyngocutaneous fistula.

Treatment Effectiveness and Recurrence of Extracranial Arteriovenous Malformations Following Surgical Operations: A 15-Year Retrospective Cohort Study.

Background: At present, there is no golden standard for treatment of extracranial arteriovenous malformations (AVMs) and recurrence remains a major challenge with limited available evidence on the associated factors. This study aimed to evaluate the effectiveness of surgical treatment options, in terms of size reduction, symptoms, and early recurrence in patients treated surgically for AVMs.

Methods: A retrospective cohort study was conducted to evaluate patients with AVMs following surgical treatment in 2 centers from 2005 to 2020.

Orbital Fat Herniation Through Inferior Orbital Fissure and Persistent Diplopia Caused by Facial Trauma.

Orbital fat herniation is often accompanied by orbital floor fractures. Furthermore, herniation through the inferior orbital fissure (IOF) is rare, and its pathophysiology remains largely unknown. Here, the authors report a case of a patient with IOF herniation and diplopia caused by orbital trauma.

Simultaneous Reconstruction of Smiling Eye Using V-Shaped Long Latissimus Dorsi Muscle Transfer in Patients with Flaccid Facial Paralysis.

Various neurovascular free muscle transfers for smile reconstruction in patients with facial paralysis have been reported. However, these methods focused on perioral smiling rather than eye smiling. Although the lower eyelid does not contribute significantly to eyelid closure, dynamic reanimation of the upward movement of the lower eyelid with bulging of the malar region during smiling is important in smile reconstruction.

Vascularized Fibular Grafts for Failed Liquid Nitrogen-treated Autografts in the Humerus: Report of Two Cases.

With advances in chemotherapy and surgical techniques, limb salvage and biological reconstruction, including autologous bone grafting, have become the preferred treatment options for primary malignant bone tumors of the extremities. Although autografts, which involve recycling of tumor-bearing bones, have the advantages of easy accessibility and anatomical matching, fracture is a frequent major complication. However, to our knowledge, salvage of refractory autograft failure has not yet been reported.

Stair-Step Incision for Composite Grafts in Nasal Reconstruction.

Composite grafts are excellent options for treating external nasal deformities because they provide support and include the skin, which improves the delicate anatomy of the nose. However, they are constrained by size limits since the grafts rely on blood flow to the nasal bed. This is a critical issue when the recipient sites have scarring or degenerative diseases.

Transverse Cervical Artery for Head and Neck Reconstruction with Free Jejunal Flaps: A Retrospective Study of Computed Tomography Angiography.

Background:  The transverse cervical artery is less commonly used than other external carotid arteries as a recipient vessel. Therefore, we aimed to compare the utility of the transverse cervical artery as a recipient vessel with that of the external carotid artery system for microvascular head and neck reconstruction by quantitative analysis of dynamic-enhanced computed tomography.

Methods:  Fifty-one consecutive patients who underwent free jejunum transfer following total pharyngolaryngectomy between January 2017 and December 2020 were retrospectively reviewed.

Internal jugular vein reconstruction using a triple-paneled great saphenous vein graft.

Background: Donor-recipient diameter discrepancy can be problematic when using an autologous great saphenous vein graft for internal jugular vein reconstruction. A triple-paneled method of saphenous vein grafting is one solution.

Case Presentation: A 54-year-old man with a thyroid papillary carcinoma underwent total thyroidectomy and bilateral neck dissection.

Crescent-shaped skin paddle for a fibular flap: Avoiding skin grafting at the donor site.

A fibular osteocutaneous flap is the mainstay of oromandibular reconstruction. This report aimed to present a crescent-shaped skin paddle, a novel fibular skin paddle designed to achieve both sufficient intraoral lining and primary closure of the donor site. A 3-5-cm-wide crescent-shaped skin paddle was harvested according to the locations of the distal septocutaneous perforators on preoperative color Doppler sonography.

Microsurgical Lymphovenous Anastomosis for Pelvic Lymphoceles after Gynecological Cancer Surgery.

Background: Pelvic lymphoceles are the most common complications after pelvic lymphadenectomy. Microsurgical procedures have attracted attention as an alternative treatment for lymphoceles. Here, we report six cases of refractory lymphoceles that were successfully treated using lymphovenous anastomosis (LVA).

Total Maxillectomy and Free Flap Reconstruction in Hemodialysis Patients: Report of Two Cases.

Currently, an increasing number of patients are undergoing hemodialysis. However, little is known regarding the outcome or perioperative management of head and neck cancer reconstruction in patients undergoing hemodialysis. Here, we report two cases of patients with maxillary squamous cell carcinoma undergoing hemodialysis.

Open Abdomen Negative Pressure Device Applied for Two-stage Closure of Enterocutaneous Fistula.

Enterocutaneous fistula (ECF), which is an abnormal connection between the gastrointestinal tract and skin, is a serious complication of abdominal surgery, and a multidisciplinary approach is required for its treatment. Here, we report the case of a 46-year-old woman who had a large ECF measuring 6 × 12 cm that was successfully treated with a 2-stage surgery. After the first surgery of intestinal wall reconstruction, an abdominal negative pressure wound therapy (NPWT) device was administered to facilitate the reexploration of the abdominal cavity.

Thorax anthropometric position index: a simple evaluation of the inframammary fold position in the thorax.

Appropriate positioning of the inframammary fold (IMF) is essential for breast reconstruction. The purpose of this study was to quantitatively measure and evaluate the anthropometric position of the IMF in the thorax. A total of 145 Japanese women with unilateral breast cancer were analyzed.

Pediatric-Specific Midfacial Fracture Patterns and Management: Pediatric Versus Adult Patients.

Purpose: The purpose of this study was to compare the midfacial fracture patterns and management approaches between pediatric and adult patients.

Methods: We retrospectively analyzed 164 pediatric patients (<16 years old) and 564 nongeriatric adult patients (16 to 65 years old) with midfacial fractures at a single institution between 2011 and 2016. The location of the fractures, along with the etiology and management of the midfacial fractures, were compared.

Costochondral Grafting for Nasal Airway Reconstruction in an Infant With Frontonasal Dysplasia.

Frontonasal dysplasia (FND) is a congenital malformation of the central portion of the face, including the eyes, nose, and forehead. Owing to its rarity and wide spectrum of phenotypes, the optimal timing and technique of surgery remain controversial. Here, we report a case of a patient with FND, who presented with respiratory distress.

Nipple adenoma in a 2-year-old boy.

Nipple adenoma is an uncommon proliferative process of the breast and predominantly occurs in women aged 40-50. Its incidence is extremely low in men, and it has not been reported in a boy. Although nipple adenoma is rare and benign, being familiar with it is important because it clinically resembles Paget disease and histologically adenocarcinoma.

Distinct effects of Hoxa2 overexpression in cranial neural crest populations reveal that the mammalian hyomandibular-ceratohyal boundary maps within the styloid process.

Most gnathostomata craniofacial structures derive from pharyngeal arches (PAs), which are colonized by cranial neural crest cells (CNCCs). The anteroposterior and dorsoventral identities of CNCCs are defined by the combinatorial expression of Hox and Dlx genes. The mechanisms associating characteristic Hox/Dlx expression patterns with the topology and morphology of PAs derivatives are only partially known; a better knowledge of these processes might lead to new concepts on the origin of taxon-specific craniofacial morphologies and of certain craniofacial malformations.

Endothelin receptor type A expression defines a distinct cardiac subdomain within the heart field and is later implicated in chamber myocardium formation.

The avian and mammalian heart originates from two distinct embryonic regions: an early differentiating first heart field and a dorsomedially located second heart field. It remains largely unknown when and how these subdivisions of the heart field divide into regions with different fates. Here, we identify in the mouse a subpopulation of the first (crescent-forming) field marked by endothelin receptor type A (Ednra) gene expression, which contributes to chamber myocardium through a unique type of cell behavior.