Flow-Through Flaps as a Robust Method for Advanced Free Flap Reconstruction in the Head and Neck: A Multi-Institutional Experience.

Background: Flow-through flaps (FTFs) are an advanced technique in which a free flap is anastomosed to the pedicle of another free flap to reconstruct extensive head and neck defects when recipient vessels are scarce.

Methods: A multi-institutional cohort of FTFs used for head and neck reconstruction were reviewed. For comparison, FTF outcomes were compared to free flaps that required vein grafts (VG) to reach distant recipient vessels.

O-TO-T Advancement Reconstruction for Partial Glossectomy Defects: A Case Series.

We present O-T advancement reconstruction (OTAR) in lateral tongue defects, describing technique, indications, outcomes, and limitations. 11 patients with lateral tongue defects who underwent OTAR after earlystage cancer removal. Demographics, staging, functional oral intake scale (FOIS), dysphagia outcome severity scale (DOSS), defect size, and complications were included.

Outcomes of free flap reconstruction for mandibular ORN: Systematic review and meta-analysis.

Objective: This study aims to evaluate the success rates and complications associated with different free flap donor sites used in surgical reconstruction for mandibular osteoradionecrosis, providing insights to aid clinical decision-making.

Data Sources: MEDLINE, Embase, Cochrane, and Web of Science.

Review Methods: Comprehensive database searches were conducted up to October 2023.

Advanced laryngeal squamous cell carcinoma in an adolescent: A case and treatment considerations.

Pediatric laryngeal SCCa is a rare malignancy in childhood. High index of suspicion is critical to obtain timely tissue sample and diagnosis. Shared decision making is important when choosing treatment modalities for curative management, especially when working with adolescent patients.

The Impact of Preoperative Flexible Fiberoptic Laryngoscopy on Anesthesia's Intubation Plans.

To assess the value of conducting a preairway management review of flexible fiberoptic laryngoscopy examinations (FFL) by the anesthesia team for patients with head and neck cancer and to examine its impact on intubation strategies and overall patient safety. Prospective study at a single tertiary referral center including patients with stage T2 and greater cancers of the oropharynx, hypopharynx, or larynx who underwent intubation by the anesthesia team between May 2022 and April 2023. Pre- and postoperative surveys gathered data on the intubation plan, including details such as method, sedation, patient respiration, laryngoscope, tube size, and use of paralysis.

Extralaryngeal Spread in Total Laryngectomy: Comparing the Need for Thyroidectomy.

At our institution, thyroid preservation during total laryngectomy (TL) varies by surgeon, offering a distinctive dataset to compare disease outcomes in TL patients with or without thyroidectomy. This retrospective chart review study, conducted at a tertiary referral medical center, comprises patients who underwent TL for laryngeal or hypopharyngeal squamous cell carcinoma from 2014 to 2022. The study includes data on patient demographics, surgeries, pathological staging, tumor subsites, thyroid involvement, and adjuvant therapy.

The Microvascular Anastomotic Coupler for Venous Anastomosis in Head and Neck Reconstruction: An Institutional Experience.

Background This study aimed to identify outcome predictors with the GEM microvascular coupler system (GEM Coupler) in a series of patients undergoing free flap reconstruction for head and neck defects. Methodology In this retrospective chart review of 218 consecutive microvascular procedures performed on 204 patients at an academic tertiary care center, demographics, comorbidities, surgical data, and outcomes were retrieved. The endpoints for the analysis were microvascular revision surgery and flap survival.

Reirradiation in head and neck squamous cell carcinoma; prognostic indicators, oncologic and functional outcomes.

Objectives: Patients with recurrent squamous cell carcinoma of the head and neck (HNSCC) have a poor prognosis and limited therapeutic alternatives. While reirradiation is feasible, it is usually associated with high treatment toxicity and is not yet considered the standard of care. Based on current NCCN guidelines, in the context of very advanced head and neck cancer (recurrent and/or persistent disease), surgical intervention is explored initially with/without adjuvants while unresectable disease is approached with radiation and/or systemic therapies.

Oncological outcomes of partial thickness calvarial resection for locally advanced scalp malignancies.

Objective: Traditionally, locally advanced scalp malignancies have been managed through composite, full-thickness calvarial resection. The aim of this study is to explore the oncologic outcomes of partial calvarial resection for locally invasive scalp malignancies without medullary space invasion, employing a burr-down approach.

Study Design: Retrospective case series.

Head and neck cancer surveillance: The value of computed tomography and clinical exam.

Purpose: The recurrence of head and neck cancer (HNC) is most prevalent during the initial two years following curative treatment, underscoring the criticality of regular surveillance for HNC survivors. This study aims to evaluate the effectiveness of computed tomography (CT) imaging and clinical physical examination (CE) in HNC surveillance, assessing whether these imaging protocols meet the current treatment limitations confronting HNC specialists.

Methods: Retrospective chart review of a 9-year experience with head and neck cancer patients at a single, academic tertiary care center.

Functional Status Predicts Delay to Radiation in Free Tissue Transfer for Head and Neck Cancer.

Objective: Evaluate the effect of functional status and patient factors on delays in treatment with adjuvant therapy.

Methods: Retrospective chart review (2020-2022) was conducted at a single tertiary referral center. Data were collected between January 2020 and October 2022, and 63 patients underwent free flap reconstructive surgery of the head and neck due to the presence of cancer and received adjuvant radiation therapy (RT).

Elective Neck Dissection in Patients Undergoing Salvage Laryngectomy: Outcomes, Complications, and Considerations.

Objective In this study, we sought to identify the predictors for occult nodal disease (OND) and compare oncologic outcomes in patients undergoing elective neck dissection (END) at the time of salvage laryngectomy (SLE) versus the observation group. Methods A retrospective chart review was conducted involving all patients with clinically node-negative (cN0) necks who underwent SLE at a tertiary academic center over 12 years. A total of 58 patients met the inclusion criteria and were divided into two groups: END (n=39) and observation (n=19).

Functional Outcomes After the Sacrifice of Mandibular Condyle Using Fibula Free Flap for Immediate Surgical Reconstruction.

Introduction Head and neck cancer with mandibular invasion often necessitates composite resection, leading to defects requiring reconstruction. Microvascular fibula free flap (FFF) surgery is a common approach for this purpose. In this study, we focus on our experience with condyle sacrifice, emphasizing treatment outcomes and functional results.

Oncologic Outcomes of Salvage Surgery in Recurrent Oral Tongue Squamous Cell Carcinoma.

Objective: This study aimed to determine the oncologic outcomes and identify prognostic factors in patients undergoing salvage glossectomy for recurrent oral tongue squamous cell carcinoma (OTSCC).

Methods: A retrospective chart review was conducted encompassing all patients who underwent salvage oral glossectomy out of 259 individuals undergoing oral glossectomy at a tertiary academic center. Inclusion criteria comprised patients who met the following conditions: 1) biopsy-proven oral tongue recurrence, 2) salvage glossectomy performed with curative intent, 3) availability of imaging records, and 4) comprehensive documentation.

Utility of video fluoroscopic swallow study in advancing oral diet post TORS for oropharyngeal malignancies.

Objective: TORS is a minimally invasive surgical alternative to chemoradiotherapy for oropharyngeal malignancies. While early postoperative oropharyngeal dysphagia is linked to TORS, this study explores both subjective and objective swallowing outcomes.

Study Design: Retrospective and prospective review of the patients who underwent TORS for oropharyngeal malignancy from 2018 to 2023.

Reconstruction for Salvage Laryngectomy With Limited Pharyngectomy.

Importance: Closure technique for optimization of postoperative and functional outcomes following salvage laryngectomy remains an area of debate among head and neck surgeons.

Objective: To investigate the association of salvage laryngectomy closure technique with early postoperative and functional outcomes.

Design, Setting, And Participants: This retrospective cohort study included patients from 17 academic, tertiary care centers who underwent total laryngectomy with no or limited pharyngectomy after completing a course of definitive radiotherapy or chemoradiotherapy with curative intent between January 2011 and December 2016.

Diarrheagenic Escherichia coli with Multidrug Resistance in Cattle from Mexico.

Mexico is an important producer/exporter of cattle and cattle products. In the last decade, an increase in antibiotic resistance in E. coli pathotype strains from livestock environments has been reported.

Chromosome-level assembly of the gray fox (Urocyon cinereoargenteus) confirms the basal loss of PRDM9 in Canidae.

Reference genome assemblies have been created from multiple lineages within the Canidae family; however, despite its phylogenetic relevance as a basal genus within the clade, there is currently no reference genome for the gray fox (Urocyon cinereoargenteus). Here, we present a chromosome-level assembly for the gray fox (U. cinereoargenteus), which represents the most contiguous, non-domestic canid reference genome available to date, with 90% of the genome contained in just 34 scaffolds and a contig N50 and scaffold N50 of 59.

Virtual surgical planning for mandibular reconstruction in an abbreviated admission pathway.

Objectives: Virtual Surgical Planning (VSP) creates individualized surgical plans for free flap reconstruction of mandibular defects. Prior studies indicate that VSP can offer cost benefits due to reduced operative time and length of stay (LOS). We assessed the impact of VSP in the context of a validated postoperative abbreviated LOS clinical pathway.

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).

Loss of BAP1 Protein Expression by Immunohistochemistry in the Salivary Duct Carcinoma Component of an Intracapsular Carcinoma ex Pleomorphic Adenoma of the Parotid Gland.

Background: BRCA1-associated protein 1 (BAP1) is a tumor suppressor gene that is altered in a variety of neoplasms as well as in BAP1 tumor predisposition syndrome. BAP1 alterations are associated with aggressive behavior in some malignancies and may have treatment implications in future. We present the first documented case of loss of BAP1 protein expression by immunohistochemistry in the salivary duct carcinoma (SDC) component of an intracapsular carcinoma ex pleomorphic adenoma (CXPA) in the context of molecular loss of function of BAP1 in the neoplasm.

Routine Contrasted Chest CT Accurately Identifies Anatomic Variations of the Proximal Subscapular System.

Objective: The vascular anatomy of the proximal subscapular artery has been previously classified into 2 major types depending on the presence of a common subscapular trunk. The purpose of this study was to determine the utility, reliability, and cost of routine chest imaging to identify these anatomical variations.

Methods: Data were collected retrospectively at a tertiary medical center for patients who were undergoing CT chest for various indications between October 2019 and October 2020.

Comparing donor site morbidity in osteocutaneous radial forearm versus fibula free flap for mandibular reconstruction.

Purpose: The osteocutaneous radial forearm free flap has gained popularity as a less morbid option for oromandibular reconstruction compared to the fibular free flap. However, there is a paucity of data regarding direct outcome comparison between these techniques.

Methods: Retrospective chart review of 94 patients who underwent maxillomandibular reconstruction intervened from July 2012-October 2020 at the University of Arkansas for Medical Sciences.

A randomized study on the value of self-directed versus traditional mentor-led microsurgical training.

Objective: Analyze efficacy of self-directed resident microvascular training versus a mentor-led course.

Study Design: Randomized, single-blinded cohort study.

Setting: Academic tertiary care center.