Iliac Crest Bone Graft and Fascia Lata Free Flap for Rescue of Mandibular Osteoradionecrosis.

Objective: Describe the use, indications, and outcomes of iliac crest bone graft (ICBG) with concomitant anterolateral thigh fascia lata (ALTFL) rescue flap for the management of mandibular osteoradionecrosis (ORN).

Study Design: Retrospective chart review.

Setting: Single institution.

Use of Occipital Vessels in Head and Neck Microvascular Reconstruction: A Comprehensive Preclinical Evaluation.

Objectives: To assess the use of occipital vessels for microvascular anastomosis in head and neck free tissue transfer reconstruction.

Methods: A literature search was undertaken to identify studies utilizing the occipital vessels for microvascular anastomosis in free tissue transfer. Following literature review, 30 anatomic cadaveric dissections on 15 fresh unfixed cadavers were performed to evaluate the occipital artery and identify a reliable vein within reasonable proximity.

Managing Mandibular Osteoradionecrosis.

Objective: Mandibular osteoradionecrosis (MORN) is a morbid complication of head and neck radiation therapy. Recent advances in surgical and medical therapies underscore the need for a shift in traditional treatment paradigms and a disease grading system that can guide appropriate management.

Data Sources: Pubmed/MEDLINE.

Preoperative Hypoalbuminemia Predicts 30-day Complications in Head and Neck Microvascular Surgery.

Introduction: Hypoalbuminemia, a marker for poor nutritional status, has been associated with postoperative complications, including head and neck cancer surgery. This study investigates the impact of hypoalbuminemia on head and neck microvascular free tissue transfer reconstruction.

Methods: This retrospective cohort study queried the 2005-2021 American College of Surgeons National Surgical Quality Improvement Program databases.

Positive Trends in Racial Disparities for Head and Neck Microvascular Reconstructive Surgery.

Objective: To evaluate national trends in racial disparities for patients undergoing head and neck reconstructive surgery.

Methods: Retrospective analysis using the 2008 to 2021 American College of Surgeons National Surgical Quality Improvement Program database. Patients receiving microvascular free tissue transfer were eligible for inclusion.

Longitudinal Analysis of the Use of Facial Reanimation Procedures for Bell's Palsy.

Treatment of Bell's palsy ranges from medical management with high-dose corticosteroids to complex facial reanimation procedures. To characterize the number of static, dynamic, and combined facial reanimation procedures for the management of Bell's palsy using a national database over time. This retrospective cohort study included patients in the 2013-2020 National Surgical Quality Improvement Project database with a postoperative diagnosis of Bell's palsy.

Masseteric Atrophy Following Masseteric Nerve Transfer: Radiographic Findings of Asymmetry in the Paralyzed Face?

Objectives: To characterize the effect of facial reanimation using masseteric nerve transfer on the masseter muscle itself, examining whether there is any demonstrable atrophy postoperatively.

Methods: Electronic medical records of adult patients who underwent facial reanimation using masseteric nerve transfer at our institution over a 15-year period were reviewed. To account for the impact of postoperative radiation, randomly selected patients who underwent radical parotidectomy without nerve transfer and received postoperative radiation served as controls in a 1:1 fashion against those who underwent masseteric nerve transfer with postoperative radiation.

Clinical features, evaluation, and management of ophthalmic complications of facial paralysis: A review.

The purpose of this review was to study the evaluation, diagnosis, and management of ophthalmic complications associated with facial nerve palsy and to discuss the current and future interventions. The ophthalmic complications of facial paralysis include lagophthalmos, ectropion, exposure keratopathy, ocular synkinesis, and crocodile tears. Evaluation by an ophthalmologist skilled in recognizing and managing complications of facial paralysis shortly after its initial diagnosis can help identify and prevent long-term complications.

Clinical application of physical therapy in facial paralysis treatment: A review.

This review aims to summarize recent studies regarding the specific modalities of physical therapy as a form of treatment for patients with facial paralysis, analyze the different components of physical therapy, and provide healthcare providers with guidance for their best practice in treating patients with facial paralysis. This paper will discuss the mechanism, indications, and impact factors for facial retraining, evaluate the standards for facial retraining, the creation of a treatment plan, and analyze the combined use of facial retraining with botulinum toxin injections and the application of facial retraining in post facial reanimation patients. Other modes of physical therapy, including electrical stimulation, dry needling, and acupuncture, will be addressed.

Mandibular Osteoradionecrosis: Defining the Microbial Milieu and Antimicrobial Resistance at the Time of Rescue Flap Surgery.

Objective: To report the microorganisms and their antibiotic sensitivity profile from tissue cultures and stains at the time of anterolateral thigh fascia lata (ALTFL) rescue flap for management of mandibular osteoradionecrosis (ORN).

Methods: Retrospective chart review of patients who underwent ALTFL rescue flap for native mandibular ORN between 2011 and 2022.

Results: Twenty-six cases comprising 24 patients (mean age 65.

The psychological and psychosocial effects of facial paralysis: A review.

Facial nerve function is essential for a multitude of processes in the face, including facial movement; expression; and functions, such as eating, smiling, and blinking. When facial nerve function is disrupted, facial paralysis may occur and various complications for the patient may result. Much research has been conducted on the physical diagnosis, management, and treatment of facial paralysis.

Evaluation of Anterolateral Thigh Fascia Lata Rescue Flap for Mandibular Osteoradionecrosis.

Importance: Mandibular osteoradionecrosis (ORN) is a progressive disease that can be difficult to treat. Conservative measures often fail, while conventional definitive management requires a morbid segmental resection with osteocutaneous reconstruction. Evidence of the anterolateral thigh fascia lata (ALTFL) rescue flap technique's safety, effectiveness, and long-term outcomes is needed.

Trilayer temporalis fascia interposition graft: A reliable technique for nasal septal perforation repair.

Purpose: Nasal septal perforation (NSP) repair is a complex procedure with variable techniques and success rates. In this study we describe NSP repair using a trilayer interposition graft of temporalis fascia and thin polydioxanone (PDS) plate without intranasal flaps and report outcomes in our patient population.

Materials And Methods: IRB-approved retrospective review of 20 consecutive patients presenting to a tertiary medical center with NSP from September 2018 to December 2020 and who underwent NSP repair via our trilayer temporalis fascia interposition graft.

Advances in Facial Reanimation.

Facial nerve paralysis is a debilitating clinical entity that presents as a complete or incomplete loss of facial nerve function. The etiology of facial nerve palsy and sequelae varies tremendously. The most common cause of facial paralysis is Bell's palsy, followed by malignant or benign tumors, iatrogenic insults, trauma, virus-associated paralysis, and congenital etiologies.

Management, Referral Patterns, and Outcomes in Bell's Palsy: A Single-Institution 903 Patient Series.

Objective: In 2013, the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) published guidelines for Bell's palsy (BP), including recommendations for workup, management, and specialist referral. Patients with BP often present to primary care; however, adherence to guidelines may vary by setting. This study sought to evaluate the management of patients with BP presenting to primary care, emergency department (ED), and urgent care settings.

Rates of osteoradionecrosis in resected oral cavity cancer reconstructed with free tissue transfer in the intensity-modulated radiotherapy era.

Background: Resected oral cavity carcinoma defects are often reconstructed with osteocutaneous or soft-tissue free flaps, but risk of osteoradionecrosis (ORN) is unknown.

Methods: This retrospective study included oral cavity carcinoma treated with free-tissue reconstruction and postoperative IMRT between 2000 and 2019. Risk-regression assessed risk factors for grade ≥2 ORN.

The profunda artery perforator flap for head and neck reconstruction.

Introduction: The profunda artery perforator (PAP) fasciocutaneous flap is underutilized in head and neck reconstruction, with advantages including ease of harvest and minimal donor site morbidity.

Methods: Cadaveric dissection of cutaneous perforators to origin at profunda femoris system to characterize vascular anatomy.

Results: 22 PAP flaps were studied.

Association between hypertension requiring medication and 30-day outcomes in head and neck microvascular surgery.

Background: Hypertension has been shown to be both a protective factor and a risk factor for complications in head and neck reconstructive surgery.

Methods: Retrospective analysis of microvascular free tissue transfer patients using the National Surgical Quality Improvement Program database.

Results: Hypertensive patients (n = 1598; 46.

Angular Vessels for Free-Tissue Transfer in Head and Neck Reconstruction: Clinical Outcomes.

Objectives/hypothesis: To evaluate the efficacy and reconstructive applications of angular vessel microvascular anastomosis in free-tissue transfer.

Study Design: Retrospective cohort study.

Methods: A study of patients treated from January 2010 to July 2017 was performed.

Reconstructive trends and complications following parotidectomy: incidence and predictors in 11,057 cases.

Background: Parotidectomy is a common treatment option for parotid neoplasms and the complications associated with this procedure can cause significant morbidity. Reconstruction following parotidectomy is utilized to address contour deformity and facial nerve paralysis. This study aims to demonstrate national trends in parotidectomy patients and identify factors associated with adverse postoperative outcomes.

Predictive value of the ACS NSQIP calculator for head and neck reconstruction free tissue transfer.

Background: Predictive models to forecast the likelihood of specific outcomes after surgical intervention allow informed shared decision-making by surgeons and patients. Previous studies have suggested that existing general surgical risk calculators poorly forecast head and neck surgical outcomes. However, no large study has addressed this question while subdividing subjects by surgery performed.

Osseocartilaginous Rib Graft L-Strut for Nasal Framework Reconstruction.

Background: In the setting of major nasal framework reconstruction, it is critical to create a stable, warp-resistant L-strut to resist the contractile forces of healing to achieve a durable outcome.

Objectives: The authors sought to demonstrate the effectiveness of the osseocartilaginous rib graft for nasal framework reconstruction.

Methods: Retrospective analysis was performed of all patients who underwent osseocartilaginous rib graft for L-strut reconstruction from 2007 to 2017 at a tertiary care hospital.

Pediatric vestibular testing: Tolerability of test components in children.

Introduction: Objective of the study is to define rates of successful completion of components of pediatric vestibular testing (VT).

Methods: Retrospective review of VT performed on patients less than 18 years of age from 2004 to 2015.

Results: 188 pediatric patients (mean age: 13.

Comprehensive approach to reestablishing form and function after radical parotidectomy.

Introduction: The reconstructive goals following radical parotidectomy include restoration of symmetry, reanimation of the face, and reestablishment of oral competence. We present our experience utilizing the anterolateral thigh (ALT) free flap, orthodromic temporalis tendon transfer (OTTT), and facial nerve cable grafting to reestablish form and function.

Material And Methods: From 2010 to 2016, 17 patients underwent radical parotidectomy followed by immediate reconstruction.