Late Flap Failure: Etiology and Management.

Objective: Late free flap failure is an unusual setback for patients; we investigated the etiology and management of late flap failure.

Study Design: Single-institution retrospective review of 1959 free flaps from 2010 to 2023 for head and neck defects.

Setting: Tertiary Academic Medical Center.

The Impact of Lovenox Prophylaxis and Other Anticoagulants on Microvascular Free Flap Outcomes.

Objective: Microvascular free flap reconstruction for head and neck defects carries a 95% success rate. When flap compromise occurs, it is often due to vascular occlusion. This study seeks to determine what impact lovenox prophylaxis has on flap outcomes and postoperative complications.

Long-Term Complications in Patient-Specific Plates for Maxillary Reconstruction.

Objectives: Virtual surgical planning (VSP) allows for optimal reconstruction of maxillary defects with fibula free flaps. Current data are limited regarding long-term complications of patient-specific plates (PSPs) in this setting. Our objective was to determine long-term complications of PSPs in maxillary reconstruction using fibula free flaps.

Long-Term Plate Complications in Patient-Specific Plates Utilizing Computer-Aided Design.

Objective: Assess the long-term plate complications with patient-specific plates (PSPs) created with computer-aided design (CAD) and computer-aided manufacturing (CAM) for fibula free flap reconstructions for mandibular defects.

Methods: Retrospective chart review from January 2010 to July 2022 of patients who underwent mandibular reconstruction with a fibula free flap and PSP. Primary outcome was plating-related complications, defined as plate exposure, fracture, loose screws, and plate removal.

Fibula Free Flap Reconstruction of Cervical Spine Defects: A Multi-Institutional Study.

Introduction: Cervical spine defects result in spinal instability, putting the spinal cord and vertebral arteries at risk of damage and possibly devastating neurological injuries. The fibula free flap can span the spinal defects for stability. There is a paucity of literature on this technique.

Microvascular reconstruction of midface osteoradionecrosis.

Background: Head and neck osteoradionecrosis (ORN) of the midface requiring free flap (FF) reconstruction is uncommon. This multi-institutional study was designed to review outcomes for this rare patient population.

Methods: Retrospective multi-institutional review of FF reconstruction for midface ORN (2005-2022; n = 54).

Microvascular reconstruction of medication related osteonecrosis of the head and neck.

Background: Medication related osteonecrosis of the jaw (MRONJ) requiring free flap (FF) reconstruction is uncommon with limited reported findings.

Methods: Multicenter, retrospective case series of 49 consecutive adult patients presenting with advanced MRONJ requiring FF reconstruction from 2010 to 2022. Perioperative complications and outcomes were analyzed.

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).

A Rare Manifestation of Infectious Mononucleosis Tonsillitis.

The purpose of this case report is to describe a rare case of infectious mononucleosis (IM) hemorrhagic tonsillitis. Our patient presented with acute tonsillitis complicated by spontaneous tonsillar hemorrhage. This is a single case report with a literature review.

Outcomes Following Treatment for Carotid Blowout in Head and Neck Cancer Patients.

Objective: The aim of the study was to determine outcomes after interventional radiology treatment of carotid blowout.

Methods: Patients with head and neck cancer and who received interventional radiology treatment for carotid blowout between 2000 and 2022 were included. Pre-treatment, treatment, and post-treatment variables were evaluated.

Management of the Failing Flap.

Free tissue transfer has become the reconstructive modality of choice for replacing composite tissue defects. While the success rate in high-volume centers is reported to be greater than 95%, up to 10% of patients will require revision of their vascular anastomosis secondary to thrombosis or compromise to flow. In the intraoperative setting, immediate revision is successful in the majority of cases.

Head and neck cancer readmission reduction (HANCARRE) project: Reducing 30-day readmissions.

Objective: Unplanned 30-day readmissions result in increased costs and decreased patient satisfaction. The objective of this study was to compare readmission rates before and after a multidisciplinary quality improvement initiative that focuses on patient and staff education, use of targeted skilled nursing facilities, and appropriate use of patient observation status.

Methods: This was a quality improvement study of all unplanned admissions to the Head and Neck Oncology service at a tertiary care facility during a 3-year period between October 2015 and September 2018.

MR angiographic findings of aberrant right subclavian artery with agenesis of the left common carotid artery and anomalous origin of the vertebral arteries.

Introduction: Congenital aortic arch anomalies and variants have been extensively characterized in the medical literature. Proper identification of these anomalies is important when surgical or percutaneous interventions are indicated.

Case Presentation: We present a case of a 48-year old male who presented to the emergency department with altered mental status.

Sinusitis as a cause of insidious headache in a pregnant woman: A case report.

Background: The incidence of headaches during pregnancy is 35%. Although ruling out pre-eclampsia as a possible cause for headache is important in the pregnant population, acute sinusitis should remain on the differential as it occurs six times more frequently in pregnant women. Untreated disease can lead to rare intracranial complications such as a subdural empyema.

Superior Semicircular Canal Dehiscence Syndrome Following Head Trauma: A Multi-institutional Review.

Objective: To evaluate patients who become symptomatic from superior semicircular canal dehiscence (SSCD) following head trauma.

Study Design: Case series assessing patients presenting with SSCD after a trauma.

Methods: A case series was completed assessing patients presenting with SSCD after trauma.

The Dynamic Tracheoesophageal Prosthesis Length.

Objective: In a postlaryngectomy patient, tracheoesophageal (TE) speech is considered to be the most effective and preferred method of communication. Previous research has demonstrated that despite an appropriately sized TE prosthesis placement at the time of puncture, there are a portion of patients that require resizing postoperatively. The purpose of this study was to report on the variability of the tracheoesophageal prosthesis length.

Cutaneous Vasculitis in a Patient With COVID-19.

We describe a 43-year-old patient with coronavirus disease 2019 who developed a bullous hemorrhagic rash that progressed to necrotic lesions. Histopathology confirmed a vasculitis of small- and medium-sized cutaneous vessels.

Total thyroidectomy: Safe and curative treatment option for hyperthyroidism.

Background: While use of total thyroidectomy has increased in management of hyperthyroidism, concerns exist about increased surgical complication rates; most notably, hematoma, recurrent laryngeal nerve (RLN) injury, and hypocalcemia.

Methods: Retrospective cohort study of 454 patients undergoing total thyroidectomy between 2003 and 2015. All patients had surgery for hyperthyroidism, benign euthyroid disease, or thyroid malignancy.

Self-Resolving Vulvar Breast Tissue Arising in the Post-Partum Setting: A Case Report and Review of Literature.

Introduction: During the postpartum period, breast engorgement in preparation for lactation may trigger the onset of vulvar labial nodules that present with pain and discomfort. These labial nodules may originate from ectopic breast tissue and can rarely present in women during the postpartum period in the labia majora.

Main Issue: A 37-year-old African American female, gravida 1 para 1, presented to the Loma Linda University Medical Center with complaints of new onset labial swelling worsening 6 days following her full term spontaneous vaginal delivery.

Discharge breastmilk feeding rates in asymptomatic term newborns admitted to the neonatal intensive care unit for maternal chorioamnionitis.

Purpose: To compare discharge breastmilk feeding rates among asymptomatic term newborns receiving 48-hour versus >48-hour antibiotics in the neonatal intensive care unit (NICU) and a cohort of well-baby nursery (WBN) newborns.

Materials And Methods: This retrospective review included asymptomatic term neonates admitted to the NICU due to maternal chorioamnionitis and a comparison group of WBN neonates between January 2012 and December 2015. Demographic, birth, feeding, and lactation consultant visit data were analyzed in univariate and multivariate models.