Prolonged operative time predicts postoperative deep venous thrombosis in head and neck cancer patients who undergo free flap reconstruction.

Objective: This study sought to quantify the deep venous thrombosis (DVT) incidence in head and neck cancer (HNC) patients undergoing free tissue transfer and to identify independent predictors of postoperative DVT.

Materials And Methods: This is a cross-sectional study of the National Surgical Quality Improvement Program database from 2010 through 2020. The sample included all HNC surgical patients treated with free flap reconstruction.

Immune Cell Deconvolution Reveals Possible Association of γδ T Cells with Poor Survival in Head and Neck Squamous Cell Carcinoma.

(1) Background: The role of rare immune cell subtypes in many solid tumors, chief among them head and neck squamous cell carcinoma (HNSCC), has not been well defined. The objective of this study was to assess the association between proportions of common and rare immune cell subtypes and survival outcomes in HNSCC. (2) Methods: In this cohort study, we utilized a deconvolution approach based on the CIBERSORT algorithm and the LM22 signature matrix to infer proportions of immune cell subtypes from 517 patients with untreated HPV-negative HNSCC from The Cancer Genome Atlas.

The Role of Fluorescent Angiography in Free Flap Reconstruction of the Head and Neck.

Objectives: Highlight the use of fluorescent angiography in free flap reconstruction of the head and neck. Qualify how fluorescent angiography can be selectively added to management paradigms for head and neck free flap reconstruction.

Methods: Retrospective chart review of 993 free flaps completed from the time the SPY Elite® system first became available at our institution between September 2013, until August 2020.

Tracheostomy Outcomes in Patients With COVID-19 at a New York City Hospital.

Objective: Tracheostomies have been performed in patients with prolonged intubation due to COVID-19. Understanding outcomes in different populations is crucial to tackle future epidemics.

Study Design: Prospective cohort study.

Targeted Neoadjuvant Intra-arterial Chemotherapy in Lacrimal Gland Adenoid Cystic Carcinoma: A Histological Correlation Using Apoptotic Tumor Markers.

Neoadjuvant intra-arterial cytoreductive chemotherapy is used for the treatment of lacrimal gland adenoid cystic carcinomas (ACC) to improve outcomes in this condition with an otherwise dismal prognosis. We share our experience in the management of an advanced case of ACC using a novel, highly targeted intra-arterial cytoreductive chemotherapy delivery technique involving both the internal and external carotid circulation, with an attempt to correlate the effect histologically. Refinement of the chemotherapy delivery using the tumor's vascular anatomy and appropriate blood vessel selection may lead to future globe sparing procedures without compromising survival.

A novel neck brace to characterize neck mobility impairments following neck dissection in head and neck cancer patients.

Objective: This article introduces a dynamic neck brace to measure the full range of motion (RoM) of the head-neck. This easy-to-wear brace was used, along with surface electromyography (EMG), to study changes in movement characteristics after neck dissection (ND) in a clinical setting.

Methods: The brace was inspired by the head-neck anatomy and was designed based on the head-neck movement of 10 healthy individuals.

Conditional and Overall Disease-Specific Survival in Patients With Paranasal Sinus and Nasal Cavity Cancer: Improved Outcomes in the Endoscopic Era.

Background: The management of paranasal sinus and nasal cavity malignancies has evolved significantly with the development of advanced endoscopic techniques and improvements in adjuvant therapy. We sought to characterize both disease-specific survival (DSS) and 5-year conditional disease-specific survival (CDSS, the change in life expectancy with increasing survivorship) for sinus malignancies diagnosed before and after the year 2000.

Methods: Patients diagnosed with sinus and nasal cavity cancer between 1973-2015 were extracted from the Surveillance, Epidemiology, End Results (SEER) registry.

Venous Flow Coupler in Head and Neck Free Flap Reconstruction.

Objective: To describe the utility of venous flow couplers in monitoring free tissue flaps in the immediate postoperative setting.

Study Design: Retrospective case series.

Setting: Otolaryngology department at a single tertiary care institution.

Shift in the timing of microvascular free tissue transfer failures in head and neck reconstruction.

Objective: Analyze the cause and significance of a shift in the timing of free flap failures in head and neck reconstruction.

Study Design: Retrospective multi-institutional review of prospectively collected databases at tertiary care centers.

Methods: Included consecutive patients undergoing free flap reconstructions of head and neck defects between 2007 and 2017.

Outcomes and cost implications of microvascular reconstructions of the head and neck.

Background: Critical review of current head and neck reconstructive practices as related to free flap donor sites and their impact on clinical outcomes and cost.

Methods: Retrospective multicenter review of free tissue transfer reconstruction of head and neck defects (n = 1315). Variables reviewed: defect, indication, T classification, operative duration, and complications.

Combined endoscopic and transcervical approach for free flap reconstruction of nasopharyngeal and clival defects: A case report.

We report a case during which a new method of reconstruction for a nasopharyngeal and skull base defect was successfully performed. A 45-year-old female with granulomatosis with polyangiitis presented with computed tomography (CT) findings demonstrative of chronic clival and cervical spine osteomyelitis secondary to nasopharyngeal destruction. The posterior nasopharyngeal defect, evident as a wide area of mucosal erosion exposing the clivus centrally, was successfully reconstructed with an anterior serratus muscle-free tissue transfer via both transcervical and endoscopic transnasal approaches utilizing a laparoscopic fixation device, a previously unreported method for free flap inset, to secure the free flap.

Osteocutaneous radial forearm free flap in nonmandible head and neck reconstruction.

Background: The osteocutaneous radial forearm free flap (RFFF) is a versatile flap primarily used to reconstruct composite defects involving the mandible. The purpose of this study was to describe our experience with this flap for nonmandible reconstruction.

Methods: All patients undergoing nonmandible osseous reconstruction with free-tissue transfer were reviewed.

Effect of Overlapping Operations on Outcomes in Microvascular Reconstructions of the Head and Neck.

Objective To compare outcomes after microvascular reconstructions of head and neck defects between overlapping and nonoverlapping operations. Study Design Retrospective cohort study. Setting Tertiary care center.

Secondary free-flap reconstruction following ablation for acute invasive fungal sinusitis.

Objective: Acute invasive fungal sinusitis (AIFS) is a frequently fatal infection for which extensive and debilitating surgical debridement is a mainstay of therapy. Resulting defects are often composite in nature, mandating free tissue-transfer reconstruction. Outcomes data for free flap reconstruction are limited.

High-grade malignant transformation of a radiation-naïve nasopharyngeal angiofibroma.

Background: Nasopharyngeal angiofibromas are typically considered benign vascular neoplasms, with descriptions of high-grade sarcomatous change found only in lesions with prior radiotherapy.

Methods And Results: We describe the first reported case of high-grade malignant change in a nasopharyngeal angiofibroma naive to radiation. A 45-year-old man presented with left-sided nasal congestion and fullness and was found to have a left-sided nasopharyngeal mass with intracranial extension on CT scan.

Transoral robotic retropharyngeal node dissection.

Background: Surgical access to metastases in the retropharyngeal lymph nodes (RPLNs) could be difficult. Transoral robotic surgery (TORS) can be utilized to access RPLNs. The purpose of this study was to describe a TORS approach to RPLN dissection.

An evidence-based algorithm for intraoperative monitoring during cochlear implantation.

Objective: To generate an evidence-based algorithm for the use of intraoperative testing during cochlear implantation (CI).

Study Design: Retrospective review.

Setting: Tertiary referral center.