Publications by authors named "Wax M"

Hepatitis E virus (HEV) is one of the most common causes of viral hepatitis. We examined HEV seroprevalence and associations of sociodemographic and lifestyle characteristics with HEV immunoglobulin G (IgG) seropositivity in the Arab population. A cross-sectional single-centre study was conducted among adults in the Nazareth area during 2022.

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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.

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Objective: To examine implementation of virtual reality (VR) and Fitbit wearable activity devices in postoperative recovery.

Methods: This was a prospective, 4-arm, randomized controlled trial of patients undergoing inpatient head and neck surgery at a tertiary academic center from November 2021 to July 2022. Patients were randomized to Control, VR, Fitbit, or combined VR + Fitbit groups.

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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.

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Facial paralysis severely impacts a person's ability to interact with the world. Advances in microsurgery, especially free neurotized muscle transfers, have greatly improved reanimation outcomes. The gracilis free muscle transfer, introduced in 1971, is the most widely used procedure for long-standing flaccid paralysis.

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Scalp Reconstruction.

Facial Plast Surg Clin North Am

February 2025

This article describes the background and importance of scalp reconstruction. The relevant anatomy and neurovasculature will be discussed. Finally, the entire reconstructive ladder will be examined in its relation to scalp reconstruction and how to optimally reconstruct scalp defects.

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Donor site morbidity has become a major focus in free tissue transfer as flap success rates have approached 98%. Emphasis is placed on minimizing the morbidity and optimizing cosmetic and functional outcomes at the donor site. This article reviews techniques to mitigate the donor site morbidity of commonly used free flaps in head and neck reconstruction.

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Article Synopsis
  • Vessel grafting is a technique used in head and neck reconstruction when a direct artery connection isn't possible, and there’s limited data on interposition artery grafts for this purpose.
  • A study reviewed records from four hospitals, focusing on patients who underwent free tissue transfer using interposition artery grafts, assessing factors like graft types, reasons for using grafts, and postoperative complications.
  • Nine patients were included in the study, with common grafts from the lateral circumflex femoral artery and facial artery, and no major complications were reported; however, two patients did experience flap failure due to clot formation.
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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.

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Article Synopsis
  • The study analyzes free flap reconstruction in patients with traumatic head and neck injuries, focusing on experiences from multiple institutions, involving 103 cases.
  • Most injuries were due to gunshot wounds (85%) and motor vehicle accidents (11%), with the majority requiring bone reconstruction (82%).
  • Free flap failures (9% of cases) occurred exclusively in gunshot wound patients and were linked to multiple injured sites, while preoperative antibiotics were found to significantly reduce certain postoperative complications.
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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.

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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).

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Virtual reality (VR) and Fitbit devices are well tolerated by patients after skull base surgery. Postoperative recovery protocols may benefit from incorporation of these devices. However, challenges including patient compliance may impact optimal device utilization.

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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.

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This study presents an analysis of the epidemiological trends of parvovirus B19 (B19V) in Israel from 2010 to 2023, with particular emphasis on the outbreak in 2023. The analysis utilized molecular diagnostic data from individual patients obtained at the Central Virology Laboratory. Between 2010 and 2022, 8.

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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.

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A popular approach for modeling brain activity in MEG and EEG is based on a small set of current dipoles, where each dipole represents the combined activation of a local area of the brain. Here, we address the problem of multiple dipole localization with a novel solution called Alternating Projection (AP). The AP solution is based on minimizing the least-squares (LS) criterion by transforming the multi-dimensional optimization required for direct LS solution, to a sequential and iterative solution in which one source at a time is localized, while keeping the other sources fixed.

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As the demand for clean energy becomes greater worldwide, there will also be an increasing demand for next generation nuclear power plants that incorporate advanced sensors and monitoring equipment. A major challenge posed by nuclear power plants is that, during normal operation, the reactor compartment is subjected to high operating temperatures and radiation flux. Diagnostic sensors monitoring such structures are also subject to temperatures reaching hundreds of degrees Celsius, which puts them at risk for heat degradation.

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Background: Massive oropharyngeal bleeding post-chemoradiotherapy is a life-threatening condition that requires emergent management.

Methods: This retrospective case series included 11 patients with oropharyngeal squamous cell carcinoma who suffered from massive bleeding during or following treatment with definitive chemoradiotherapy. Details of acute and definitive management of oropharyngeal bleeding are reported.

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Article Synopsis
  • - The study investigated virological failure (VF) in HIV-1 patients on first-line antiretroviral therapy (ART) from 2010 to 2018, following 1130 individuals for a median of two years to identify contributing factors.
  • - Results showed that VF occurred in 5.8% of participants, with higher risks associated with being diagnosed at CD4 counts below 200 cells/mm³ (especially with AIDS-defining conditions) and using non-integrase strand transfer inhibitor (non-INSTI) regimens.
  • - The study suggests that early detection of HIV-1 and the use of INSTI-based treatments could help reduce the risk of virological failure.
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Phylogenetic analysis of dengue serotypes 1 and 3, which were diagnosed in travelers and Nepalese infected in Kathmandu during the October 2022 outbreak, revealed that both serotypes were clustered closest to the sequences sampled in India. This suggests both serotypes may have originated in India.

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Background: Estimating HIV-1 recency of infection for incidence and local outbreaks detection usually involves specifically designed assays. Here, we established an approach to identify recent infections, estimate their rate, and assess potential risk factors.

Methods: Randomly selected HIV-1 positive samples (n = 382) collected in 2017-2021 were tested by Sedia and compared to the results of Geenius recency algorithm and the S/CO values of the HIV-1/2 Combo assay.

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The palatal island rotation flap is a rarely used reconstructive technique. The tissue is robust and the morbidity is low. It can be used as a primary reconstructive technique in patients with limited oral cavity/pharynx lesions.

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Article Synopsis
  • COVID-19 can lead to a hypercoagulable state, which raises concerns for patients undergoing head and neck microvascular free flap reconstructions.
  • A study reviewed 40 patients with COVID-19 during their surgery period and found 5% experienced free flap complications, while 10% had surgical complications and 25% had medical complications.
  • Overall, while COVID-19 patients are not at higher risk for free flap complications, they do face increased medical risks, emphasizing the need for careful management during the perioperative phase.
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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).

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