140 results match your criteria: "Royal Prince Alfred Institute of Academic Surgery[Affiliation]"

Background: Facial prosthetics are an important means to rehabilitate patients with congenital or acquired facial defects. However, with a time-consuming manual workflow and workforce shortage, access to facial prosthetics is limited in Australia and worldwide, especially for rural and remote patients. Optical 3D scanning has been increasingly integrated in digitizing data.

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Background: Cutaneous squamous cell carcinomas (cSCC) metastasizing to the parotid gland can cause facial nerve (FN) dysfunction secondary to direct invasion, perineural spread, or surgical ablation. This study aims to characterize the prevalence of preoperative FN involvement in metastatic cSCC to the parotid and identify risk factors resulting in FN sacrifice.

Methods: Patients with parotid metastases from cSCC, treated surgically with parotidectomy with curative intent were identified through a retrospective cohort analysis of a prospectively maintained Sydney Head and Neck database from 1992 to 2021.

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Quality of life outcomes in patients receiving dental implants in vascularised bone flaps for mandibular reconstruction.

Br J Oral Maxillofac Surg

May 2024

Department of Head and Neck Surgery, Sydney Head and Neck Cancer Institute, Chris O'Brien Lifehouse, Sydney, New South Wales, Australia; Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia; Royal Prince Alfred Institute of Academic Surgery, Sydney Local Health District, Sydney, New South Wales, Australia.

Resection, reconstruction, and rehabilitation of the mandible impact function and health related quality of life (HRQOL). In this study, we aimed to understand the impact of delayed versus immediate dental implant placement. A cross-sectional and prospective study was conducted including patients who underwent reconstruction of the mandible via osseous vascularised bone flaps and dental implants.

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Zygomatic Implant Perforated Flap vs Fibula Osseous Flap Maxillary Reconstruction.

JAMA Otolaryngol Head Neck Surg

November 2024

Department of Head and Neck Surgery, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia.

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Objective: This study evaluates how health care professionals manage trismus in Australia and identifies facilitators and barriers experienced by clinicians in routine patient care.

Methods: A mixed-methods approach was used to evaluate the experience of clinicians. Medical, nursing, and allied health practitioners in Australia were invited to participate if they had treated patients with trismus in the last 5 years.

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Acceptance and willingness of patients with chronic facial nerve palsy for an implantable device that assists with eye closure.

J Plast Reconstr Aesthet Surg

September 2024

Department of Head and Neck Surgery, Chris O'Brien Lifehouse, Camperdown, Sydney, NSW, Australia; Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Camperdown, Sydney, NSW, Australia; Sydney Facial Nerve Clinic, The Chris O'Brien Lifehouse, Camperdown, NSW 2050, Australia; Department of Otolaryngology-Head & Neck Surgery, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, NSW 2109, Australia.

Background: Patients with facial nerve palsy often experience lagophthalmos (incomplete eye closure), which can lead to exposure keratitis. The Bionic Lid Implant for Natural Eye Closure (BLINC) is a medical device designed to mimic the more natural blink kinetics than traditional lid loading techniques.

Aims: This study aimed to evaluate potential factors that might influence the design of the BLINC device and willingness of participant to undergo the implant placement surgery.

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Objective: Understanding survivorship issues among people with head and neck cancer (HNC) is important as survival rates increase. Most research has focused on urban patients, leaving a gap in understanding the challenges faced by those in rural areas. This study aims to summarise the literature on survivorship needs for people with HNC in rural areas.

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Radiologic myosteatosis predicts major complication risk following esophagectomy for cancer: a multicenter experience.

J Gastrointest Surg

November 2024

Department of Upper Gastrointestinal and Hepatobiliary Surgery, Royal Prince Alfred Hospital, Sydney, Australia; Royal Prince Alfred Institute of Academic Surgery, Sydney, Australia; School of Medicine, University of Sydney, Sydney, Australia; Surgical Outcomes Research Centre, Sydney, Australia.

Background: Myosteatosis is a measure of skeletal muscle quality that is readily identifiable on computed tomography (CT). The effect of preoperative myosteatosis on outcomes after radical esophagectomy remains unclear. This study aimed to correlate the presence of myosteatosis on CT scan with perioperative morbidity, mortality, and survival outcomes after esophagectomy in an Australian population across 3 esophageal cancer centers.

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Background: Perineural spread (PNS) is associated with a poor prognosis in cutaneous squamous cell carcinoma of the head and neck (cSCCHN). Hence, investigating facilitators and barriers of early diagnosis and treatment of PNS in cSCCHN may improve outcomes.

Methods: Patients were recruited from an institutional database.

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Jaw in a day surgery: early experience with 19 patients at an Australian tertiary referral center.

ANZ J Surg

September 2024

Department of Head and Neck Surgery, Chris O'Brien Lifehouse, Sydney, New South Wales, Australia.

Background: The Jaw-in-a-Day (JIAD) procedure aims to achieve immediate functional occlusion via a single-stage approach to maxillofacial reconstruction. While JIAD has gained popularity since its inception by Levine and colleagues, efficacy and outcome data remain limited. In this report, we discuss our experience with the JIAD technique at an Australian tertiary referral centre.

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Keeping Swallowing on Track During Radiation Therapy for Head and Neck Cancer.

Int J Radiat Oncol Biol Phys

September 2024

Department of Head and Neck Surgery, Chris O'Brien Lifehouse, Sydney, New South Wales, Australia; Sydney Medical School, Faculty of Medicine and Health Sciences, University of Sydney, Sydney, New South Wales, Australia; Royal Prince Alfred Institute of Academic Surgery, Sydney Local Health District, Sydney, New South Wales, Australia.

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A comparison of preoperative soft tissue contour versus bone accuracy as a predictor of quality of life outcomes in osseous free flap jaw reconstruction using occlusal-based virtual surgical planning.

J Plast Reconstr Aesthet Surg

October 2024

Department of Head and Neck Surgery, Chris O'Brien Lifehouse, 119-143 Missenden Road, Camperdown, NSW 2050, Australia; Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Anderson Stuart Building, Camperdown, NSW 2006, Australia; Royal Prince Alfred Institute of Academic Surgery, Sydney Local Health District, 145 Missenden Road, Camperdown, NSW 2050, Australia.

Objectives: Occlusal-based virtual surgical planning (VSP) prioritises the placement of endosseous dental implants, over replicating native bone contour. This may compromise facial aesthetics. This study aimed to compare function and health-related quality of life (HRQOL) following maxillomandibular reconstruction according to the ability to replicate preoperative soft-tissue contour and virtual plan.

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Background: We aimed to identify predictors of distant metastatic recurrence (DMR) in patients with head and neck cutaneous squamous cell carcinoma (HNcSCC) with nodal metastases treated with curative intent.

Methods: Predictors of DMR were identified using Cox regression in a multicenter study of 1151 patients.

Results: The 5-year risk of DMR was 9.

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What is the force required to treat trismus in patients undergoing oral cavity free flap reconstruction?

Head Neck

December 2024

Department of Head and Neck Surgery, Chris O'Brien Lifehouse, Sydney, New South Wales, Australia.

Background: Trismus therapy is often delayed after jaw reconstruction to avoid hardware failure or non-union. The aim of this study is to document the forces that have been applied to patients undergoing free flap reconstruction of the oral cavity in the 12 months following oral cavity reconstruction, and to analyze the associations between force and maximal interincisal opening (MIO) over time.

Methods: Participants with trismus after free flap reconstruction of the oral cavity completed a 10-week jaw stretching program using Restorabite™.

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Purpose: Rural people with head and neck cancers (HNC) are likely to experience poorer health outcomes due to limited access to health services, so many benefit from models of care that account for rurality. The aim of this review was to synthesise literature on models of care in this population.

Methods: Studies were identified using seven databases: PubMed, PsycINFO, Scopus, Embase, CINAHL, Medline, and Web of Science.

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The long-standing divide in Australia between medicine and dentistry has left many with inequitable access to dental care. People with oral cancer, in particular, may have few options for dental rehabilitation after cancer treatment, even with private health insurance. However, 2024 could finally see health care reforms that address these inequities, with significant momentum building in Australia.

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Systematic review of adherence to swallow and trismus exercises during radiation therapy for head and neck cancer.

Head Neck

September 2024

Department of Head and Neck Surgery, Chris O'Brien Lifehouse, Sydney, New South Wales, Australia.

Understanding the barriers and facilitators for prophylactic swallowing and trismus exercises for patients undergoing radiation to the head and neck may help exercise adherence. The analysis reviews all published reports of exercise adherence with a critical appraisal following PRISMA guidelines. A total of 137 potential papers were identified; 20 studies met the inclusion criteria.

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Background: The radiation dose to dysphagia and aspiration-related structures (DARS) for patients undergoing transoral robotic surgery (TORS) and post-operative radiation therapy (PORT) for primary oropharyngeal carcinoma is unknown.

Methods: This prospective study measured swallowing using the MD Anderson Dysphagia Inventory at baseline and then 12-months after PORT. Dosimetric parameters were collected.

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Exercise adherence for patients with trismus after head and neck cancer treatment.

Head Neck

November 2024

Department of Head and Neck Surgery, Chris O'Brien Lifehouse, Sydney, New South Wales, Australia.

Background: Head and neck cancer treatment often leads to trismus, a condition characterized by limited mouth opening. Exercise-based therapy is the most common intervention but there are no clear guidelines as to the optimal exercise regimen. Restorabite™ is a portable and force-regulated trismus device designed to enhance exercise adherence.

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A Preclinical Trial Protocol Using an Ovine Model to Assess Scaffold Implant Biomaterials for Repair of Critical-Sized Mandibular Defects.

ACS Biomater Sci Eng

May 2024

Integrated Prosthetics and Reconstruction, Department of Head and Neck Surgery, Chris O'Brien Lifehouse, Camperdown, NSW 2050, Australia.

The present work describes a preclinical trial (, and ) protocol to assess the biomechanical performance and osteogenic capability of 3D-printed polymeric scaffolds implants used to repair partial defects in a sheep mandible. The protocol spans multiple steps of the medical device development pipeline, including initial concept design of the scaffold implant, digital twin finite element modeling, manufacturing of the device prototype, device implantation, and laboratory mechanical testing. First, a patient-specific one-body scaffold implant used for reconstructing a critical-sized defect along the lower border of the sheep mandible ramus was designed using on computed-tomographic (CT) imagery and computer-aided design software.

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Case report. Osteoradionecrosis (ORN) of the jaw is a potentially devastating consequence of head and neck irradiation. The progression of ORN can lead to loss of bone, teeth, soft tissue necrosis, pathologic fracture, and oro-cutaneous fistula.

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Patients treated for oral cancer, may experience restricted mouth opening (trismus). Barriers such as cost have limited the utilization of traditional jaw stretching devices, and consequently, patients experience problems with swallowing, oral care, communication, and cancer surveillance. The safety and efficacy of Restorabite™, a new device designed to overcome these barriers, is evaluated prospectively over 12 months.

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Sarcopenia impacts perioperative and survival outcomes after esophagectomy for cancer: a multicenter study.

J Gastrointest Surg

June 2024

Department of Upper Gastrointestinal and Hepatobiliary Surgery, Royal Prince Alfred Hospital, Sydney, Australia; Royal Prince Alfred Institute of Academic Surgery (RPA IAS), Sydney, Australia; School of Medicine, University of Sydney, Sydney, Australia; Surgical Outcomes Research Centre (SOuRCe), Sydney, Australia.

Background: The impact of sarcopenia on outcomes after esophagectomy is controversial. Most data are currently derived from Asian populations. This study aimed to correlate sarcopenia to short-term perioperative complication rates and long-term survival and recurrence outcomes.

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Re: Minimum detectable change in occlusal load - Normative data for healthy and head and neck cancer populations.

Br J Oral Maxillofac Surg

April 2024

Department of Head and Neck Surgery, Chris O'Brien Lifehouse, 119-143 Missenden Road, Camperdown, NSW 2050, Australia; Royal Prince Alfred Institute of Academic Surgery, Sydney Local Health District, Camperdown, NSW 2050, Australia; Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Anderson Stuart Building, Camperdown, NSW 2006, Australia.

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Background: Magnetic resonance-guided focused ultrasound (MRgFUS) for treatment of essential tremor (ET) traditionally targets the ventral intermediate (Vim) nucleus. Recent strategies include a secondary lesion to the posterior subthalamic area (PSA).

Objective: The aim was to compare lesion characteristics, tremor improvement, and adverse events (AE) between patients in whom satisfactory tremor suppression was achieved with lesioning of the Vim alone and patients who required additional lesioning of the PSA.

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