ABSTRACT
Five patients with primary malignancies in the pterygopalatine fossa (PPF) and infra temporal fossa (ITF) were enrolled in this retrospective study between January 2012 and January 2018. After malignancies proven by biopsy and evaluation with CT and MRI scan, all patients received modified maxillary swing (MMS) approach for extirpation of malignant tumors in the PPF and ITF under general anesthesia. En bloc resection with wide surgical margins was successfully performed in all cases. Negative margins were observed in 4 cases and positive margins were found in one patient with adenoid cystic carcinoma who received postoperative radiotherapy. The most common complication was facial numbness. During the follow-up period (range 12 to 57 months), one patient suffered from recurrence while others did not. The advantages of MMS include wide surgical field, full exposure and easy manipulation. The MMS approach is expected to become an standard method for monobloc resection of malignancies in the PPF and ITF.
ABSTRACT
Objective To evaluate the application of microvascular coupler device (MVCD) in the free-tissue flap transfer for head-and-neck defects reconstruction.Methods Its a retrospective study of the clinical data of 743 patients who received 763 free-tissue flap transfer for head and neck defects reconstruction in Hunan Cancer Hospital from January,2014 to January,2016.For microvascular anastomoses,413 were done manually (the manual group) and 350 done with MVCD (the MVCD group),of which the latter included end-to-end venous anastomosis in 159,endto-side venous anastomosis in 190 and end-to-end arterial anastomosis in 1.The time for anastomosis,rate of blood leakage from the anastomosis and venous thrombosis,and the survival rate of flaps were compared between the manual group and the MVCD group.The impacts of types of anastomosis of end-to-end vs end-to-side (both with MVCD),on the formation of venous thrombosis and survival of flaps were also recorded.The analysis was performed under t-test and chi-square test using SPSS software 19.0 with P ＜ 0.05 for differences with a statistical significance.Results Time for anastomosis was significantly shorter in the MVCD group (4.43±0.51min) than in the manual group (14.75± 2.43min,P＜0.05).The rates of anastomosis leakage were 0 in the MVCD group and 9.7％ in the manual group(P＜0.01),flap necrosis were 0.57％ and 1.69％ (P=0.15),the rate of venous thrombosis were 1.15％ and 3.63％(P=0.02),respectively.There was no significant difference in the time for anastomosis,the rate of venous thrombosis and the survival rate of flaps with end-to-end anastomosis and end-to-side anastomosis with MVCD.Conclusion The application of microvascular coupler device is valuable in the reconstruction of head-and-neck defects with free-tissue flaps because it can significantly shorten the time for anastomosis,decrease the ocurrence of anastomosis leakage and venous thrombosis,reduce the risk of flap failure.
ABSTRACT
OBJECTIVE@#This study aimd to evaluate the application and clinical effect of improved submental island flap in hypopharyngeal cancer reserved laryngeal function surgery.@*METHOD@#A retrospective review of clinical data was performed on 38 patients of hypopharyngeal cancer reserved laryngeal function using sumental island flaps, by the way of improving in design of vascular pedicle, reconstructive mode of laryngeal and hypopharyngeal function and closing of wound of neck following hypopharyngeal cancer resection. Meanwhile, the effect and prognosis was comprehensively assessed on patients with hypopharyngeal cancer reserved laryngeal function using improved submental island flaps.@*RESULT@#The submental flaps kept alive in all 38 cases. During the follow-up period, 18 cases were dead, and of them, 7 cases died of the second primary carcinoma, included 4 cases of esophagus cancer, 1 case of cancer of soft palate, 2 cases of nasopharyngeal carcinoma; and 5 cases died of cervical or parapharyngeal lymph nodes recurrence; 2 cases died of hepatic metastasis; and 4 cases died of pulmonary metastasis. The overall 5-years survival rate was 52.6%.@*CONCLUSION@#Improved submental island flap repairing postoperative defect of hypopharyngeal cancer reserved laryngeal function has many advantages including higher success rate, more security, easy and simple to operate as well as good clinical effects, and is worth to widespread using.