ABSTRACT
INTRODUCTION: Reconstruction of the soft palate after oncologic resection remains a surgical challenge. Speech and swallowing problems are the consequences of velopharyngeal incompetence following soft palate resection. Free tissue transfer like radial forearm flaps can be used in larger defects for complex reconstruction. The conformation of the flap in order to be closer to the shape of the soft palate improves the functional outcome. In the same way, we describe an original "double-arched" flap design. METHODS: A double arch of the exact length of the soft palate tumor resection is designed. After suturing, the flap spontaneously formed a double arch of the exact dimensions of the resected piece. RESULTS: The patient achieved good functional recovery without any surgical complications. CONCLUSION: The original "double-arched" forearm flap design allows a tailored reconstruction with exactly the same shape and dimensions, preserving the functional requirements of speech and deglutition.
Subject(s)
Forearm/surgery , Free Tissue Flaps , Palate, Soft/surgery , Carcinoma, Squamous Cell/surgery , Humans , Male , Middle Aged , Oropharyngeal Neoplasms/surgeryABSTRACT
Follicular dendritic cell sarcomas are a recently described entity, with biphenotypic characteristics of lymphomas and sarcomas. The treatment is hardly consensual in the literature. We report two head and neck cases, of favorable outcome after surgery and radiotherapy. Histopathology and differential diagnoses are discussed as well as the therapeutic strategies used.
Subject(s)
Dendritic Cell Sarcoma, Follicular/radiotherapy , Head and Neck Neoplasms/radiotherapy , Parotid Neoplasms/radiotherapy , Radiotherapy, Conformal , Aged, 80 and over , Castleman Disease/complications , Combined Modality Therapy , Dendritic Cell Sarcoma, Follicular/pathology , Dendritic Cell Sarcoma, Follicular/surgery , Dose Fractionation, Radiation , Female , Head and Neck Neoplasms/pathology , Head and Neck Neoplasms/surgery , Humans , Middle Aged , Neoplasms, Second Primary/radiotherapy , Neoplasms, Second Primary/surgery , Parotid Neoplasms/pathology , Parotid Neoplasms/surgeryABSTRACT
PURPOSE: Mandibular reconstruction with fibula free flap harvest is currently the reference technique. Various preoperative processes have been developed to optimize this reconstruction. We report our experience with a simple, inexpensive, preoperative technique requiring a 3D printer, a device for maintaining mandibular reduction, a paper-cutting guide. TECHNICAL NOTE: Stereomodels of the mandible were obtained from computed tomography scan data and printed 3D in ABS. It allowed planning mandibular osteotomies, determine the angle between two bone fragments, and preoperatively modeling the osteosynthesis plate. A paper-cutting guide, and a simple device for maintaining mandibular reduction were also built. Two patients were operated on with this technique, with follow-up at 6 and 8 months. Reconstructions were successful with good clinical outcome in terms of mandibular contour and reconstructed segments positions. DISCUSSION: Preoperative planning of reconstruction may be used for mandibular osteotomies, fibular osteotomies, maintaining mandibular reduction, osteosynthesis, or placing implants for dental rehabilitation. The most complex procedures can virtually plan all these steps, but they are expensive and long to implement. Nevertheless, such procedures are quite expansive and require time not always compatible with carcinoma. Using a mandibular stereomodel is fast, easy, and cheap.
ABSTRACT
The effects of 1-[(E)-2-(2-methyl-4-nitrophenyl)diaz-1-enyl]pyrrolidine-2-carboxy lic acid (LY29) and diphenyliodonium chloride (DIC) on the degradation of protein to ammonia were determined in a mixed rumen microbial population taken from sheep on a grass hay-concentrate diet. Both compounds decreased NH3 production by inhibiting deamination of amino acids. LY29, but not DIC, inhibited growth of the high-activity ammonia-producing species, Clostridium aminophilum and Clostridium sticklandii.
