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Background@#Keloid treatment is challenging because of the high likelihood of recurrence and a lack of definitive treatment combinations. The treatment of bulky and recurrent keloids is particularly difficult. We investigated the administration of extralesional cryotherapy (EL) in conjunction with intralesional (IL) triamcinolone (TA) injections as adjuvant therapy after surgical excision for the management of keloids. @*Methods@#Among all patients who visited our scar laser center between January 2016 and August 2017, 54 patients who underwent IL keloid excision with EL cryotherapy and IL TA injection as adjuvant therapy were included in this retrospective study. We examined sex, site, the number of cryotherapy sessions and TA injections, symptoms after surgery, and recurrence. The Vancouver Scar Scale (VSS) was used as to quantify treatment outcomes. @*Results@#Among 54 cases of IL keloid excision, after an average of 6.26 cryotherapy sessions and IL TA injections as combined adjuvant treatment, the lesion was controlled without recurrence in 49 cases. Relapse occurred in five patients, requiring additional treatment and reoperation. For 49 patients with photographic data, the average VSS score before and after treatment improved from 10.1 to 5.0. In 17 patients in whom symptoms recurred after surgery, all symptoms were controlled and maintained with adjuvant therapy. @*Conclusions@#Initial direct surgical excision, followed by a combination of EL cryotherapy and IL TA injections, was shown to be effective in challenging cases of large and recurring keloids.
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Purpose@#Robotic head and neck surgery is widespread nowadays. However, in the reconstruction field, the use of robotic operations is not. This article aimed to examine methodologies for conventional head and neck reconstruction after robotic tumor surgery in an effort to obtain further options for future reconstruction manipulations. @*Materials and Methods@#A retrospective review of all patients who received head and neck robot surgery and conventional reconstructive surgery between October 2016 and September 2021. @*Results@#In total, 53 cases were performed. 67.9% of the tumors were greater than 4 cm. Regarding defect size, 47.2% of the lesions were greater than 8 cm. In terms of TNM stage, stage 3 disease was recorded in 26.4% and stage 4 in 52.8%. To make a deep and narrow field wider, we changed the patient’s posture in pre-op field, additional dissection was done. We used radial forearm flap mostly (62.2%). @*Conclusion@#Conventional head and neck reconstruction after robotic ENT cancer surgery is possible. One key step is to secure additional space in the deep and narrow space left after robotic surgery. For this, we opted for a radial forearm flap mostly. This can be performed as a bridgehead to perform robotic head and neck reconstruction.
