The presence and the anatomical variations of the accessory appendicular artery: A systematic review of 604 cases.

INTRODUCTION: The accessory appendicular artery (AAA) is an accessory source of blood supply to the appendix. Its existence and potential point of origin are seldom addressed in the literature. METHODS: To fill this knowledge gap, we performed a systematic review of all available studies involving both cadaveric and surgical specimens and documented the presence and the origin of the AAA, following the guidelines outlined in the preferred reporting items for systematic reviews and meta-analysis (PRISMA) statement. RESULTS: Eleven studies, with an overall of 604 specimens were included. Our research revealed that the AAA is notably absent in most cases (83.6%). When present, it most commonly originates from the posterior cecal artery (12.4%), followed by the descending branch of the ileocolic artery (2%), and the ileal branch of the ileocolic artery (0.7%). Instances of origin from the anterior cecal, common cecal, or the ileocolic trunk were even more infrequent. Based on our observations, we introduced a new simplified classification system. DISCUSSION: The effect of an accessory artery on the process of appendicitis remains to be clarified. We firmly recommend that surgeons should consider the possible presence and various origins of the AAA during appendectomy procedures to avoid serious complications.

Locally Advanced Laryngeal Squamous cell Carcinoma in a Patient with a Synchronous Second Primary Thyroid Carcinoma.

Laryngeal squamous cell carcinoma (SCC) is one of the most common primary tumors of the head and neck region. Unfortunately, patients with laryngeal SCC tend to develop second primary tumors (SPTs), accounting for increased mortality. The lung is the predominant site of a second presentation, followed by the mucosa of the upper aerodigestive tract. In contrast, the thyroid gland rarely hosts an SPT. Our study describes the management and treatment of a 69-year-old female who presented with a rare combination of synchronous laryngeal and thyroid carcinomas. Supplementary Information: The online version contains supplementary material available at 10.1007/s12070-023-03968-y.

Extended Scalp Reconstruction With a Free Supraclavicular Graft: A Case Report.

Skin restoration after tumor excision, trauma, or burns may be achieved with full or split-thickness skin grafts or local flaps. The success rate of a skin graft depends on several independent factors. The supraclavicular region is considered a reliable donor site for head and neck skin defects because of its easy access. We present a case of a supraclavicular skin graft harvested to cover a skin deficit after the excision of a squamous cell carcinoma of the scalp. The postoperative course was uneventful regarding graft survival, the healing procedure, and the cosmetic outcome.

Four Years of Disease-Free Survival After Conservative Treatment of Subglottic Adenoid Cystic Carcinoma.

Adenoid cystic carcinoma (ACC) is a rare malignancy of the larynx. Surgical excision seems to be the preferred treatment modality; however, a paucity of high-evidence suggestions due to the small number of cases have been noted. Here we present the case of a 35-year-old woman with subglottic ACC who denied laryngectomy and opted for concurrent chemotherapy and radiotherapy. She remains disease-free four years later. This case illustrates that concurrent chemoradiation, instead of laryngectomy, should be considered in selected cases.

The Supraclavicular Artery Island Flap for Pharynx Reconstruction.

The supraclavicular artery island flap (SCAIF) is a reliable, easy-to-harvest and versatile fasciocutaneous flap that can be used for pharynx reconstruction. Instead of free flaps, it requires no microsurgical technique, reduced operating time and postoperative care, making it an ideal option, especially during the COVID-19 pandemic. The primary aim of our study was to present two cases of a total laryngectomy and reconstruction with the SCAIF during the pandemic. The secondary aim was to review the literature concerning surgical techniques, complications and contradictions of the SCAIF for pharynx reconstruction. A literature search was performed using the PubMed, ScienceDirect, Wiley Online Library, Google Scholar, Scopus and Cochrane Library databases, using MeSH terms: larynx AND reconstruction AND flap. Ten full-text articles comprising 92 patients with 93 supraclavicular flaps were included. The patch graft, pharyngeal interposition graft, tubularization or "U"-shaped SCAIF were the main surgical techniques. Pharyngocutaneous fistula was the most frequent postoperative complication, especially in patients with previous radiotherapy, but just 19% of patients required secondary intervention. The lack of donor-site morbidity, low flap loss rates and stenosis rates favored this reconstructive option. This review underlined that the SCAIF has comparable results with other reconstructive options, consolidating this flap in the workhorse of pharynx reconstruction.

Swallowing disorders after thyroidectomy: a systematic review and meta-analysis.

PURPOSE: Swallowing disorders following thyroidectomy are common, even after surgery without confirmed complications. The purpose of the current systematic review is to investigate the prevalence of dysphagia at various time points after thyroidectomy, at the whole spectrum of it (total/partial, open/endoscopic, for benign/malignant disease). METHODS: The literature available at PubMed, SciELO and Cochrane Library databases was reviewed, according to PRISMA guidelines, using the terms "dysphagia", "swallowing disorder", "deglutition disorder", "thyroidectomy" and "thyroid surgery" in the appropriate combinations. A quantitative synthesis of the results followed. RESULTS: The systematic review of the literature resulted in 35 articles, which met the inclusion criteria and were analyzed regarding their type, sample, follow-up and results regarding post-thyroidectomy dysphagia in multiple follow-up times. A significant increase of swallowing impairment compared to baseline was recorded shortly after surgery. Dysphagia reverted to pre-operative levels 2-3 months later. Dysphagia continued to be reported in a significantly lower proportion of patients, even 1 year after surgery. No significant difference was noticed between open and endoscopic thyroid surgery at 2-3 months post-surgery. CONCLUSIONS: The swallowing disorders reported after thyroidectomy should be expected, but are not always detectable through objective methods. This should not lead to underestimation of symptoms, since the patients' quality of life is negatively affected by the symptomatology.

Life events in schizoaffective disorder: A systematic review.

BACKGROUND: Life events play a central role in the development of psychiatric disorders and impact course and outcome. We present a systematic review of the literature on the relationship of life events with the onset and long-term course of schizoaffective disorder. METHODS: MEDLINE was searched with the combination of the key words: 'life events' plus 'schizoaffective'. The PRISMA method was followed in the review process. RESULTS: From the identified 66 papers only 12 were considered to be of relevance to the current study and 6 more papers were identified by inspecting the reference lists of the identified papers. LIMITATIONS: There are very few studies focusing on the role of life events in schizoaffective disorder indicating insufficient data concerning the relationship of life events with onset and long-term course of schizoaffective disorder. Reported effects are not generic but concern specific events like the loss of mother, and females seem to be more vulnerable. Patients with schizoaffective disorder manifest high rates of PTSD. CONCLUSION: The literature on life events with the development and course of schizoaffective disorder is limited and precludes solid conclusions.