[Advanced locoregional chest wall recurrence of breast cancer].

Locoregional recurrence of breast cancer continues to be a significant clinical issue involving extensive examination programmes, modified oncologic therapy and advanced surgery. The latter includes tumour resection followed by reconstruction of the thoracic wall. The type of reconstruction depends on tumour location, depth, aetiology and whether the resection involves the stabilising osseous structures as summarised in this review. The treatment strategy is planned at multidisciplinary team conferences with the presence of relevant specialists to ensure evidence-based treatment of consistent quality.

Surgical management of rhinocerebral mucormycosis: A case series.

Rhinocerebral mucormycosis (RCM) is a rare and rapidly progressive, destructive, angioinvasive fungal infection, which primarily affects immunocompromised patients. A high suspicion is required to diagnose RCM as initial clinical manifestations are often nonspecific. A cornerstone of the management is early diagnosis and radical surgery, which often requires complex reconstructive procedures. The optimal timing of reconstructive surgery is controversial. This case series presents the reconstructive perspective on four RCM cases treated with aggressive debridement, targeted antifungal treatment, and hyperbaric oxygen therapy followed by an early local flap or microsurgical reconstruction - to enable adequate local blood perfusion, antifungal treatment, and to decrease the risk of secondary infection. In all four patients, the early reconstructive surgery was successful without relapse of RCM or flap failure. We suggest aggressive surgical debridement till clear resection margins are obtained based on histopathology and/or microbiology, at a point which reconstructive surgery can be performed safely.

[Microsurgical replantation of traumatic amputated lip].

This is a case report of two patients with traumatic amputated lip due to respectively human bite and bicycle head-on-car collision. Both patients were successfully treated by microsurgical replantation within 24 hours and with post-operative leech treatment. Furthermore, a MEDLINE/PubMed search was performed for all scientific English articles of lip amputation and replantation using microsurgery. We want to address the importance of preserving amputated parts and the necessity of 24-hour access to plastic surgery and microsurgery in trauma if needed.

[Lengthening temporalis myoplasty in treatment of chronic facial paralysis].

Introducing the lengthening temporalis myoplasty (LTM), a newly implemented surgical treatment of chronic facial paralysis. LTM is a single-stage operation where the temporalis muscle is transposed for dynamic smile reconstruction, hereby serving as an alternative to the more complex two-stage microvascular functional muscle transplantation. This case report demonstrates how LTM can be used to treat patients, who are not motivated or suitable for extensive surgery. The introduction of this technique aims to help a larger number of patients with chronic facial paralysis.