Vascularized free tissue transfer for reconstruction of ablative defects in oral and oropharyngeal cancer patients undergoing salvage surgery following concomitant chemoradiation.

The purpose of this study was to determine whether chemotherapy delivered concurrently with external beam radiation therapy for loco-regionally advanced head and neck cancer affects the rate or severity of postoperative complications in patients who underwent salvage surgery for recurrent or persistent disease with simultaneous microvascular free flap reconstruction. The primary study group consisted of patients with head and neck malignancies that had undergone surgical salvage with microvascular free flap reconstruction for persistent or recurrent disease following definitive radiation or concomitant chemoradiation treatment. A group of demographically matched patients who underwent microvascular free flap reconstruction for non-malignant and malignant conditions who never received radiation were randomly selected to serve as a control group. The study cohort was divided according to radiation treatment. The overall success rate of flap reconstruction was 92%, with an overall complication rate of 23%. Concurrently administered chemotherapy did not appear to affect the type of or the complication rate. The results of this investigation indicate that microvascular free flap reconstruction of head and neck defects is highly predictable, results in relatively few major complications, and suggests that neither radiation alone nor concomitant chemoradiation has a statistically significant effect on overall flap survival or complication rate.

Source cuing: memory for melodies.

Source cuing is a source-monitoring process in which the retrieval of a memory trace is aided by the use of a memory probe that includes information that is indicative of the original source. This is in contrast to source discrimination, where people need to retrieve the identity of the source of information. Thus, in source cuing, the source information is given, and in source discrimination, the source information is to be retrieved. The operation of source cuing was demonstrated in two experiments in which people had to identify which of two melodies had been heard earlier. Source cuing was present for information that was more indicative of the source (i.e., timbre), but not for information that was less indicative of the source (i.e., pitch). A third experiment demonstrated that the use of source cuing can be influenced by the retrieval context.

Macroscopic and microscopic details of the cartilaginous nasal pyramid.

PURPOSE: The purpose of this investigation was to ascertain the macroscopic and microscopic details at rhinion and throughout the cartilaginous nasal pyramid in 35 white cadavers. MATERIALS AND METHODS: Demographic information on 35 white cadavers was collected. This included sex, height, weight, brief medical history, age at death, and cause of death. All soft tissues were removed from the nasal bones, lateral nasal cartilages, and alar cartilages and the overlap between bone and cartilage was measured at 4 sites. The lateral nasal cartilage (LNC) was measured for width and length. The relationship between the caudal end of the LNC, and the anterior septal angle was also noted. The septum and LNC were removed en bloc randomly from 25 of the cadavers. These specimens were fixed in formalin, processed, embedded in paraffin, and coronally sectioned every 3 mm, and prepared for microscopic examination. RESULTS: The LNC was 22.51 mm long and 13.71 mm wide on average. It underlapped the nasal bone 14.97 mm on average from the nasal septum laterally. The cephalocaudal underlapping was greatest in the midline (mean, 8.63 mm) and least (2.77 mm) about halfway down the nasal bone. Microscopic examination showed extreme variation in the attachment of the septum and LNC. This ranged from no cartilaginous connection to complete fusion. Thirty-two percent of the specimens showed the caudal edge of the LNC to be coincident with the anterior septal angle. CONCLUSIONS: At the time of aesthetic, functional, or post-traumatic nasal surgery, one must be prepared to deal with diverse attachments between the septum and the LNC.