• 제목/요약/키워드: head and neck reconstruction

검색결과 267건 처리시간 0.028초

노인 두경부 종양환자에서 노쪽아래팔유리피판술의 유용성 및 공여부 결과의 비교 (Versatility of Radial Forearm Free Flap on Head and Neck Cancer in Old-Aged Patient and its Donor Site Morbidity)

  • 이기응;고성훈;어수락
    • Archives of Reconstructive Microsurgery
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    • 제15권2호
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    • pp.92-100
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    • 2006
  • Radial forearm free flap (RFFF) has been established itself as a versatile and widely used method for reconstruction of the head and neck, although it is still criticized for high mortality of donor site. Delayed wound healing, cosmetic deformity, vascular compromise and potentially reduced wrist function have many plastic surgeons hesitate to adapt it as a first choice in micro-reconstruction. To overcome these drawbacks, some techniques for donor-site repair such as V-Y advancement with full thickness skin graft (FTSG), application of artificial dermis (Terudermis(R)Terudermis(R)) or acellular dermal matrix (AlloDerm(R)AlloDerm(R)), and double-opposing rhomboid transposition flap have been reported. Authors performed 4 cases of RFFF in old-aged patients of the head and neck cancer from April 2005 to February 2006. We compared the outcomes of donor site of RFFF which were resurfaced with split thickness skin graft (STSG) only and STSG overlying an AlloDerm(R)AlloDerm(R). Patients were all males ranging from 59 to 74 years old (mean, 67.5). Three of them had tongue cancers, and the other showed hypopharyngeal cancer. All cases were pathologically confirmed as squamous cell carcinomas. We included the deep fascia into the flap, so called subfascially elevated RFFF in three cases, and in the other one, we dissected the RFFF suprafascially leaving the fascia intact. The donor site of the suprafascially elevated RFFF was resurfaced with STSG only. Among three of subfascially elevated RFFFs, donor-sites were covered with thin STSG only in one case, and STSG overlying AlloDerm(R)AlloDerm(R) in two cases. All RFFFs were survived completely without any complication. The donor site of the suprafascially elevated RFFF was taken well with STSG only. But, the partial graft loss exposing brachioradialis and flexor carpi radialis muscle was unavoidable in all the subfascially elevated RFFFs irregardless of AlloDerm(R)AlloDerm(R) application. Considering that many patients of the head and neck cancer are in old ages, we believe the RFFF is still a useful and versatile choice for resurfacing the head and neck region after cancer ablation. Its reliability and functional characteristics could override its criticism for donor site in old-aged cancer patients.

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다형샘종 제거 후 발생한 연구개 점막 결손의 무세포 동종 진피기질을 이용한 재건 1례 (Use of Acellular Allogenic Dermal Matrix in Soft Palate Reconstruction after Excision the Pleomorphic Adenoma)

  • 이재성;임길채;김정홍;강재경;신명수;윤병민
    • 대한두경부종양학회지
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    • 제35권1호
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    • pp.21-23
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    • 2019
  • Recent studies have reported on the reconstruction of oral mucosal defects using acellular dermal matrix (ADM). This case report describes the reconstruction of a soft-palate mucosal defect using ADM. A 43-year-old man developed a 2.5cm×3cm2.5cm×3cm soft-palate mucosal defect after the removal of a lump on the soft palate andreconstructed the defect using ADM without further complications. Reconstruction of the soft palate with ADM could be more convenient than traditional methods including primary closure, skin graft, and local or free flap without complications.

소아 후두기관협착 환자에서 single-stage 방법의 후두기관재건수술 (Single-stage Laryngotracheal Reconstruction in the Children with Laryngotracheal Stenosis)

  • 고문희;손영익;백정환;정한신;정만기
    • 대한기관식도과학회지
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    • 제13권2호
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    • pp.50-56
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    • 2007
  • Background and Objectives: Laryngotracheal stenosis and its reconstruction in children is a highly challenging field to airway surgeons, and the way of stenting after a reconstructive surgery is still controversial. The aims of this study were to analyze the single institutional experiences of laryngotracheal reconstruction (LTR) in the pediatric patients with laryngotracheal stenosis and to compare the outcomes of single-stage LTR (SSLTR) with conventional two-stage LTR (TSLTR) in these patients. Materials and Methods: Medical records of 14 children (mean age 4.1 years) were reviewed, who received 20 LTR including 6 revisions for their moderate to severe subglottic stenosis and/or combined posterior glottic stenosis. Of these 20 LTR, tracheostoma was temporarily maintained after LTR in 12 cases (TSLTR) or not in the other 8 cases (SSLTR). Results: Overall decannulation rate of LTR that were performed before and after the year of 2003 was 40% (4/10) and 70% (7/10) respectively. Decannulation rate was 42% (5/12) in TSLTR group and 75% (6/8) in SSLTR group (P = 0.197). Mean interval to decannulation after LTR was 9.8 months and 7.2 days in TSLTR and SSLTR groups respectively (P = 0.004). A number of additional touch-up procedures that were required after LTR was 4 in TSLTR and 2.7 in SSLTR group (P = 0.238). Major complication rate was similar in both groups (33% in TSLTR and 38% in SSLTR, P = 0.910). Conclusion: A laryngotracheal reconstruction in children is a technically demanding procedure and its outcome is largely dependent on the surgeon's experience. Albeit there was a tendency that SSLTR ofters a higher decannulation rate, less additional touch-up procedures and similar complication rates, a shorter interval to decannulation after LTR was the only advantage that was confirmed as statistically significant in this study.

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연구개 및 구개수 암종의 광범위 절제 및 국소 점막근 피판 재건술 1예 (A Case of the Soft Palate Reconstruction Using the Bilateral Palatal Mucomuscular Flap and Pharyngeal Flap after Wide Resection)

  • 구가영;이혜란;장전엽
    • 대한두경부종양학회지
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    • 제38권1호
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    • pp.31-35
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    • 2022
  • The soft palate of carcinoma limited to the uvular region is infrequent among oropharyngeal cancers. The oropharynx regulates swallowing and speech through dynamic motions. Failure to reconstruct after surgical resection of the oropharynx structure can lead to permanent velopharyngeal insufficiency. Therefore, suitable reconstruction is important in establishing proper functional outcomes while maintaining oncological safety. We present a case of a 66-year-old male who was diagnosed with oropharynx cancer limited in the uvula accompanied by lymph node metastasis. After surgical resection, reconstruction was performed with the united arrangement of bilateral palatal mucomuscular flap and superiorly based posterior pharyngeal flap. There was no aspiration or reflux after feeding and epithelialization completely occurred after 1 month postoperatively. We report a successful case that the reconstruction with the local flap described above could preserve proper oropharyngeal function after primary surgery in small-sized oropharyngeal cancer.