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Improving the temporal contour in reconstruction

A feature of the temporalis flap is the sunken contour left behind. This group from Japan present a variation for filling defects for which we would traditionally use a temporalis muscle containing. The laterally based peri-cranial flap they present uses...

Money saving using CAD-CAM in mandibular reconstruction

CAD-CAM (computer aided design and computer aided manufacturing) is an exciting field in the functional and accurate reconstruction of oral cavity defects. This is a prospective study from Italy based on data from 20 consecutive mandibular reconstructions from 2011 to...

A rare superior tongue tie

The authors present a very rare case of ankyloglossia superior syndrome: first described in 1911 but with only 14 case reports in English literature it was of sufficient interest to discuss the aetiology, classification and management. As the palatal shelves...

Microvascular surgery - does size matter

Success rates for microvascular free tissue transfer performed for head and neck reconstruction are currently very high. As the recipient vessel diameter decreases, questions of reliability and ease of access are raised. This retrospective analysis looked at 89 flaps in...

One stage nasal reconstruction with local flaps

This is an excellent and authoritative review of an often difficult and controversial (as there are so many options or so few) clinical subject. Better education and earlier diagnosis of skin tumours allows defects with limited size and depth to...

Deglutition in pharyngolaryngectomy patients

Circular defects after total pharyngolaryngectomy present a reconstructive challenge. In this study, the authors compared the swallowing results after three reconstructive techniques: free forearm flap, free jejunal loop and folded pectoralis major flap. Forty-six patients were included and were evaluated...

Rib grafts for mandibular reconstruction

Reconstruction of the mandible following ablation requires good bone stock to allow optimal function and the placement of dental implants. In the developed world, vascularised bony flaps are accepted as the gold standard but these may not be widely available...

Microvascular free flap failures – looking beyond surgical technique

Microvascular free flaps are commonly used in reconstruction for head and neck defects. Failures of these flaps, however, are associated with a significant morbidity and mortality. Flap failures within the first 72 hours are commonly attributed to technical failure of...

Brown classification of a maxillary defect and prognosis

This is a retrospective study from Peking over the 10-year period, 2000-2010, for 137 patients with maxillary squamous cell carcinoma assessed. The overall survival rate was comparable with other studies at 64.8%. The most common Brown maxillary defect was 2b...

Is benign intracranial hypertension underdiagnosed in patients with spontaneous CSF leaks?

In ENT practice we come across spontaneous CSF leaks. Patients present either as unilateral watery rhinorrhoea or otorrhoea, or sometimes as hearing loss with a watery middle ear effusion. Clinicians, after confirming the diagnosis of CSF leak with beta 2...