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Are elective neck dissections needed during salvage laryngectomy?

There has recently been a move away from elective neck dissections in the setting of salvage laryngectomy. This has mainly resulted from an appreciation of the increase in morbidity, in particular pharyngocutaneous fistula formation, and an improvement in cross-sectional imaging...

One anastomosis or two

This is a cumulative meta-analysis from Hong Kong reviewing 27 articles and a total of 7,389 flaps. The authors, at the outset, acknowledge that the number of anastomoses is not the only factor of venous compromise and flap failure. Nonetheless...

Risk factors in free flap failure

This is a retrospective analysis from China of 881 free flaps over nearly four years, 49 of which were ‘taken back’, 26 of which were lost, giving a 97% success rate. The commonest cause of flap failure was venous thrombosis....

Reconstructing post-resective auricular defects

The auricle is split into six specific anatomic subunits that vary in skin thickness, contour, structural integrity and the availability of healthy surrounding tissues. It is important to reconstruct an aesthetically pleasing auricle as slight deformities may be prominent. The...

Revising pinna embryology and anatomy

This forms an introductory article for a group of papers discussing the reconstruction of the pinna. It is a succinct yet adequately detailed article that all of us, at whatever stage of our careers should endeavour to read, as it...

Which is the best graft for myringoplasty?

This is a systematic review and meta-analysis of retrospective studies for type 1 tympanoplasty (myringoplasty) surgery comparing temporalis fascia and cartilage autograft materials for reconstruction. Inclusion criteria was patients with more than 50% perforated tympanic membrane with intact ossicular chain....

Is there time for intraoperative scans?

Intraoperative imaging plays an integral role in orthopaedic surgery during the repair of long-bone fracture. Given the complexity of the facial skeleton, intraoperative imaging has the potential for similar benefits in reconstructive surgery. The objectives of the study were to...

Two for one forearm flaps

There are many and varied free flaps available for reconstructions. Here is a variant on the workhorse radial free forearm flap. The modification involves a longer, narrower flap that can be rotated back on itself to increase the flap width...

Semi dynamic reconstruction of the lower lip

The main goal of reconstructive surgery for facial paralysis is the restoration of smiling and function of eye closure. The deformity of the lower lip in paralysis is ptosis of the corner of the mouth, eversion of the vermillion and...

Postauricular advancement flap for partial helix defect repair

Ear defects can be the result of trauma, burns or ablative surgery. The three dimensional structure of the pinna presents a difficult reconstructive challenge as successful ear reconstruction requires both similar tissue cover and a supporting framework. Partial ear reconstruction...

REARRANGED: An Opera Singer’s Facial Cancer And Life Transposed

Rearranged is a wonderfully positive memoir telling of Kathleen Watt’s ordeal through maxillary osteosarcoma. As an early career opera singer in the New York Metropolitan Opera’s chorus, her dreams are derailed and life transformed when this most rare diagnosis hits....