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278 results found

Surgical management of refractory osteoradionecrosis

This is a French single-centre, 10-year experience of 55 surgical resection and reconstruction procedures. They claim an overall effectiveness rate of 92.3%. A total of 36 segmental and 19 marginal mandibulectomies were performed. A variety of free flaps were used,...

Functional considerations in reconstruction after laryngectomy

With a plethora of different reconstructive options and techniques available after laryngectomy, it can be difficult to clearly see which give the lowest complication rates and best functional outcomes. This article aims to summarise the current evidence in swallowing and...

How good is secondary intention healing post nasal cutaneous tumour excision?

The variation in size and site of nasal cutaneous tumours allows the surgeon to propose various methods to close the resulting defect post-tumour excision. This prospective multicentre cohort study executed in China encompassed 150 patients, comparing wound healing times and...

Partial reconstruction of the pinna

Reconstruction of the pinna is one of the most challenging procedures in facial plastic surgery. Although there has been significant progress since one of the earliest recorded descriptions by Sushruta in 600 BC, the complex three-dimensional structure of the pinna...

Occurrence of cancer in asymmetrical tonsillar enlargement in adults

With significant increase in head and neck cancer in the last decade, attributed to HPV, fast-track referrals from primary care have markedly increased, adding further to the burden on the NHS. Whether or not unilateral tonsillar enlargement alone, without red...

Global health missions – not just for consultants. A guide for trainees.

Lulu Ritchie is a courageous and driven trainee in London, inspired by humanitarian missions but conscious of the usual requests for consultant level doctors. Lulu didn’t let that hold her back. She found a way and has kindly summarised her...

Multi-layered repair of lateral sphenoid CSF rhinorrhoea

This case series describes the author’s results with repairing lateral sphenoid encephalocoeles in seven patients. Alloderm inlay with abdominal fat onlay and nasoseptal flap onlay repair resulted in a 100% success rate with no recurrence of cerebrospinal fluid (CSF) rhinorrhoea,...

A move away from bony free flaps in reconstruction

Techniques for facial reconstruction have come on in leaps and bounds since the world wars. The use of titanium implants is more recent and the technology for manipulating the metal and how we use it is rapidly developing. Here the...

CAD/CAM assisted mandibular reconstruction or freestyle?

The gold standard for the reconstruction of the mandible is a free bone flap and the fibula is commonly used. The fibula is a straight bone and presents considerations and difficulties in the formation of a U-shaped neo-mandible. Computer aided...

Tongue tie – just a snip?

This article regarding ankyloglossia raises an eyebrow; surely it’s just a snip isn’t it? Seemingly not. The authors describe two types of tongue tie – the first being posterior, with the frenulum being short and tight, the second being anterior,...

Harvesting the flexor hallucis longus: what is the increased morbidity?

The free fibula flap is now widely used in clinical applications for microvascular reconstruction and occasionally, to add bulk, the flexor hallucis longus (FHL) muscle is harvested along with the fibula. The post-operative morbidity is usually described as mild and...

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...