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Objectives: To describe the use of the scapular tip free flap (STFF) in the reconstruction of head and neck defects.Study Design: Case series with chart review.Setting: Academic medical center.Subjects and Methods: A review of the electronic medical record was performed of all patients who underwent head and neck reconstructive surgery with STFFs from January 1, 2014, through January 1, 2016. Details regarding the disease, defect reconstructed, and surgical outcomes were quantified.Results: Thirty-one consecutive cases were performed at our institution within the period reviewed. The procedures included reconstruction of 5 maxillectomy and 26 mandibulectomy defects. The mean length of mandible reconstructed was 6.8 cm (95% CI, 6.01-7.59; range, 4.0-10.2). Osteotomies were made to contour the scapular bone in 11 cases, including double osteotomies performed in 2 cases. The most common surgical complications were orocutaneous fistula and postoperative hematoma, which occurred in 3 (10%) and 2 (6.5%) of 31 patients, respectively.Conclusion: This series describes a large number of STFFs performed in head and neck reconstruction. The average length of bony defect repair can be significantly larger than what was previously described. Performing osteotomies to the STFF allows for application to anterior mandibular defects. The STFF offers a large soft tissue component, a relatively long pedicle, and acceptable donor site morbidity. The STFF is a versatile reconstructive option that should be considered to address composite defects of the head and neck. [ABSTRACT FROM AUTHOR]

Abstract: Congenital infiltrating lipomatosis is a benign yet locally invasive lipomatous tumor. Current treatment involves surgical excision and reconstruction of craniofacial deformity. Invasion of vital structures often makes complete resection problematic and recurrence is common. We present the case of a 15-year-old female patient with extensive congenital infiltrating lipomatosis involving the left face. A broad treatment algorithm was devised involving surgical resection as well as targeted chemotherapy. At 18 month follow-up the patient demonstrated improved facial symmetry without evidence of disease progression. Combining surgical and medical intervention may allow for a synergistic approach to controlling this rare disease. [Copyright &y& Elsevier]

Background Paragangliomas are benign neoplasms of neuroendocrine origin. It is estimated that from 20% to 50% of these tumors are familial. Mutations in the succinate dehydrogenase (SDH) gene family have been found to be responsible for a significant percentage of familial paragangliomas. Methods A 33-year-old man who was found to have 3 synchronous primary tumors including a catecholamine-secreting intrapericardial paraganglioma is presented. Results Genetic workup diagnosed this patient with an underlying germ-line mutation in the succinate dehydrogenase complex subunit C (SDHC) gene; consistent with a diagnosis of hereditary paraganglioma/pheochromocytoma syndrome (PGL/PCC). Current knowledge regarding the clinical implications of an SDHC gene mutation is reviewed. Conclusion Modern molecular techniques have identified that a significantly greater proportion of paragangliomas are due to underlying hereditary conditions than was previously thought. Appropriate screening in these individuals and their immediate family members may allow for early tumor diagnosis and improved disease outcomes. © 2012 Wiley Periodicals, Inc. Head Neck, 2013 [ABSTRACT FROM AUTHOR]