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Background and purpose: Free flap has become the main way of reconstruction after surgery for head and neck tumor. Vascular crisis is easy to cause skin flap necrosis, and hypercoagulability is the main cause of vascular crisis. This study explored the factors influencing postoperative hypercoagulability of free flap reconstruction for head and neck tumor, and provided reference for the prevention and treatment of hypercoagulability. Methods: A retrospective analysis was conducted according to the medical records of 243 patients admitted to Department of Otolaryngology, Second Affiliated Hospital of Fujian Medical University from Apr. 2017 to Jul. 2020 who underwent free flap reconstruction for head and neck tumor. The patients were divided into the hypercoagulable group and the non-hypercoagulable group according to whether postoperative hypercoagulable state occurred, and the incidence of postoperative hypercoagulable state and related influencing factors were statistically analyzed. Results: Among the 243 patients, 128 patients had postoperative hypercoagulability, and the incidence was 52.7% (128/243), including 73.4% (94/128) of two postoperative coagulation abnormalities, 21.1% (27/128) of three abnormalities and 5.5% (7/128) of four abnormalities. Results of single factor analysis showed that gender, age, alcoholism, diabetes, tumor stage, surgical repair, intraoperative blood loss, intraoperative blood transfusion, operative time, postoperative leukocyte, postoperative triglyceride, postoperative high-density lipoprotein and postoperative Ca 2+ were the possible influencing factors of postoperative hypercoagulability (all P

Aim: The aim of this study was to investigate the efficacy of multiple perineal perforator flaps in repairing deep perineal defects after pelvic exenteration for locally advanced or recurrent rectal cancer. Method: We investigated the outcomes of eight patients whose repairs involved a novel method of using an internal pudendal artery perforator (IPAP) flap combined with an inferior gluteal artery perforator (IGAP) flap. Results: There were four male and four female patients with a mean age of 56 years (36–72 years). Bilateral IPAP flaps combined with bilateral IGAP flaps were used in five patients, unilateral IPAP flaps combined with bilateral IGAP flaps were used in two patients and bilateral IPAP flaps were used in one patient. There were no functional limitations in daily activities during the 6‐month follow‐up period. Conclusion: Our study showed that using multiple perineal perforator flaps combined with lining repair is feasible for repairing deep perineal defects in patients who have undergone rectal cancer surgery that includes pelvic exenteration. [ABSTRACT FROM AUTHOR]

Purpose – This paper aims to explore the applicability of construction partnering in Mainland China, and to provide useful suggestions and possible implications for decision-makers to adopt this collaborative approach to project procurement. Design/methodology/approach – Document analysis was first employed to identify the favourable conditions and potential difficulties in the application of partnering in Mainland China. A series of face-to-face semi-structured interviews targeting academic experts and industrial practitioners was undertaken to solicit their perceptions of the benefits and difficulties of implementing partnering in Mainland China, coupled with their overall assessment of the applicability of, and suggestions for, the implementation of partnering in the region. Findings – The results of document analysis indicated that the cultural roots of co-operation and mutual trust, together with the increasing need to improve the current state of project performance in Mainland China, underpin the application of partnering in the construction market, although its application and generalisation still encounter some significant difficulties. The perceived benefits, potential barriers and effective strategies for partnering application in Mainland China were determined from the interviewees. The interview results further supported the applicability of construction partnering and provided constructive and practical suggestions for possible implementation in the Mainland Chinese construction industry. The partnering approach is evaluated as being practicable and appropriate in this study for the construction industry in Mainland China. Research limitations/implications – Although it is essential to base the analysis of partnering applicability on a qualitative study, an empirical quantitative investigation of the benefits and difficulties of partnering application could further reinforce the quality of analysis. Future research could look into the project-based assessment of partnering application in terms of the perceived benefits and potential difficulties of, and success factors for, partnering implementation in Mainland China. Practical implications – Policy-makers aiming for the introduction of the partnering approach could be equipped with stronger confidence from favourable cultural environment and industrial needs. Restrictions to the application of partnering underlying in the current working culture could be mitigated when appropriate strategies are taken by the initiators of the partnering approach. Originality/value – Increased worldwide attention on construction partnering has shed light on the construction industry in Mainland China to achieve better value for money in project procurement and management. This paper provides valuable reference for decision-makers to consider the adoption of partnering based on the qualitative analysis of the applicability of partnering in the construction industry in Mainland China. [ABSTRACT FROM AUTHOR]

Objective: To explore the clinical effectiveness of reconstructing laryngeal function using thyroid cartilage fenestration and "draw-out" resection, supplemented by internal fixation with titanium microplates in early glottic carcinoma., Methods: Data from 99 patients with glottic carcinoma treated in the Second Affiliated Hospital of Fujian Medical University between January 2014 and September 2021 were retrospectively analyzed. Forty-eight patients who underwent thyroid cartilage fenestration and resection followed by internal fixation with titanium microplates for laryngeal function reconstruction were assigned to the thyroid cartilage fenestration group (TCF group), while the other 51 patients who underwent sternohyoid muscle and fascia repair for laryngeal function reconstruction were assigned to the sternohyoid muscle repair group (SMR group). Patients were followed up for 1-8 years. Data on postoperative phonatory function, respiratory function, swallowing function, and survival status were collected., Results: Compared to the SMR group, patients in the TCF group showed better postoperative recovery in phonatory function and verbal communication (all P<0.05). In the TCF group, patients demonstrated stable respiration and the extubation rate was 100.00%, which was significantly higher than 82.35% in the SMR group (P<0.05). Patients in both groups showed good postoperative recovery of swallowing function (P>0.05)., Conclusion: One-stage reconstruction of laryngeal function by thyroid cartilage fenestration and "draw-out" resection with adjuvant internal titanium microplate fixation in early glottic carcinoma demonstrates good postoperative recovery and good preservation of the laryngeal function., Competing Interests: None., (AJTR Copyright © 2024.)

Objective: To explore the diagnosis, treatment and surgical approaches of parapharyngeal space tumors., Method: This retrospective study consisted of 112 patients with parapharyngeal space tumors underwent surgeries. The data included clinical symptoms and signs, pathological types, imaging examinations, surgical approaches and postoperative complications., Result: Computerized tomography (CT), magnetic resonance imaging (MRD and digital subtraction angiography (DSA) made clear the tumor size, localization and its relation to adjacent structures. The postoperative histopathology varied and showed benign in 98 cases consisting of salivary gland tumors (52 cases), neurogenic tumors(33 cases) and other types (13 cases). During the 3 years follow-up period, local recurrence appeared in 3 patients with salivary pleomorphic adenoma and 1 patient with neurofibromatosis. These recurrent tumor cases were cured with second surgery. In 14 patients with malignant tumors reported, 8 cases survived for 5 years, 2 cases (1 adenoid cystic carcinoma and 1 carcinoma in pleornorphic adenoma) recurred in the two and a half years cured with second surgery affiliated radiation therapy through 3 years follow-up time and the rest were followed up 1 to 3 years without recurrence. Peripheral facial paralysis was observed in 25 patients, and 3 patients experienced hypoglossal nerve palsy. Only 1 patient encountered vagus nerve injury, and 2 patients appeared Horner's syndrome, and 4 patients endured Frey syndrome. Gills leakage was discovered in 3 cases and cavity infection was noted in 1 patient., Conclusion: CT, MRI and DSA were important in the diagnosis and differential diagnosis of parapharyngeal space tumors. The key to successful treatment is knowing the anatomy of the parapharyngeal space, preoperative assessment and appropriate surgical approach.

Objective: To explore the application of decompression in the treatment of ganthous cystic lesions., Method: Decompression surgery were performed on 32 patients with gnathous cystic lesions, the cavities of cysts were open and the cysts pressure was relieved. The cavities of cysts were flushed after the operation and the prognosis were assessed in the regular follow-up., Result: All cysts cavities were shrinks afer decompression operation. Through the X-line and/or CT scans, we could observe that the new bones formed around cysts cavities, tilt shift teeth were gradually corrected and the permanent tooth germs of pediatric patients almost returned to the right places and erupted; There were the only remaining small bone indentations in the 18 cases, which do not need the Phase II surgery. Eight cases of cysts cavities shrinks more than 50%, which needed cystectomy. Six cases of cysts cavities shrinks less than 50%, which were still in the follow-up treatment., Conclusion: The decompression surgery is a simple, economical and effective method for the treatment of gnathous cystic lesions.

Objective: To improve the understanding of the symptoms and signs of isolated sphenoid sinus disease and decrease the occurrence of misdiagnoses., Method: The clinical manifestation and the advantage of endoscopic sinus surgery were analyzed in 22 cases of isolated sphenoid sinus disease., Result: Twelve cases had endoscopic sphenoidotomy, 7 cases had external ethmoidal sphenoidotomy, 3 cases had antibiotic, steroid and neurotrophic therapy. All of the patients were free of headache,improvement in vision and ocular motility after treatment. After 3 to 6 months' follow up, 1 case recurred and symptom relieved after endoscopic sinus surgery. 1 case adenoid cystoid carcinoma underwent post operative radiotherapy without recurrence after 3 years follow up., Conclusion: Isolated sphenoid sinus disease presented the primary symptom as headache and/or ocular disturbance is prone to be misdiagnosed, application of CT, MRI and endoscopy improve its diagnosis and treatment standard. Endoscopic sinus surgery is the primary therapy for isolated sphenoid sinus disease.

Objective: To explore the value of using Rapid Nasal Dressing with Gel Knit in the patients with the postoperative nasal cavity and sinuses or severe epistaxis., Method: A comparative study was carried out for the clinical effects of traditional Vaseline gauze with that of Rhino Rapid Nasal Dressing with Gel Knit as nasal packing materials, through a valuation on the patient discomfort with headache and control of postoperative bleeding and ease of removal., Result: There was a significant difference in headache during the period of packing and removal between two groups (P < 0.01, P < 0.05). There was no significant difference in the volume of bleeding during the 24 hours packing (P > 0.05), but there was one time during removal (P < 0.01), and it was also more ease of removal than that of the group with Vaseline gauze (P < 0.01 )., Conclusion: Rhino Rapid Nasal Dressing with Gel Knit is a kind of ideal material for nasal packing, because of its effect of drug hemostasis and compressive hemostasis.

Objective: To investigate the application of arteria reconstruction in the therapy of the carotid artery involved with advanced head and neck cancer., Method: The artificial blood vessel made of polytetrafluoroethylene (PTFE) was used in two patients with supraglottic carcinoma to reconstruct the carotid artery. In the two cases, their common carotid artery and internal carotid artery involved with metastatic lymph nodes, were resected before reconstruction., Result: The wound of two cases had grade I healing, no serious cranium-cerebrum complication occurred. The patency of the artificial blood vessel was observed by ultrasonography. The vessels were at good condition. Two patients died two and three years later., Conclusion: The artificial blood vessel reconstruction for vascular damaged by head and neck cancer is safe and convenient in clinical practice. At the same time, it is an alternative method to solve the deficiency of auto vessels in the body.

Objective: To assess the clinical features and the treatment result of cephalic and cervical adenoid cystic carcinoma (ACC)., Method: A retrospective analysis was performed on 38 patients with cephalic and cervical ACC by their clinical manifestation, the therapy and follow-up results., Result: We had 38 patients of operation. All patients followed up from 3 years to 13 years. The overall 3-year survival rate of patients was 71.1%, the overall 5-year survival rate of patients was 63.2%., Conclusion: Cephalic and cervical ACC is not easy to exact diagnosis in early stage. It progresses slowly. It also has the tendency of recurrence and cancerous metastasis. Thus it, is necessary to do both thorough surgery.

Objective: To study the diagnosis and treatment of nasopharyngeal angiofibroma., Method: Forty-one cases with nasopharyngeal angiofibroma accepted different kinds of surgical excision: 31 cases via palatal approach, 7 cases via mido-facial revelational approach, 3 cases via enlarged pergomaxillary fissure approach., Result: The average of blood loss was 1,450 ml in operation but it became 500-800 ml when had a selective preoperative angiography embolization. After 0.5 to 2 years of operation, five cases recurred one time, three cases recurred two times, one case recurred four times., Conclusion: CT examination is necessary in evaluation of the tumor's size, shape, duration, staging and invasive extent. It is important in designing the operative approach. The preoperative embolization can reduce the amount of bleeding during operation.