Search

Objective: To determine the surgical outcomes of free tissue transfer surgery following head and neck tumor extirpation in a low-volume medical center. Methods: Retrospective chart review of patients who underwent free tissue transfer surgery for head and neck cancer at Moanalua Medical Center from 2015 to 2018. Main Outcome of Measure: Free flap failure rate and free flap-related complications. Results: From 2015 to 2018, there were 27 free tissue transfer surgery (mean 6.75 flap surgery/year). There were 2 events of partial flap necrosis, and no cases of total flap loss. One patient required leech therapy for venous congestion. One patient required additional free flap surgery. Two patients developed orocutaneous fistula that resolved with local wound care. One patient developed malocclusion following mandible reconstruction using fibular free flap. Overall free flap success rate was 96%. Conclusion: This study supports the ability of small-volume centers to produce positive outcomes with few complications in head and neck cancer free flap reconstructive surgery. While the data are limited to a single surgical team in one care center, it provides additional support for the idea that there are factors beyond the surgical volume that determine outcome. [ABSTRACT FROM AUTHOR]

We examined the functional morphology of loach Misgurnus anguillicaudatus skin by using synchrotron X‐ray micro‐computed tomography (SR‐μCT) and high‐contrast staining using osmium tetroxide or phosphotungstic acid (PTA), which enhances the image contrast of soft tissues. The captured high‐spatial resolution images revealed that the surface ornamentations were stuck in the basement membrane of the loach scales. The ornamentations consisting of grooves (radii) and ridges (circuli) that can move freely and bend flexibly. The cross‐sectional lateral microstructures of flat, concave and convex loach skins were observed from a live image of loach skin obtained through dark‐field optical coherence tomography (OCT) imaging. The thickness of loach skin was changed with varying empty space between the mucous‐cell layer and the scales by bending motion of loach. In addition, through direct measurement of drag reduction of loach skin, the mucous layer was found to have a strong influence on the reduction of skin friction. The present results enhance the understanding of the functional morphologies of mucous layer of loach to secrete mucus for skin friction reduction. [ABSTRACT FROM AUTHOR]

Objectives/hypothesis: To determine the feasibility of using a mouse tumor model as a microsurgical training tool for otolaryngology-head and neck surgery (OHNS) trainees.Study Design: Animal study.Methods: We injected athymic nude mice with human cutaneous squamous cell carcinoma (A431 cell line) deep to the parotid region overlying the masseter muscle. We sacrificed the animals 1 to 3 weeks postinjection, once a visible tumor growth was confirmed. We then asked 10 OHNS trainees to excise the tumor with preservation of the facial nerves under a high-magnification dissecting microscope. The trainees graded the tasks in several areas of specific measures using a visual analogue scale (VAS) including 1) tumor texture, 2) surgical realism, 3) usefulness, and 4) difficulty of the task.Results: Noticeable tumor growth occurred within 5 days following A431 cell injection and reached measureable size (0.5-1.5 cm) within 1 to 3 weeks. The tumor displaced the facial nerve laterally and medially, with few demonstrating infiltration of the nerve. VAS scores (± standard deviation) were 8.1 (± 1.7), 7.7 (± 2.5), 9.0 (± 0.9) and 6.6 (± 1.9) for tumor texture, surgical realism, usefulness, and the difficulty of the task, respectively.Conclusions: We demonstrate a novel, reliable and cost-effective mouse model for simulating tumor extirpation microsurgery with preservation of important neural structures. OHNS trainees have found this simulation model to be realistic, useful, and appropriately challenging. [ABSTRACT FROM AUTHOR]

The article discusses a study on the efficacy of transorbital neuroendoscopic surgery (TONES) for the management of sinogenic complications involving the frontal sinus, orbit and anterior cranial fossa in a prospective series of 13 patients presented with these symptoms. Results demonstrated the safety and efficacy of TONES in the management of sinogenic complications and the procedure's use as a primary surgical modality or in multiportal combination with endonasal approaches.

Background: Intranasal agents play a critical role in the management of sinonasal disorders. There are ongoing efforts to develop new intranasal medications to combat sinonasal disease. Some intranasal agents, however, can have cytotoxic effects on human sinonasal tissue. In order to facilitate safe drug discovery, we developed a simple and reliable in vitro screening assay using human sinonasal explants to measure the cytotoxic profiles of intranasal agents. Methods: We obtained sinonasal tissues from several regions of the nasal cavity from 12 patients undergoing endoscopic sinonasal surgery. These tissues were cultured on polytetrafluoroethylene membrane in serum-free growth medium. We determined the biochemical properties of these explants by measuring extracellular lactate dehydrogenase (LDH) levels and performing histological analyses over a period of 1 to 2 weeks. We then examined the cytotoxic profiles of 13 intranasal agents by measuring extracellular LDH levels using the human sinonasal explant system. Results: Sinonasal explants exhibited a rapid reduction in extracellular LDH levels indicating stabilization in the culture environment within 2 days. Histological analysis showed maintenance of good cellular architecture for up to 2 weeks. The explants displayed intact epithelium and expressed βIII-tubulin and Ki-67. Of the 13 tested intranasal agents, 1% zinc sulfate (ZnSO4), 5% ZnSO4, and Zicam application were cytotoxic. Conclusion: Based on the unique biochemical properties of the human nasal explant culture system, we developed a simple and reliable in vitro screening assay to determine the cytotoxic profiles of various intranasal agents by examining extracellular LDH levels and histopathology. © 2011 ARS-AAOA, LLC. [ABSTRACT FROM AUTHOR]

The article describes the case of a 42-year-old male who developed tenosynovial giant cell tumor of temporomandibular joint and skull base. Topics covered include the patient's history of left ear fullness associated with subjective hearing loss and crunching noise when eating, the diagnosis, and the recommended treatment, which is complete surgical resection.

Extracranial carotid artery aneurysms (ECAAs) are rare in comparison to the total number of peripheral artery aneurysms. Although there are multiple treatment modalities, no clear guidelines exist for the optimal management of ECAA. We describe a case of a 59-year-old female with an incidental finding of a 2.6 cm right internal carotid artery (ICA) aneurysm on computed tomography (CT) that was eventually excised via transcervical approach followed by end-to-end anastomosis with great saphenous vein (GSV) graft. To our knowledge, this case demonstrates a novel multidisciplinary approach to an ECAA near the skull base involving head and neck surgery (HNS), vascular surgery (VS), and neuro-interventional radiology (NIR)., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Armida Ayala issued approval N/A. A designated reviewer on the Kaiser Permanente Southern California/Hawaii (KPSC/HI) Institutional Review Board (IRB) reviewed the submission above and determined that this activity is exempt from IRB review because the activity does not meet the regulatory definition of research as defined by 45 CFR 46.102 (l) “A systematic investigation, including research development, testing and evaluation, designed to develop or contribute to generalizable knowledge”. No further IRB action is required. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Kejriwal et al.)