Validity of parentral nutrition after major neck surgeries

Assessment of parentral nutrition as a substitute therapy to enteral nutrition after major neck surgeries with primary pharyngeal repair. Forty patients were included in this study underwent various neck surgeries were prospectively randomized to receive either enteral nutrition [20] patients or parentral nutrition [20] patients. The patients were monitored for postoperative complications, wound healing, hospital stay, time to natural feeding and weight loss. The compared items were similar in both groups [mean duration of nutrition was 9.65, 9.9 days for TPN and NGT group respectively, mean hospital stay was 11.65, 11.9 days for TPN and NGT groups respectively, wound dehiscence and infection was in 15%, 20% in TPN and NGT respectively and also same result for pharyngocutaneous fistula, weight loss was 2.6 Kgm for TPN group and 2.39 Kgm for NGT group; p value was insignificant in all items. There were no major postoperative complications in both groups. The present study reveals that there was no significant statistical difference between parentral and enteral nutrition when used for postoperative nutrition after major neck surgeries

Reconstruction of anterior skull base after craniofacial resection

Anterior craniofacial resection and reconstruction surgeries were per formed upon 21 patients [13 females and 8 males] aged 12-72 years, at the period between 1996-2002 at Mansoura University Hospital, Department of ORL Head and Neck surgery. Surgeries were performed for nasal and paranasal sinus malignant tumors with cranial and/or intracranial extention. Various forms of anterior cranial base reconstruction strategies were used in our work, anteriorly pedicled galeal pericranial flap, galeal- pericranial flap+ skin graft, galeal pericranial flap + calvarial bone graft, and galeal-pericranial flap+ temporal is osteo muscular flap. Orbital exenteration was done for two patients with ethmoidal undifferentiated carcinoma and obliteration of the orbit was done using pedicled temporalis muscle flap. Subtotal maxillectomy [18 cases], and total maxillectomy [3 cases] were per- formed. We described the technique of the resection and the reconstruction with evaluation of reconstruction results. Our objective is to evaluate the clinical outcome of our technique in resection and reconstruction of anterior skull base. We concluded that Knowledge's about different methods of reconstruction after craniofacial resection enabled the skull base surgeons to extend their resections in or der to increase the safety margin. Also we found that the pericranial flap is the most ideal and reliable method for reconstruction of skull base after resection. Rigid bony reconstruction can be used in cases where the resection of anterior skull base was extended laterally to involve the orbital roof