Anatomical study of improved lateral arm free flap / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To study the anatomy and preparation methods of an improved lateral arm free flap (LAFF) for the future clinical application.</p><p><b>METHODS</b>Twenty-two adult upper extremities from cadavers after injected with red latex through common carotid arteries were used. The course, branches, distribution and variations of the blood vessels and nerves of the improved LAFF were observed. The outer diameters of the vessels were measured.</p><p><b>RESULTS</b>The mean length of vascular pedicle of the improved LAFF was (14.85 ± 1.28) cm, significantly more than that (5.46 ± 2.60) of traditional LAFF (t = -8.483, P < 0.001). The mean outer diameters of pedicle arteries and veins in the improved LAFF were (2.24 ± 0.66) mm and (2.22 ± 0.52) mm, significantly more than those (1.15 ± 0.21 and 1.26 ± 0.23) in traditional LAFF (t = -8.690, P < 0.001; t = -15.057, P < 0.001), respectively.</p><p><b>CONCLUSION</b>The improved LAFF has a longer vascular pedicle and larger artery and vein in diameter than conventional LAFF, and is more suitable for the repair of the small and medium-sized defects of the head and neck.</p>

Endoscope-assisted thyroidectomy with minimal incision in neck / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To explore the feasibility of endoscope-assisted thyroidectomy with minimal neck incision.</p><p><b>METHODS</b>Endoscope-assisted thyroid surgeries had been accomplished through incision above sternal notch and in submental area respectively from August 2003 to August 2005, including 11 partial lobectomy, 3 lobectomy, 2 two-sides partial lobectomy, 1 isthmectomy.</p><p><b>RESULTS</b>In this group, 12 cases approached through above sternal notch, 5 cases approached through the submental area, and all were successful. The mean length of incisions was 2.3 cm (range from 1.5 cm to 3.0 cm). No one was converted to open surgery. The mean time of operation was 61.3 minutes (range from 30 minutes to 120 minutes). The mean volume of hemorrhage during the operation was 15.6 ml (range from 10 to 40 ml). The mean volume of drainage of post-operation was 22.5 ml (range from 6 ml to 40 ml). The mean length of stay was 4. 5 days (range from 3 days to 6 days). There were no hoarseness and no low serum calcium. Following visits were performed after operation from 1 month to 12 months, and there were no stiff feelings on skin. The cosmetic outcomes of the incisions were good, except 1 case for scar physique.</p><p><b>CONCLUSIONS</b>Endoscope-assisted thyroidectomy was safe and feasible with good cosmetic outcome. The selection of approach with minimal incision depends on the location of neoplasm.</p>