ABSTRACT
We report three cases of squamous cell carcinoma of the columella invading the sub-partitions. Wide resection raised the problem of several nasal esthetics sub-units. A chronological review of columella reconstruction procedures explained why the nasolabial fragment rarely used for partial rhinopoiesis, was appropriate in these three patients.
Subject(s)
Carcinoma, Squamous Cell/rehabilitation , Nasal Septum/surgery , Nose Deformities, Acquired/surgery , Nose Neoplasms/rehabilitation , Rhinoplasty/methods , Surgical Flaps , Carcinoma, Squamous Cell/surgery , Humans , Male , Middle Aged , Nose Neoplasms/surgeryABSTRACT
Flap failure is mostly caused by venous thrombosis of the anastomosis. The failure rate is higher in post-irradiated neck. To reduce the risk of venous thrombosis, the authors propose to harvest the radial forearm flap using the cephalic vein as the drainage vein and as a pedicle. Only a single arterial anastomosis is carried out. This technique has been described already in patients who underwent head and neck ablative surgery with radical neck dissection. The authors report 2 cases in patients with post-irradiated neck. The flap transfers were successful in the 2 cases. The operative time of harvesting this hybrid version is the same with the conventional free flap technique. This version of the radial forearm flap can be a method of choice for some complex microvascular reconstruction in the head and neck region.
Subject(s)
Head/surgery , Muscle, Skeletal/transplantation , Skin Transplantation , Surgical Flaps , Aged , Aged, 80 and over , Anastomosis, Surgical , Axillary Vein/transplantation , Carcinoma, Squamous Cell/radiotherapy , Carcinoma, Squamous Cell/surgery , Female , Forearm/blood supply , Glossectomy , Graft Survival , Head and Neck Neoplasms/radiotherapy , Head and Neck Neoplasms/surgery , Humans , Male , Microsurgery , Middle Aged , Mouth Floor/radiation effects , Mouth Floor/surgery , Mouth Neoplasms/radiotherapy , Mouth Neoplasms/surgery , Muscle, Skeletal/blood supply , Skin Neoplasms/radiotherapy , Skin Neoplasms/surgery , Surgical Flaps/blood supply , Tongue Neoplasms/radiotherapy , Tongue Neoplasms/surgery , Venous Thrombosis/prevention & controlABSTRACT
Recommended treatment for head and neck cancer associates surgery and radiotherapy. Indication for bone-anchored epitheses in irradiated patients is also a common situation. The outcome of the implant appears to be improved with a special protocol for hyperbaric oxygen therapy, antibiotic therapy and calcitherapy. The problem of radiotherapy in patients with titanium osseointegrated implants is also discussed.
