ABSTRACT
A retrospective analysis of our experience with 41 patients who received a platysma myocutaneous flap for reconstruction of intraoral and pharyngeal defects is presented. All patients had epidermoid carcinoma of the head and neck region, with tumor size ranging from T1 to T4. The primary sites of malignancy were the oral cavity (61%), the oropharynx (32%), and the hypopharynx (7%). Either radical or modified radical neck dissection requiring routine ligation of the facial artery was performed in all 41 patients. Adjuvant therapy included preoperative or postoperative radiotherapy (39%) and preoperative chemotherapy (73%). The mean hospital stay was 13 days. Flap-related complications occurred in eight patients (19%) only. These included partial flap necrosis involving the epithelium alone, skin necrosis of the neck suture line, and fistula formation. Most complications resolved with local care only. Minor surgical intervention was required in three patients. There were no perioperative deaths. These results indicate that the platysma myocutaneous flap is a viable alternative in head and neck reconstruction.
Subject(s)
Carcinoma, Squamous Cell/surgery , Head and Neck Neoplasms/surgery , Surgical Flaps/methods , Adult , Aged , Aged, 80 and over , Female , Follow-Up Studies , Humans , Length of Stay , Male , Middle Aged , Reoperation , Retrospective Studies , Surgical Flaps/adverse effectsABSTRACT
The purpose of tonsillectomy is the complete removal of the palatine tonsils with minimal blood loss while avoiding unnecessary trauma to adjacent tissue. Despite the fact that advances in modern general anesthetic techniques have lessened risks, it has not been clear what specific differences there are when using local versus general anesthesia for tonsillectomy. In order to provide some objective information as to the advantages or disadvantages of performing tonsillectomy using local or general anesthesia, a retrospective analysis was performed on 73 fully evaluable cases of adult tonsillectomy performed in an 8 1/2-year period. Approximately one half of these were performed using local and one half general anesthesia. Analyses of the data indicated statistically significant differences in the methods. With local anesthesia the operation required less time, produced less intraoperative hemorrhage, and was less costly. However, there was no significant difference in the incidence of postoperative complications or morbidity.
