Reconstruction of a Pharyngeal Cutaneous Fistula Using a Bi-Paddled Pectoralis Major Flap for a Patient with a Possibility of Future Postoperative Radiotherapy.

BACKGROUND Pharyngocutaneous fistulas are often difficult to treat because pharyngeal contents tend to leak into the cervical layer causing wound infections or abscesses. If reconstruction with free flaps is difficult, pedicled pectoralis major flaps are an option. CASE REPORT A 51-year-old male patient who had undergone radiation and chemotherapy for laryngeal cancer was scheduled for total laryngectomy with combined skin resection for local tumor recurrence. Reconstruction with a left deltopectoral (DP) flap was performed. However, a pharyngocutaneous fistula constructed due to cervical soft-tissue infection required reconstruction using a right bi-paddled pectoralis major muscle. The anterior pharyngeal wall was reconstructed with the medial skin island, and the lateral skin island was folded back to reconstruct the soft tissues. Since this was the patient's third recurrence, the possibility of subsequent local recurrences, and hence of the need for radiation therapy, were high. In such cases, the pedicle of the pectoralis major muscle flap is normally closed using a DP flap. However, in the present case, the DP flap had already been used on both sides. We therefore utilized a right bi-paddled pectoralis major flap for cervical reconstruction. CONCLUSIONS We successfully reconstructed the cervical skin and soft tissue thickly, and primarily-closed the donor site, by creating a second skin island from surplus areas of the existing skin island. This method is particularly useful for the reconstruction of cervical skin and soft tissues due to the possible need for future radiation therapy, when the use of free flaps and DP flap is unfeasible.

Reconstruction of a high-resolution image on a compound-eye image-capturing system.

The authors have proposed an architecture for a compact image-capturing system called TOMBO (thin observation module by bound optics), which uses compound-eye imaging for a compact hardware configuration [Appl. Opt. 40, 1806 (2001)]. The captured compound image is decomposed into a set of unit images, then the pixels in the unit images are processed with digital processing to retrieve the target image. A new method for high-resolution image reconstruction, called a pixel rearrange method, is proposed. The relation between the target object and the captured signals is estimated and utilized to rearrange the original pixel information. Experimental results show the effectiveness of the proposed method. In the experimental TOMBO system, the resolution obtained is four times higher than that of the unit image that did not undergo reconstruction processing.

Color imaging with an integrated compound imaging system.

Color-imaging methods with an integrated compound imaging system called TOMBO (Thin observation module by bound optics) are presented. The TOMBO is a compact optoelectronic imaging system for image capturing based on compound-eye imaging and post digital processing. First, a general description of the TOMBO system is given, and then two configurations for color imaging are described. Experimental comparison of these configurations is made by use of an experimental TOMBO system. The characteristics and the performance on the proposed methods are briefly discussed.