[Combined endovascular and surgical management of carotid paraganglioma].

Surgical intervention is the only method of radical treatment of carotid paraganglioma (CP). Intraoperative blood loss may exceed 2 litters. Ligation of the external carotid artery (ECA) is not always possible technically due to tumour invasion to the ECA's walls. Prior to operation, in order to diminish blood loss it is suggested to perform endovascular embolization (EE) of the vessels feeding the tumour. The case report presented herein concerns an 18-year-old male patient with CP after comprehensive diagnosis including ultrasonographic duplex scanning with Doppler colour mapping, enhanced-contrast spiral computed tomography, selective carotid angiography. The patient was subjected to selective. EE of the afferent vessels of CP. Embolization of the branch of the ascending pharyngeal artery travelling to the lower pole of the tumour, and that of the large branches feeding the upper pole of the tumour from the initial portion of the occipital artery with poly vinyl alcohol (PVA-300) and hydrogel "Embox" was followed by surgical intervention: removal of the tumour, closure of the ostia of the tumour's own arteries, ligation of the EC A. The volume of intraoperative blood loss amounted to 350 ml. The postoperative period proved uneventful with nothing to report. During the check-up examinations of the patient, performed 3, 6, 12 and 24 months after the operation, a good postoperative therapeutic outcome was noted to persist.

[Experience of vascularized autotransplants use for lower jaw defect substitution after its resection with disarticulation].

To 17 patients after lower jaw resection with disarticulation (on the occasion of neoplasm and traumas) the defects were replaced by vascularized autotransplants of the 2nd radius of pedis and vascularized fibula autotransplants in combination with titanium implants. In all cases positive results were received. The authors consider that microsurgery with vascularized fibula autotransplants in combination with titanium implants was an optimal way to replace lower jaw defects after its resection with disarticulation in TMJ.

[Experience in using complex flaps on microvascular anastomoses in treating with skin cancer on the face and scalp, appearing in scarred areas]. / Opyt ispol'zovaniia slozhnykh loskutov na mikrososudistykh anastomozakh v lechenii bol'nykh rakom kozhi litsa i volosistoi chasti golovy, voznikshim iz rubtsov.

The authors describe 11 patients operated upon for carcinoma of the face skin and hairy part of the head developing from scars of various etiology. The substitution of vast defects which had appeared after dissection of a tumor was performed by means of microsurgical autotransplantation of tissue complexes. The following vascularized autotransplants were used: musculus serratus anterior, scapular and radial grafts. Positive results were obtained in all the cases. The authors consider the microsurgical autotransplantation of tissue complexes to be a necessary component of surgical treatment of carcinoma of the skin and hairy part of the head developed from vast and deep scars.