[Our experience in the treatment advanced neoplasms of floor of the mouth]. / Doswiadczenia wlasne w leczeniu zaawansowanych nowotworów dna jamy ustnej.

AIM: The aim of this study was to evaluate results of our surgical treatment of advanced neoplasms of the floor of the mouth, treated from 2005-2011 in Department of Otolaryngology and Department of Plastic Surgery Medical University of Gdansk MATERIAL: We analyzed group of 12 patients (aged 36 to 70 years, mean 55) treated by primary surgical excision of neoplasms of the floor of the mouth (with tracheotomy and mandibulotomy) and selective or radical neck dissection (uni- or bilateral) in combination with chemoradiotherapy. All patients referees with advancement of locoregional disease: primary tumors (T3 or T4) and neck metastases (N1 or N2b) Most of the patients required to use free microvascular reconstruction with free forearm skin flaps. Histological examinations revealed squamous cell carcinoma (11/12) and adenocarcinoma (1/12). RESULTS: Two patients die in 1 and 4 months after surgery. Three die from 2 to 3 years after surgery. Rest live from 6 month to 6 year after therapy. CONCLUSION: Free forearm skin microvascular flap is good (anatomical and functional) for reconstruction for large defects after resection neoplasms of the floor of the mouth.

A new method for using a silicone rod for permanent nipple projection after breast reconstruction procedures.

Nipple-areola complex (NAC) is a unique part of the human body. Not only is it a functional structure, but it plays an aesthetic role as well. It offers the final touch to the convex shape of the breast. Its lack frequently leads to depression in patients. This paper describes the method used by the authors for reconstructing nipple mound projection in patients following an autologous breast reconstruction procedure. To reconstruct the nipple mound an adapted local C-V flap technique described by Losken was used, with a silicone rod to support the nipple. The new method is based on simple preparation of flaps, fixing the silicone rod at the nipple bottom and below the top, it is quick and efficient in terms of time and materials used. The procedure was conducted in 30 patients: 10 cases following LDf reconstruction and Becker prosthesis or expander prosthesis, 20 cases following body tissue reconstruction with TRAM flap (Transverse Rectus Abdominis Musculocutaneous flap). All the patients who had undergone the LDf procedure developed flap necrosis followed by rod removal. In the patients who had undergone TRAM flap reconstruction no necrosis or wound split was observed, healing progressed without complications. In this group durable nipple projection was achieved. The new method for reconstructing nipple projection may be applied both in simultaneous and staged procedures, only in patients who have undergone autologous breast reconstruction procedure.