Anterolateral thigh skinfold thickness and the European head and neck cancer patient: a prospective study.

The purpose of this study was to objectively assess this widely recognised problem of the bulky adipocutaneous Anterolateral thigh flap in the European population that may have implications in the reconstruction of head and neck cancer patients. We report 50 cases that underwent specific prospective thigh skinfold thickness assessment as part of assessment of suitability for ALT flap reconstruction following cancer ablation. The null hypothesis was that thigh skinfold thickness and circumference in an oral cancer population do not differ significantly from published sino-Asian norms. This study confirms anthropometrically the suspicion that European thigh skinfold thickness in a head and neck cancer population is greater than sino-Asian comparators.

Intraoral defect coverage with prelaminated epigastric fat flaps with human amniotic membrane in rats.

BACKGROUND: The aim of this study was to investigate whether or not wound healing after the use of microvascular anastomosed fat flaps prelaminated with human amniotic membrane, for intraoral defect coverage, is improved when compared wth wound healing of pure fat flaps. METHODS: Microsurgical transplantation of the superficial epigastric fat flap prelaminated with HAM was evaluated using 47 Sprague-Dawley rats. Standardized oral mucosa defects were created and covered by HAM or polyglactin910/polydioxanon patches only, prelaminated and bare flaps, uncovered or by HAM after flap insertion. After 7, 15, and 35 days, postoperatively, the flaps were reassessed. RESULTS: The mean value of the defect size after 7 days was 47.73 ± 2.63 mm(2) in the control, 48.63 ± 2.23 mm(2) in the bare flaps covered by HAM after insertion, and 36.85 ± 2.79 mm(2) in the prelaminated HAM group. The mean value of the wound closure time in all rats was 13.74 ± 2.05 days (range 11-18). Intraoral defects were covered with mucosa after 15.67 ± 1.66 days in the pure flap group and 11.89 ± 0.78 days in the HAM group (p < 0.0001). CONCLUSIONS: Prelaminated flaps with HAM used in the repair of large mucosa defects complete epithelialization from the surrounding margins faster than bare flaps. Wound healing can be enhanced by using HAM as a prelaminated epithelial structure within microvascular anastomosed flaps.

Extramedullary plasmacytoma of the tongue base: a case report and clinical review of head and neck plasmacytoma.

Plasmacytomas of the head and neck are rare tumors characterized by a monoclonal proliferation of plasma cells. Very few cases of plasmacytoma of the tongue base have been reported. We present a new case of extramedullary plasmacytoma of the tongue base, we discuss its diagnosis and management, and we review the literature on plasmacytomas of the head and neck.

A second national survey of health-related quality of life questionnaires in head and neck oncology.

INTRODUCTION: With an increasing number of publications on health-related quality of life (HRQOL) following head and neck cancer, the recognition of a number of well-validated questionnaires and a growing awareness of the potential role of HRQOL in practice, it was our aim to repeat the survey of 2002 reported in the Annals to see how practice changed. MATERIALS AND METHODS: A postal survey of members of the British Association of Head and Neck Oncologists was undertaken in January 2006 with reminders sent in February, March and April. RESULTS: The response was 50% (106 of 210) of which 53% were using or had used HRQOL questionnaires. The main reasons for not using HRQOL questionnaires were that they were too time-consuming or intrusive in a clinic setting and that there was a lack of resources. CONCLUSIONS: Clinicians still see the use of questionnaires as a research-tool only, rather than an adjunct to giving patient information, promoting choice, and identifying patients with problems. The burden on HRQOL evaluation in routine clinical practice remains a substantial barrier. Advances with IT support in clinic should make it easier to collect and use these data in the future. As surgeons, we still need to be persuaded of the benefits of HRQOL outcomes in our practice.

A guide of the questionnaires used in the measurement of health-related quality of life in head and neck oncology.

AIMS AND BACKGROUND: There is a plethora of instruments which measure health-related quality of life (HRQOL), although only a fraction of these have been used in surgical studies and palliative care. Clinicians involved in the management of head and neck pathology face the difficult task of selecting the instrument most suited to the aspect of the patients' perspective that they want to measure. The aim of this article is to guide head and neck trainees in deciding on the use of the appropriate instrument for evaluation of the patient's perspective. METHODS AND STUDY DESIGN: The two authors independently searched and scrutinized the literature. The ISI search engine with cross-reference using PubMed and Ovid was searched with the terms "quality of life", "questionnaire" and specific specialty terms. Studies written in the English language were selected and the abstracts searched for evidence of patient self-completed questionnaires and HRQOL outcome. RESULTS: There are five broad category headings into which quality of life studies in head and neck oncology can be divided. These include: patient performance questionnaires, generic quality of life questionnaires, generic cancer questionnaires, head and neck cancer questionnaires, and head and neck functional questionnaires. CONCLUSIONS: Patient perspective can be assessed using a number of instruments, including open interview, semi-structured interview, and the simple questionnaire. The choice of instrument depends somewhat on personal preference, the outcomes being measured, and available resources.