Abstract:
:Soft-tissue defects of the head and neck that are too extensive to be reconstructed with local flaps without excessive impairment of either form or function usually require repair by some type of regional flap. Selection of a specific regional flap depends on the type of defect, i.e., its size and location, and on the intrinsic properties of the regional flap. Single pedicle peninsular or island axial pattern flaps are usually selected because of their improved blood supply compared with random flaps. For most skin defects of the face and neck requiring reconstruction with a regional flap, a medially based deltopectoral flap is usually preferable to musculocutaneous flaps because it is less bulky and produces less donor-site functional impairments. Likewise, for large defects of the upper or lower lip, a deltopectoral flap in most instances is the regional flap of choice for reconstruction. Nasal defects that require regional flaps for repair are reconstructed with various types of forehead flaps. The median flap remains the most useful because the donor site can be closed primarily, leaving a thin midline scar that is camouflaged relatively easily. For nasal defects that require a longer flap that can be provided by a median flap, the oblique forehead flap provides additional length sufficient to reach the base of the columella. Larger defects of the oral cavity and oral pharynx usually require regional or microsurgical flaps for reconstruction of soft-tissue deficits. In addition, mandibular reconstruction may be necessary. The pectoralis major musculocutaneous flap is the author's preferred choice of a regional flap for reconstruction of such defects. The flap readily reaches the oral cavity and oral pharynx and the muscle provides good coverage of the carotid artery when neck dissection has been accomplished. A great advantage of the flap is the ability to achieve reconstruction in one stage without the need for a controlled salivary fistula. Although the deltopectoral flap is the author's preferred regional flap for reconstruction of major defects of the hypopharynx, the pectoralis major musculocutaneous flap is the regional flap of choice when patients are severely malnourished or cachetic. Both flaps provide a source of nonirradiated skin and provide sufficient tissue for total reconstruction of the hypopharynx and cervical esophagus. Both methods of reconstruction, however, have a relatively high rate of stenosis of the distal anastomoses.
journal_name
Otolaryngol Clin North Amjournal_title
Otolaryngologic clinics of North Americaauthors
Baker SRsubject
Has Abstractpub_date
1990-10-01 00:00:00pages
925-46issue
5eissn
0030-6665issn
1557-8259journal_volume
23pub_type
杂志文章,评审abstract::Chronic rhinosinusitis (CRS) is a condition characterized by persistent inflammation due to intrinsic mucosal hypersensitivity or persistent infection. Proper medical treatment with antibiotic, leukotriene modifiers, oral corticosteroids, or even aspirin desensitization for the sinus inflammation can prevent the need ...
journal_title:Otolaryngologic clinics of North America
pub_type: 杂志文章,评审
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abstract::With fiber-based lasers that may be passed via the working channel of a flexible laryngoscope, in-office laser laryngeal surgery has become possible. The potassium-titanyl-phosphate laser has several features that make it ideal for laryngeal surgery, and it is now the laser of choice for in-office management of a vari...
journal_title:Otolaryngologic clinics of North America
pub_type: 杂志文章,评审
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abstract::It is essential for laryngologists, speech and language pathologists, and others caring for professional voice users to be familiar with the potential vocal effects of any substance ingested by a professional voice patient. This article reviews pharmacologic agents that may have laryngeal side effects. Essentially, an...
journal_title:Otolaryngologic clinics of North America
pub_type: 杂志文章
doi:10.1016/s0030-6665(05)70243-7
更新日期:2000-08-01 00:00:00
abstract::The following are our conclusions in regard to glycerol test interpretation based on 60 valve implants: Negative Tests 1. A negative glycerol test result and no audiometric evidence of significant hearing fluctuations indicate that a patient is unlikely to have postoperative hearing that is better than his best preope...
journal_title:Otolaryngologic clinics of North America
pub_type: 杂志文章
doi:
更新日期:1980-11-01 00:00:00
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journal_title:Otolaryngologic clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.otc.2005.11.002
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journal_title:Otolaryngologic clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.otc.2014.06.003
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journal_title:Otolaryngologic clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.otc.2010.02.005
更新日期:2010-04-01 00:00:00
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journal_title:Otolaryngologic clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/s0030-6665(05)70123-7
更新日期:1999-04-01 00:00:00
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journal_title:Otolaryngologic clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1997-08-01 00:00:00
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journal_title:Otolaryngologic clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.otc.2007.11.012
更新日期:2008-04-01 00:00:00
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journal_title:Otolaryngologic clinics of North America
pub_type: 杂志文章
doi:
更新日期:1978-02-01 00:00:00
abstract::This article details the incidence, etiology, classification, and radiographic findings of fungal infections. Major infections discussed include aspergillosis, mucormycosis, blastomycosis, candidiasis, chromblastomycosis, coccidioidomycosis, histoplasmosis, paracoccidioidomycosis, and rhinosporidiosis. ...
journal_title:Otolaryngologic clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1993-12-01 00:00:00
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journal_title:Otolaryngologic clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1992-06-01 00:00:00
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journal_title:Otolaryngologic clinics of North America
pub_type: 杂志文章
doi:
更新日期:1985-08-01 00:00:00
abstract::Human papillomavirus (HPV) is now recognized to cause a subset of head and neck squamous cell carcinomas (HNSCC). Although excessive tobacco and alcohol use continue to be important risk factors for HNSCC, epidemiologic studies suggest that more than 25% of HNSCC are now caused by HPV. The incidence of HPV-related HNS...
journal_title:Otolaryngologic clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.otc.2012.04.003
更新日期:2012-08-01 00:00:00
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journal_title:Otolaryngologic clinics of North America
pub_type: 杂志文章
doi:
更新日期:1984-11-01 00:00:00
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journal_title:Otolaryngologic clinics of North America
pub_type: 历史文章,杂志文章,评审
doi:
更新日期:1996-12-01 00:00:00
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journal_title:Otolaryngologic clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.otc.2015.09.005
更新日期:2016-02-01 00:00:00
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journal_title:Otolaryngologic clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.otc.2004.02.014
更新日期:2004-08-01 00:00:00
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journal_title:Otolaryngologic clinics of North America
pub_type: 杂志文章
doi:
更新日期:1978-02-01 00:00:00
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journal_title:Otolaryngologic clinics of North America
pub_type: 杂志文章
doi:10.1016/s0030-6665(05)70051-7
更新日期:1998-04-01 00:00:00
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journal_title:Otolaryngologic clinics of North America
pub_type: 杂志文章
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journal_title:Otolaryngologic clinics of North America
pub_type: 杂志文章,评审
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更新日期:2010-04-01 00:00:00
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journal_title:Otolaryngologic clinics of North America
pub_type: 杂志文章
doi:
更新日期:1991-12-01 00:00:00
abstract::The lacrimal drainage system is a very important functional and anatomic assembly in the orbit and midface. For surgeons who intend to become involved in its repair or reconstruction, it is mandatory to understand the full range of anatomic, physiologic, and diagnostic considerations prior to embarking upon a surgical...
journal_title:Otolaryngologic clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1988-02-01 00:00:00
abstract::We review the therapies for primary headache disorders: migraine, chronic migraine, tension-type headache, and cluster headache. Recommendations follow the evidence-based treatments so far as is possible with expert opinion to give clinical guidance. Headache has 2 levels of care: acute treatments designed to stop a h...
journal_title:Otolaryngologic clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.otc.2013.11.002
更新日期:2014-04-01 00:00:00
abstract::Cochlear implantation and cochlear implants (CIs) have a long history filled with innovations that have resulted in the high-performing device's currently available. Several promising technologies have been reviewed in this article, which hold the promise to drive performance even higher. Remote CI programming, totall...
journal_title:Otolaryngologic clinics of North America
pub_type: 历史文章,杂志文章,评审
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更新日期:2015-12-01 00:00:00
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journal_title:Otolaryngologic clinics of North America
pub_type: 杂志文章
doi:
更新日期:1987-08-01 00:00:00
abstract::Simulation is rapidly expanding across medicine as a valuable component of trainee education. For procedural simulation, development of low-cost simulators that allow a realistic, haptic experience for learners to practice maneuvers while appreciating anatomy has become highly valuable. Otolaryngology has seen signifi...
journal_title:Otolaryngologic clinics of North America
pub_type: 杂志文章,评审
doi:10.1016/j.otc.2017.05.006
更新日期:2017-10-01 00:00:00
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journal_title:Otolaryngologic clinics of North America
pub_type: 杂志文章,评审
doi:
更新日期:1993-10-01 00:00:00