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  1. Article ; Online: Inverted papilloma of the sphenoid sinus: clinical presentation, management, and systematic review of the literature.

    Guillemaud, Jennifer P / Witterick, Ian J

    The Laryngoscope

    2009  Volume 119, Issue 12, Page(s) 2466–2471

    Abstract: Objectives: Inverted papilloma (IP) of the sphenoid sinus is a rare neoplasm with a nonspecific and insidious presentation that is further complicated by difficult access for assessment and follow-up. In conjunction with a systematic review of the ... ...

    Abstract Objectives: Inverted papilloma (IP) of the sphenoid sinus is a rare neoplasm with a nonspecific and insidious presentation that is further complicated by difficult access for assessment and follow-up. In conjunction with a systematic review of the English literature, we review our experience with IP of the sphenoid sinus to better delineate the clinical presentation, prevalence, management, and recurrence of this challenging lesion.
    Methods: A systematic search strategy was developed to assess and summarize the best available evidence on sphenoid IP. A retrospective chart review of the 5-year database of one tertiary care Otolaryngology-Head and Neck Surgery practice was performed; all patients with histologically confirmed IP of the nasal cavity or paranasal sinuses were included.
    Results: Seventy-one patients (49 males, 22 females; mean age, 57.2 years) treated between June 2003 and January 2009 were included. Nine patients were diagnosed with IP originating in the sphenoid sinus. Two of these patients were asymptomatic, and in the remaining seven patients the most common presentation was headache (42.9%), followed by visual disturbances, hearing loss, and nasal obstruction (28.6% each). Review of the literature confirms our finding that the most common presenting symptom is headache (45.0%), followed by nasal obstruction (30.0%) and epistaxis (22.5%).
    Conclusions: This is the largest reported series of sphenoid sinus IP in the English literature. We have demonstrated a predominance of neurological and visual symptoms in symptomatic patients with sphenoid IP, and suggest that these may be early manifestations of sphenoid IP, before the more common sinonasal symptoms develop secondary to extension into the nasal cavity and paranasal sinuses.
    MeSH term(s) Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged ; Young Adult ; Diagnosis, Differential ; Endoscopy/methods ; Otorhinolaryngologic Surgical Procedures/methods ; Papilloma, Inverted/diagnosis ; Papilloma, Inverted/surgery ; Paranasal Sinus Neoplasms/diagnosis ; Paranasal Sinus Neoplasms/surgery ; Retrospective Studies ; Sphenoid Sinus ; Tomography, X-Ray Computed ; Treatment Outcome
    Language English
    Publishing date 2009-09-22
    Publishing country United States
    Document type Comparative Study ; Journal Article ; Systematic Review
    ZDB-ID 80180-x
    ISSN 1531-4995 ; 0023-852X
    ISSN (online) 1531-4995
    ISSN 0023-852X
    DOI 10.1002/lary.20718
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  2. Article ; Conference proceedings: A Systematic Review: The Clinical Presentation, Association with Malignancy, and Management of Sphenoid Sinus Inverted Papilloma

    Guillemaud, Jennifer P / Witterick, Ian J

    Skull Base

    2008  

    Abstract: Introduction: In conjunction with a systematic review of the English literature, we review our experience with inverted papilloma (IP) of the sphenoid sinus to better delineate the presentation, management, and recurrence of this challenging lesion. ... ...

    Event/congress Presentation Abstracts, Hyatt Regency Vancouver Vancouver, British Columbia,, 2008
    Abstract Introduction: In conjunction with a systematic review of the English literature, we review our experience with inverted papilloma (IP) of the sphenoid sinus to better delineate the presentation, management, and recurrence of this challenging lesion. Methods: A systematic search strategy was developed to assess and summarize the best available evidence on sphenoid IP. A 5-year retrospective chart review was performed, including all patients with histologically confirmed sinonasal IP. Results: Seventy-one patients (49 males, 22 females; mean age, 57.17 years) treated between January 2002 and September 2007 were included. Nine patients were diagnosed with sphenoid sinus IP. Two of these patients were asymptomatic, and in the remaining seven patients the most common presentation was headache (43%), followed by visual disturbances and hearing loss (29% each). Review of the literature confirms our finding that the most common presenting symptom is headache (45%), followed by nasal obstruction (30%), and epistaxis (23%). Conclusions: This is the largest reported series of sphenoid sinus IP in the English literature. We have demonstrated a predominance of neurological and visual symptoms in symptomatic patients with sphenoid IP, and suggest that these may be early manifestations of sphenoid IP, before the more common sinonasal symptoms develop secondary to growth into the nasal cavity and paranasal sinuses.
    Language English
    Publishing date 2008-09-23
    Publishing place Stuttgart ; New York
    Document type Article ; Conference proceedings
    ZDB-ID 2043690-7
    ISSN 1532-0065 ; 1531-5010
    ISSN (online) 1532-0065
    ISSN 1531-5010
    DOI 10.1055/s-2008-1093149
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  3. Article ; Online: Prognostic impact of intraoperative microscopic cut-through on frozen section in oral cavity squamous cell carcinoma.

    Guillemaud, Jennifer P / Patel, Rajan S / Goldstein, David P / Higgins, Kevin M / Enepekides, Danny J

    Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale

    2010  Volume 39, Issue 4, Page(s) 370–377

    Abstract: ... with positive intraoperative frozen section despite revision to obtain negative margins (p < .05 ... disease-specific survival (p < .05).: Conclusions: This study in patients receiving primary ...

    Abstract Objective: Although the literature suggests that a positive tumour margin on permanent section portends a poor oncologic outcome, the prognostic implication of microscopic tumour cut-through (ie, positive tumour margin on intraoperative frozen section) that is surgically revised to a negative final margin on permanent section is currently unclear. Therefore, this study aimed to analyze the influence of microscopic tumour cut-through on disease recurrence and survival and to establish clinicopathologic variables associated with tumour cut-through.
    Design: A retrospective chart review.
    Setting: The Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto.
    Methods: Comprehensive clinicopathologic data were collected, including demography, clinical tumour staging (TNM), treatment, histopathologic details, recurrence, management, and follow-up.
    Main outcome measures: Local cancer control and disease-specific survival were the main outcome measures of interest. The Kaplan-Meier method was used to assess outcome measures by patient group, and the log-rank test was used to compare survival curves. Univariate and multivariate Cox proportional hazard regression analyses were used to test the association of various clinical factors and to identify independent prognostic factors of local control and disease-specific survival.
    Results: Sixty-five patients met inclusion criteria for our study (37 males; median age 64.4 years). Both local control and disease-specific survival were statistically significantly reduced in patients with positive intraoperative frozen section despite revision to obtain negative margins (p < .05). Multivariate analysis showed that microscopic tumour cut-through independently predicted poorer local control and disease-specific survival (p < .05).
    Conclusions: This study in patients receiving primary surgery for oral squamous cell carcinoma shows that microscopic tumour cut-through on intraoperative frozen section independently portends a poorer oncologic prognosis, regardless of ultimate tumour margin pathology.
    MeSH term(s) Adult ; Aged ; Aged, 80 and over ; Carcinoma, Squamous Cell/pathology ; Carcinoma, Squamous Cell/surgery ; Cryopreservation/methods ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Monitoring, Intraoperative/methods ; Mouth Neoplasms/pathology ; Mouth Neoplasms/surgery ; Neoplasm Recurrence, Local/epidemiology ; Neoplasm Recurrence, Local/pathology ; Prognosis ; Retrospective Studies
    Language English
    Publishing date 2010-08
    Publishing country England
    Document type Comparative Study ; Journal Article
    ZDB-ID 2434004-2
    ISSN 1916-0216 ; 1916-0208 ; 0381-6605
    ISSN (online) 1916-0216
    ISSN 1916-0208 ; 0381-6605
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  4. Article: Airway pathologic abnormalities in symptomatic children with congenital cardiac and vascular disease.

    Guillemaud, Jennifer P / El-Hakim, Hamdy / Richards, Susan / Chauhan, Nitin

    Archives of otolaryngology--head & neck surgery

    2007  Volume 133, Issue 7, Page(s) 672–676

    Abstract: Objective: To identify the epidemiological profile of airway abnormalities in symptomatic children with cardiac or vascular anomalies.: Design: Retrospective medical chart review.: Setting: Tertiary referral pediatric hospital.: Patients: ... ...

    Abstract Objective: To identify the epidemiological profile of airway abnormalities in symptomatic children with cardiac or vascular anomalies.
    Design: Retrospective medical chart review.
    Setting: Tertiary referral pediatric hospital.
    Patients: Children with airway-related symptoms and coexistent cardiac or vascular abnormality were included. The source for patient identification was a prospectively kept database.
    Main outcome measures: Endoscopic airway diagnoses, presenting airway symptoms, cardiac diagnoses, other comorbid conditions and pertinent diagnoses, patient demographics, source of referral, treatments, and follow-up.
    Results: The study population comprised 77 patients (45 male and 32 female; mean age, 18.2 months) treated between June 2002 and July 2006. Only 4 patients had no findings. The most common airway abnormality was laryngeal paralysis (n=32), followed by subglottic stenosis (n=18). Congenital and acquired lesions were equally encountered (n=70 and n=64, respectively). The most frequent presentation was intolerance to feed (n=51) (stridor and/or failure of extubation). Of the 77 patients, 32 (42%) required airway surgical intervention (open vs closed); 36 (47%) still require otolaryngologic follow-up; and 32 (42%) had a named syndrome or general multisystem condition.
    Conclusions: At least 3% of all children with cardiac disease will harbor airway problems. Laryngeal paralysis was the most common problem encountered. Given the successes achievable in treating children with complex cardiac abnormalities, attention should be paid to concomitant and consequential airway problems. Counseling processes should acknowledge the role of early otolaryngologic involvement.
    MeSH term(s) Bronchoscopy ; Child ; Child, Preschool ; Eating/physiology ; Exercise Tolerance/physiology ; Female ; Granulation Tissue/pathology ; Heart Defects, Congenital/complications ; Heart Defects, Congenital/physiopathology ; Humans ; Infant ; Infant, Newborn ; Laryngoscopy ; Male ; Respiratory Sounds ; Respiratory Tract Diseases/complications ; Respiratory Tract Diseases/congenital ; Respiratory Tract Diseases/physiopathology ; Respiratory Tract Diseases/therapy ; Retrospective Studies ; Vascular Diseases/complications ; Vascular Diseases/congenital ; Vascular Diseases/physiopathology
    Language English
    Publishing date 2007-07
    Publishing country United States
    Document type Journal Article
    ZDB-ID 632721-7
    ISSN 1538-361X ; 0886-4470 ; 2168-6181
    ISSN (online) 1538-361X
    ISSN 0886-4470 ; 2168-6181
    DOI 10.1001/archotol.133.7.672
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  5. Article ; Online: Vertical partial laryngectomy with temporoparietal free flap reconstruction for recurrent laryngeal squamous cell carcinoma: technique and long-term outcomes.

    Gilbert, Ralph W / Goldstein, David P / Guillemaud, Jennifer P / Patel, Rajan S / Higgins, Kevin M / Enepekides, Danny J

    Archives of otolaryngology--head & neck surgery

    2012  Volume 138, Issue 5, Page(s) 484–491

    Abstract: Objectives: To present a technique for reconstruction of the vertical partial laryngectomy defect using a vascularized carrier consisting of a temporoparietal free flap, cartilage graft, and buccal mucosal graft; to evaluate the oncologic outcomes with ... ...

    Abstract Objectives: To present a technique for reconstruction of the vertical partial laryngectomy defect using a vascularized carrier consisting of a temporoparietal free flap, cartilage graft, and buccal mucosal graft; to evaluate the oncologic outcomes with respect to locoregional control and overall survival; and to provide an assessment of patient quality of life and functional outcomes.
    Design: Retrospective medical record review and prospective cross-sectional analysis of functional outcomes.
    Setting: Princess Margaret Hospital-University Health Network and the Odette Cancer Centre-Sunnybrook Health Sciences Centre.
    Methods: We collected data on patient demographic characteristics, tumor staging, initial treatment, recurrence, management, and follow-up. Prospectively, a cross-sectional study was performed using the European Organization for Research and Treatment of Cancer Quality of Life of Cancer Patients Questionnaire C30 and HN35 module and voice and swallowing results using the Voice Handicap Index and Swallowing Quality of Life index.
    Main outcome measures: Local recurrence-free survival, cause-specific survival, and overall survival.
    Results: Forty men met inclusion criteria (median age, 65.0 years). Local recurrence-free survival was 84% at 3 years and 75% at 5 years. Cause-specific survival was 88% at 3 years and 78% at 5 years. Thirty-eight patients were successfully decannulated; all patients tolerated oral intake after the surgical procedure. The C30 and HN35 symptomatic results were comparable with patients with standardized stages I and II head and neck tumors. The Voice Handicap Index results were comparable with patients with functional dysphonia. Patients' swallowing was in the normal range.
    Conclusions: Patients receiving vertical partial laryngectomy with temporoparietal free flap reconstruction for recurrent glottic carcinoma following radiation treatment failure have high rates of locoregional control. The use of the temporoparietal free flap in this patient population produces high-quality voice results and normal swallowing and has no major effect on quality of life.
    MeSH term(s) Aged ; Carcinoma, Squamous Cell/pathology ; Carcinoma, Squamous Cell/surgery ; Cartilage/transplantation ; Cross-Sectional Studies ; Free Tissue Flaps ; Humans ; Laryngeal Neoplasms/pathology ; Laryngeal Neoplasms/surgery ; Laryngectomy/methods ; Male ; Middle Aged ; Mouth Mucosa/transplantation ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Prospective Studies ; Quality of Life ; Reconstructive Surgical Procedures/methods ; Retrospective Studies ; Salvage Therapy ; Surveys and Questionnaires ; Survival Rate ; Treatment Outcome
    Language English
    Publishing date 2012-05
    Publishing country United States
    Document type Journal Article
    ZDB-ID 632721-7
    ISSN 1538-361X ; 0886-4470 ; 2168-6181
    ISSN (online) 1538-361X
    ISSN 0886-4470 ; 2168-6181
    DOI 10.1001/archoto.2012.410
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  6. Article ; Online: The implantable Cook-Swartz Doppler probe for postoperative monitoring in head and neck free flap reconstruction.

    Guillemaud, Jennifer P / Seikaly, Hadi / Cote, David / Allen, Heather / Harris, Jeffrey R

    Archives of otolaryngology--head & neck surgery

    2008  Volume 134, Issue 7, Page(s) 729–734

    Abstract: Objective: To determine if the implantable Cook-Swartz Doppler Flow Monitoring System (Cook Vascular Inc, Vandergrift, Pennsylvania) improves surgical salvage rates for compromised free flaps.: Design: Retrospective medical record review spanning ... ...

    Abstract Objective: To determine if the implantable Cook-Swartz Doppler Flow Monitoring System (Cook Vascular Inc, Vandergrift, Pennsylvania) improves surgical salvage rates for compromised free flaps.
    Design: Retrospective medical record review spanning 2002 to 2006 for a large head and neck oncology program.
    Setting: A tertiary care hospital.
    Patients: A consecutive series of 351 patients (244 men and 107 women; mean age, 58.63 years) who underwent free flap reconstruction of head and neck defects that were monitored using the implantable Doppler probe were included.
    Results: The most common indication for surgery was squamous cell carcinoma (81.0%), followed by functional reconstruction (4.3%). The most common free flap used was radial forearm (68.0%), followed by the fibular free flap (19.0%). With operative exploration used as the gold standard, the Cook-Swartz Doppler Flow Monitoring System had a sensitivity of 65.8% and specificity of 98.2% for the detection of flap compromise. For the detection of vascular compromise of the monitored vessel (excluding flap compromise cases whereby flow in the monitored vessel was not compromised on operative exploration, ie, venous obstruction, hematoma formation, and necrotizing fasciitis), the sensitivity increased to 100%.
    Conclusions: This is the largest reported series, to our knowledge, of implantable Cook-Swartz Doppler use, and our experience would suggest that this is a reliable technique for postoperative monitoring in head and neck reconstruction. Our use of the implantable Doppler probe allowed us to recognize vascular compromise early, resulting in an overall flap success rate of 98.1%, with a 92.0% salvage rate of flaps that experienced vascular compromise of the monitored vessel.
    MeSH term(s) Carcinoma, Squamous Cell/surgery ; Equipment Design ; Female ; Graft Survival/physiology ; Humans ; Ischemia/diagnostic imaging ; Laser-Doppler Flowmetry/instrumentation ; Male ; Middle Aged ; Neoplasm Recurrence, Local/surgery ; Otorhinolaryngologic Neoplasms/surgery ; Polytetrafluoroethylene ; Postoperative Complications/diagnosis ; Prostheses and Implants ; Retrospective Studies ; Sensitivity and Specificity ; Signal Processing, Computer-Assisted/instrumentation ; Surgical Flaps/blood supply ; Ultrasonography
    Chemical Substances Polytetrafluoroethylene (9002-84-0)
    Language English
    Publishing date 2008-07
    Publishing country United States
    Document type Journal Article
    ZDB-ID 632721-7
    ISSN 1538-361X ; 0886-4470 ; 2168-6181
    ISSN (online) 1538-361X
    ISSN 0886-4470 ; 2168-6181
    DOI 10.1001/archotol.134.7.729
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  7. Article ; Online: Double free-flap reconstruction: indications, challenges, and prospective functional outcomes.

    Guillemaud, Jennifer P / Seikaly, Hadi / Cote, David W J / Barber, Brittany R / Rieger, Jana M / Wolfaardt, Johan / Nesbitt, Peggy / Harris, Jeffrey R

    Archives of otolaryngology--head & neck surgery

    2009  Volume 135, Issue 4, Page(s) 406–410

    Abstract: Objective: To investigate the increasing use of double free flaps in the reconstruction of large head and neck defects.: Design: A 5-year retrospective medical record review in a large tertiary care head and neck oncology program. Prospectively ... ...

    Abstract Objective: To investigate the increasing use of double free flaps in the reconstruction of large head and neck defects.
    Design: A 5-year retrospective medical record review in a large tertiary care head and neck oncology program. Prospectively collected functional data were also analyzed.
    Setting: Academic research.
    Patients: A consecutive series of 35 patients (24 men and 11 women; mean age, 57.7 years).
    Main outcome measures: The use of double free flaps in the reconstruction of large head and neck defects and prospective functional outcomes.
    Results: The most common indication for surgery (n = 25 [71.4%]) was squamous cell carcinoma. The most common double free-flap combination (n = 22 [62.9%]) included an osteocutaneous fibular free flap with a fasciocutaneous radial forearm free flap. Objective evaluation by naive listeners demonstrated a mean single-word intelligibility score of 66.2% and a mean sentence intelligibility score of 84.8% in this group of patients. Modified barium swallow study results revealed no evidence of laryngeal penetration for swallowing liquid consistencies in 21 patients (60.0%), pudding consistencies in 30 patients (85.7%), and cookie consistencies in 32 patients (91.4%).
    Conclusions: With proper patient selection and planning and the use of 2 surgical teams, the length of surgery and complication rates are not significantly increased in double free-flap reconstruction. Furthermore, by using 2 free flaps, the best osseous and soft-tissue elements may be independently selected, yielding appropriate tissue characteristics for ideal defect reconstruction.
    MeSH term(s) Barium Sulfate ; Carcinoma, Adenoid Cystic/surgery ; Carcinoma, Squamous Cell/surgery ; Contrast Media ; Deglutition ; Female ; Head and Neck Neoplasms/surgery ; Humans ; Length of Stay ; Male ; Middle Aged ; Outcome Assessment (Health Care) ; Postoperative Complications ; Prospective Studies ; Retrospective Studies ; Speech Intelligibility ; Surgical Flaps
    Chemical Substances Contrast Media ; Barium Sulfate (25BB7EKE2E)
    Language English
    Publishing date 2009-04
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 632721-7
    ISSN 1538-361X ; 0886-4470 ; 2168-6181
    ISSN (online) 1538-361X
    ISSN 0886-4470 ; 2168-6181
    DOI 10.1001/archoto.2009.15
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  8. Article ; Online: Radial forearm donor site: comparison of the functional and cosmetic outcomes of different reconstructive methods.

    Chau, Jason / Harris, Jeffrey / Nesbitt, Peggy / Allen, Heather / Guillemaud, Jennifer / Seikaly, Hadi

    Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale

    2009  Volume 38, Issue 2, Page(s) 294–301

    Abstract: Objective: To determine which method of fascial dissection and skin graft reconstruction of radial forearm free flap defects has superior functional and cosmetic outcomes.: Methods: Consenting patients undergoing major head and neck operative ... ...

    Abstract Objective: To determine which method of fascial dissection and skin graft reconstruction of radial forearm free flap defects has superior functional and cosmetic outcomes.
    Methods: Consenting patients undergoing major head and neck operative resection and reconstruction with a radial forearm free flap were prospectively enrolled and randomized into one of the following four groups: (1) suprafascial dissection with meshed graft reconstruction; (2) suprafascial dissection with sheet graft reconstruction; (3) subfascial dissection with meshed graft reconstruction; and (4) subfascial dissection with sheet graft reconstruction. Functional, cosmetic, and tendon exposure outcomes were collected prospectively with patients and outcome assessors blinded to treatment group assignment. Validated self-report questionnaires and objective functional measures were used.
    Results: Sixty-two patients met the criteria for inclusion. Analysis revealed that suprafascial dissection with sheet graft reconstruction yielded superior functional, cosmetic, and tendon exposure outcomes.
    Conclusion: Suprafascial dissection with sheet graft reconstruction should be offered to patients requiring radial forearm free flap reconstruction of major head and neck defects.
    MeSH term(s) Aged ; Double-Blind Method ; Fasciotomy ; Female ; Forearm ; Humans ; Male ; Middle Aged ; Otorhinolaryngologic Surgical Procedures ; Patient Satisfaction ; Prospective Studies ; Reconstructive Surgical Procedures/methods ; Skin Transplantation/methods ; Surgical Flaps ; Surgical Mesh ; Tissue and Organ Harvesting
    Language English
    Publishing date 2009-04
    Publishing country England
    Document type Journal Article ; Randomized Controlled Trial
    ZDB-ID 2434004-2
    ISSN 1916-0216 ; 1916-0208 ; 0381-6605
    ISSN (online) 1916-0216
    ISSN 1916-0208 ; 0381-6605
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  9. Article ; Online: Impact of positive frozen section microscopic tumor cut-through revised to negative on oral carcinoma control and survival rates.

    Patel, Rajan S / Goldstein, David P / Guillemaud, Jennifer / Bruch, Guillem Andreu / Brown, Dale / Gilbert, Ralph W / Gullane, Patrick J / Higgins, Kevin M / Irish, Jonathan / Enepekides, Danny J

    Head & neck

    2010  Volume 32, Issue 11, Page(s) 1444–1451

    Abstract: Background: The objective of the study was to evaluate the prognostic and therapeutic implications of an initial positive frozen section margin that was revised until negative (microscopic tumor cut-through), and to analyze the influence of microscopic ... ...

    Abstract Background: The objective of the study was to evaluate the prognostic and therapeutic implications of an initial positive frozen section margin that was revised until negative (microscopic tumor cut-through), and to analyze the influence of microscopic margin status on oral carcinoma control.
    Methods: The approach in our investigation was through a retrospective review of patients treated with primary surgery, with frozen section margin control in oral carcinoma. Inclusion criteria included availability of frozen and permanent section histology reports of resection margins and negative final resection margins.
    Results: Of 547 patients studied, 175 received adjuvant radiation. Local and regional control and disease-specific survival rates were 81.6%, 78.4%, and 76.3%, respectively. Tumor cut-through and pathologic nodal (pN) stage had an independently adverse effect on local control. Tumor cut-through adversely affected cancer control and survival, but this effect diminished significantly in the absence of regional disease.
    Conclusions: Microscopic tumor cut-through revised to negative margins is a powerful prognosticator that is observed only when regional disease is also present. The value of adjuvant therapeutic regimens is questionable in patients with microscopic tumor cut-through, revised to negative margins, and with no regional disease.
    MeSH term(s) Adolescent ; Adult ; Aged ; Aged, 80 and over ; Carcinoma, Squamous Cell/mortality ; Carcinoma, Squamous Cell/pathology ; Carcinoma, Squamous Cell/therapy ; Chemotherapy, Adjuvant ; Disease-Free Survival ; Female ; Frozen Sections ; Humans ; Lymph Nodes/pathology ; Male ; Middle Aged ; Mouth Neoplasms/mortality ; Mouth Neoplasms/pathology ; Mouth Neoplasms/therapy ; Prognosis ; Radiotherapy, Adjuvant ; Survival Rate ; Young Adult
    Language English
    Publishing date 2010-11
    Publishing country United States
    Document type Journal Article
    ZDB-ID 645165-2
    ISSN 1097-0347 ; 0148-6403 ; 1043-3074
    ISSN (online) 1097-0347
    ISSN 0148-6403 ; 1043-3074
    DOI 10.1002/hed.21334
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  10. Article ; Online: Free tissue transfer flap reconstruction of parotidectomy defects: outcomes analysis and the utility of three-dimensional laser surface scans.

    Côté, David / Harris, Jeffrey R / Guillemaud, Jennifer / Chau, Jason K M / Grosvenor, Andrew / King, Benjamin / Seikaly, Hadi

    Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale

    2010  Volume 39, Issue 5, Page(s) 561–565

    Abstract: ... The reconstructed patients tended to perceive a better symmetry when compared to the nonreconstructed patients (p ... significant (p ≤ .0001).: Conclusions: Free tissue transfer reconstruction is an effective means ...

    Abstract Background: Tumours of the parotid gland are generally managed surgically without reconstruction. The usual long-term outcomes of these techniques are facial scars, asymmetry, and permanent contour deficits. These cosmetic deformities can significantly affect patients' self-image and negatively impact their quality of life. Free tissue transfers have been used increasingly over the past years to improve patients' cosmetic and satisfaction outcomes.
    Objective: The purpose of this study was to evaluate the cosmetic and symmetry outcomes of patients undergoing free flap reconstruction after parotid surgery.
    Methods: The study was approved by the ethics review board at the University of Alberta. All patients undergoing total parotid surgery were offered a free flap tissue transfer reconstructive procedure. Seven consecutive patients undergoing the reconstruction option were included in the study. The control group was composed of seven patients who had undergone total parotid surgery without reconstruction. Data regarding demographics, surgical procedure, pathology, and postoperative complications were collected. Facial symmetry was evaluated with questionnaires and laser surface scanning.
    Results: There were no statistically significant differences between the two groups with regard to age, sex, timing of surgery, or pathology. The reconstructed patients tended to perceive a better symmetry when compared to the nonreconstructed patients (p = .0014). The reconstructed patients had all experienced a slight volume increase on the operative side compared to the contralateral side, with a mean difference of 4.99% increase in volume. Conversely, the nonreconstructed patients all experienced a notable volume deficit on the operative side compared to the nonoperative side-an average 12.15% volume loss was seen postoperatively. This difference was statistically significant (p ≤ .0001).
    Conclusions: Free tissue transfer reconstruction is an effective means of reconstructing postparotidectomy defects in patients for whom facial volume asymmetry is a concern.
    MeSH term(s) Adult ; Aged ; Female ; Follow-Up Studies ; Humans ; Imaging, Three-Dimensional/methods ; Lasers ; Male ; Middle Aged ; Muscle, Skeletal/transplantation ; Parotid Neoplasms/surgery ; Patient Satisfaction ; Quality of Life ; Reconstructive Surgical Procedures/methods ; Surgical Flaps ; Treatment Outcome
    Language English
    Publishing date 2010-10
    Publishing country England
    Document type Comparative Study ; Journal Article
    ZDB-ID 2434004-2
    ISSN 1916-0216 ; 1916-0208 ; 0381-6605
    ISSN (online) 1916-0216
    ISSN 1916-0208 ; 0381-6605
    Database MEDical Literature Analysis and Retrieval System OnLINE

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