Colgajo submental para reconstrucción de defectos oncológicos en cabeza y cuello

Casellas, Joan; Rodríguez, J. Carballido; Herrero, Luis Barbier; Roman, Eloy; Urbieta, A. Bidaguren; Zuazua, Joseba Santamaría

doi:10.4321/s1130-05582009000400003

Cited by 3 publications

(2 citation statements)

References 17 publications

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“…The donor site can be closed primarily with low functional and esthetic sequelae, but the pedicle can also be compromised in cases of neck oncological surgery and some authors do not recommend its use in case of suspicion of cervical metastasis. 22 The objectives of secondary cervicofacial soft tissue reconstruction in ''frozen neck'' are:…”

Section: Discussionmentioning

confidence: 99%

“…The submental flap can be used to cover defects of the lower face, the ipsilateral oral cavity and even the palate. The donor site can be closed primarily with low functional and esthetic sequelae, but the pedicle can also be compromised in cases of neck oncological surgery and some authors do not recommend its use in case of suspicion of cervical metastasis 22 …”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Secondary Cervicofacial Soft Tissue Reconstruction With Upper Trapezius Myocutaneous Flap in “Frozen Neck” With Bone Flap and Reconstructive Plate Exposure

Cuéllar

Alonso

Antúnez-Conde

et al. 2020

Journal of Craniofacial Surgery

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increase the rate of middle ear problems. 1 It does not interfere with midface advancement operations, it can be surgically adjusted if necessary to tighten or loosen the sphincter, it can be performed after a failed pharyngeal flap, and it can be used for patients with VPI and no history of cleft palate. 1 It is for the reasons that the sphincter pharyngoplasty has become a durable and popular technique for the treatment of VPI. PERSONAL EXPERIENCE AND REFLECTIONOf course, the experienced cleft surgeon is guided by the trials and tribulations of daily practice. It is this experience that we will be referring to at this time. It has been suggested in the past that patients with velocardiofacial syndrome have such profound VPI that a ''wide sub-obstructing pharyngeal flap'' was necessary for correction (Robert Shprintzen reference needed). The need for a wide sub-obstructing flap stems from the poor, or even paradoxical, lateral wall movement on attempted velopharyngeal closure. It stands to reason that a ''wide sub-obstructive'' pharyngeal flap increases the risk of obstructive sleep apnea (OSA). For this reason, the senior author has avoided such pharyngeal flaps in this cohort of patients in favor of the sphincter pharyngoplasty which has been reported to have a lower risk of OSA. The port should be designed to measure 6 mm in diameter. Overlapping the palatopharyngeal flaps so each reaches the opposite sides is favored. The risk of bleeding, particularly in patients with velocardiofacial syndrome, is of concern. MRA has been recommended in patients with locardiofacial syndrome to rule out medial displacement of the internal carotid artery. We also recommend palpating the pharynx before injecting local anesthetic.As plastic surgeons, we find the neurotized and dynamic sphincter pharyngoplasty to be supremely satisfying compared to a static adynamic pharyngeal flap. The lower risk of OSA and snoring has been reported (reference), and corresponds with our own clinical experience. A further advantage is that in our cleft patients who require maxillary advancement, pharyngeal flaps may restrict Sagittarius advancement as a consequence of the central scarring, whereas the sphincter pharyngoplasty can be left in place. Although a patient with a sphincter pharyngoplasty in place who then requires a nasotracheal intubation, will typically need an endoscopic intubation.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%