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Fan ZT, Wang XX, Dong WX, Qiao T, Liu JR, Wang YT, Liu CB. Oropharyngeal Stenosis Caused by Significant Scar Hyperplasia Following Tonsillectomy: A Case Report. EAR, NOSE & THROAT JOURNAL 2024:1455613241233750. [PMID: 38357741 DOI: 10.1177/01455613241233750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2024] Open
Abstract
Oropharyngeal stenosis (OPS) is a relatively rare long-term complication of tonsillectomy in children, resulting from the narrowing of the upper aerodigestive tract between the soft palate, pharyngeal sidewalls, and base of the tongue. This is the first reported case of OPS due to significant scar hyperplasia; however, whether it is as prone to recurrence as skin scar hypertrophy remains unknown. In this article, we present the case of a 5-year-old girl who presented to our otolaryngology clinic with sleep snoring and suffocation. Her medical history included tonsillectomy and adenoidectomy, performed 3 years prior to presentation. The patient underwent a combination of surgery and administration of triamcinolone injections, resulting in significant symptomatic improvement. To date, no signs of recurrence have been reported.
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Affiliation(s)
- Zhi-Tao Fan
- Department of Otorhinolaryngology, Hebei Eye Hospital, Xingtai, Hebei Province, China
| | - Xue-Xia Wang
- Department of Otorhinolaryngology, Hebei Eye Hospital, Xingtai, Hebei Province, China
| | - Wen-Xin Dong
- Department of Otorhinolaryngology, Hebei Eye Hospital, Xingtai, Hebei Province, China
| | - Tong Qiao
- Department of Otorhinolaryngology, Hebei Eye Hospital, Xingtai, Hebei Province, China
| | - Jing-Rui Liu
- Department of Otorhinolaryngology, Hebei Eye Hospital, Xingtai, Hebei Province, China
| | - Yue-Tang Wang
- Department of Otorhinolaryngology, Hebei Eye Hospital, Xingtai, Hebei Province, China
| | - Chao-Bing Liu
- Department of Otorhinolaryngology, Hebei Eye Hospital, Xingtai, Hebei Province, China
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Fatani B, Alhilal AI, Alzahrani HH, Alkhattabi RR, Alhindi M. Facial Reconstruction Using Facial Artery Myomucosal Flap: A Comprehensive Review. Cureus 2023; 15:e42060. [PMID: 37602111 PMCID: PMC10433401 DOI: 10.7759/cureus.42060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/18/2023] [Indexed: 08/22/2023] Open
Abstract
The facial artery myomucosal (FAMM) flap is a type of facial flap that is constructed with the buccal mucosa and submucosa along with a portion of the buccinator muscle, which is connected to nearby blood vessels to maintain its blood supply. It is a versatile and reliable option for head and neck reconstruction, particularly in oral cavity defects. This flap is employed in the reconstruction of the floor of the mouth, alveolar cleft surgery, and tongue defect repair. Previous studies have discussed the use of FAMM flaps for facial reconstructions. However, there are no current and updated comprehensive reviews discussing the use of FAMM flaps in facial reconstruction. In light of this, this study aimed to review all relevant studies that discuss the use of FAMM flaps in facial reconstruction.
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Affiliation(s)
- Bader Fatani
- Dentistry, College of Dentistry, King Saud University, Riyadh, SAU
| | | | - Hadeel H Alzahrani
- College of Dentistry, Princess Nourah Bint Abdulrahman University, Riyadh, SAU
| | - Raghad R Alkhattabi
- College of Dentistry, Princess Nourah Bint Abdulrahman University, Riyadh, SAU
| | - Mariam Alhindi
- Oral and Maxillofacial Surgery, King Saud University, Riyadh, SAU
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Oropharyngeal reconstruction after transoral robotic surgery. Curr Opin Otolaryngol Head Neck Surg 2022; 30:384-391. [PMID: 36004787 DOI: 10.1097/moo.0000000000000842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW Transoral robotic surgery (TORS) has experienced an evolution in recent years. This technique has proved to be a safe and effective method for extirpation of select oropharyngeal tumors. Advances in technology as well as improved surgeon experience allow for the resection of larger, more complex cancers. Although healing by secondary intention remains the current standard for limited oropharyngeal defects, larger resections demand reconstruction with vascularized tissue to minimize morbidity and optimize functional outcomes. The objective of this review is to evaluate recent literature regarding oropharyngeal reconstruction after TORS. RECENT FINDINGS A variety of reconstructive options to manage oropharyngeal defects exist. Several reconstructive algorithms have been suggested; however, careful consideration must be used to select the most ideal flap type. Locoregional flaps have shown excellent functional outcomes with limited morbidity. An increase in free flap reconstruction has been demonstrated, particularly among patients with larger TORS defects and following chemoradiation therapy. Despite limited data, robotic-assisted flap inset and microvascular anastomosis has recently shown promise. SUMMARY Reconstruction and flap selection following TORS should be tailored to the patient and unique oropharyngeal defect. Functional outcomes are promising with low complication rates among these patients.
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Barrette LX, De Ravin E, Carey RM, Mady LJ, Cannady SB, Brody RM. Reconstruction following transoral robotic surgery for head and neck cancer: Systematic review. Head Neck 2022; 44:1246-1254. [PMID: 35137993 DOI: 10.1002/hed.26998] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 01/30/2022] [Accepted: 02/01/2022] [Indexed: 12/17/2022] Open
Abstract
We performed a systematic review to characterize reconstructive modalities and postoperative surgical outcomes following TORS resection. A search of the PubMed, SCOPUS, and EMBASE databases was conducted to identify studies describing patients undergoing reconstruction of TORS defects. Twenty-six studies met inclusion criteria, consisting of 260 patients who underwent TORS resection followed by reconstruction. Twenty-one studies reported tumor classification information, with TORS performed for 44 (23.0%) T1, 86 (45.0%) T2, 33 (17.3%) T3, and 28 (14.7%) T4 tumors. Eighteen distinct reconstructive modalities were described in the studies identified, including nine unique free flap types. The most commonly performed reconstruction was the radial forearm free flap (RFFF), accounting for 121/260 (46.5%) of reconstructions performed. Reported surgical complications included 5 pharyngocutaneous fistulae, 13 hemorrhagic complications, 24 infectious complications, and 5 free flap failures. Our findings demonstrate favorable surgical outcomes but minimal quantitative functional data to compare reconstructive options following TORS.
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Affiliation(s)
- Louis-Xavier Barrette
- Department of Otorhinolaryngology, Head & Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Emma De Ravin
- Department of Otorhinolaryngology, Head & Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Ryan M Carey
- Department of Otorhinolaryngology, Head & Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Leila J Mady
- Department of Otorhinolaryngology, Head & Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Steven B Cannady
- Department of Otorhinolaryngology, Head & Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Robert M Brody
- Department of Otorhinolaryngology, Head & Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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