JAMA otolaryngology-- head & neck surgery
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JAMA Otolaryngol Head Neck Surg · Mar 2013
Comparative StudyComparison of fibular and scapular osseous free flaps for oromandibular reconstruction: a patient-centered approach to flap selection.
Provides an approach to osseous free flap selection for reconstruction of segmental mandible defects that takes into consideration general medical status of the patient and reconstruction requirements; demonstrates the complementary qualities of fibular and subscapular system free flaps; and describes the different surgical indications for lateral border scapular and scapular tip free flaps. ⋯ The FFFs and subscapular flaps are complementary options for oromandibular reconstruction. The FFF is ideal for younger patients, extended defects, multiple osteotomies, and limited soft-tissue requirements. The subscapular system free flaps (LSBF and STFF) are excellent options for (1) elderly patients; (2) those with significant comorbidities, such as peripheral vascular disease; and (3) mandible defects associated with complex soft-tissue requirements. Furthermore, the STFF offers a reliable option to reconstruct short-segment defects, in particular, defects involving the angle of the mandible.
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JAMA Otolaryngol Head Neck Surg · Mar 2013
Posttonsillectomy hemorrhage in children with von Willebrand disease or hemophilia.
It is uncertain whether children with bleeding disorders are at higher risk of posttonsillectomy hemorrhage compared with the general pediatric population. ⋯ The frequency of immediate posttonsillectomy hemorrhage in children with VWD or hemophilia is similar to rates in the general healthy population. However, among children with VWD or hemophilia, the rate of delayed hemorrhage is substantially higher, especially in older children.