The British journal of oral & maxillofacial surgery
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Br J Oral Maxillofac Surg · Dec 2013
Case ReportsClinical anatomical study and evaluation of the use of the free anteromedial thigh perforator flaps in reconstructions of the head and neck.
The anteromedial thigh (AMT) perforator flap is usually thin, pliable, and nearly hairless, making it particularly suitable to repair defects of the head and neck. We studied the topography and outcomes of AMT perforator flaps in such defects after excision of tumours. We retrospectively reviewed the casenotes of 11 consecutive patients who had had reconstructions of the head and neck with the initial intent of using an AMT perforator flap from January 2010 to July 2011. ⋯ All flaps survived with good functional and aesthetic outcomes. The free AMT perforator flap is suitable for reconstructions of the head and neck if a sizeable perforator can be found. The AMT flap may be used as a primary flap rather than as an alternative to the anterolateral thigh flap or a component of a chimeric flap.
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Br J Oral Maxillofac Surg · Dec 2013
Six-year retrospective study of reconstructive options for defects of the skull base after resection of tumour.
The successful management of tumours that involve the skull base depends on resection and reconstruction of the defect. The challenge is to create a protective vascularised seal between the intracranial contents and the adjacent paranasal sinuses, nasopharynx, and oral cavity. Failure to create a protective barrier for the intracranial contents can result in cerebrospinal fistulas, potentially fatal infections, and radiotherapy being delayed. ⋯ Ninety-two percent of the free flaps were successful. We also report details on disease, complications, and survival at 3, 6, and 12 months. Survival depended not only on the type of disease, coexisting conditions, and adequate resection of tumour, but equally on the reconstruction of the defect.
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Br J Oral Maxillofac Surg · Dec 2013
Comparative StudyCharacterisation of explosive fragments injuring the neck.
Penetrating explosive fragments are the most common cause of neck injuries sustained by UK service personnel deployed to Afghanistan. Analysis of these fragments will enable future ballistic protective materials to be tested with appropriate projectiles. However, only a small number of fragments excised from the neck have been available for analysis and they are potentially unrepresentative. ⋯ A fragment-simulating projectile of 0.49 g represented 85% of fragments retained in the neck. CT can accurately delineate the shape and mass of fragments, which increases the number from which the most appropriate simulated projectile can be designed. We think that this methodology should be applied to fragments retained in other parts of the body to enable broader recommendations to be made regarding the testing of ballistic materials used to protect service personnel.