1/12. Repair of the pharyngocutaneous fistula with a fasciocutaneous island flap pedicled on the superficial temporalis artery.The case of an 84-year-old man with a pharyngocutaneous fistula after radiotherapeutic treatment and total laryngectomy for a squamous cell carcinoma was reported. Treatment with local flaps failed and normal flaps were not likely to succeed because of general and locally poor conditions considering that intensive radiotherapy had been administered. We therefore decided to use a fasciocutaneous island flap from the temporoparietal region pedicled on the parietal branch of the superficial temporalis artery. We obtained efficient and stable repair of the lesion both from a cosmetic and a functional point of view. We were forced to use this procedure for lack of another choice; however, we think that this could become a useful option in covering substance loss in this area when simpler solutions are not available.- - - - - - - - - - ranking = 1keywords = island (Clic here for more details about this article) |
2/12. Repair of a pharyngo-cutaneous fistula.A method for closure of a midline pharyngo-cutaneous fistula by providing lining from an epidermal island on a cervical skin flap and outer cover from a split skin graft has been described. It can be useful in selected cases.- - - - - - - - - - ranking = 0.2keywords = island (Clic here for more details about this article) |
3/12. Repair of pharyngocutaneous fistulas with the submental artery island flap.Pharyngocutaneous fistulas after total laryngectomy are difficult to manage and are a cause for significant morbidity to the patient. When fistulas fail to close with conservative measures, debridement and flap closure are indicated. Although a number of techniques to repair pharyngocutaneous fistulas are described, each of these procedures has its drawbacks. The authors have used the submental island flap to close postoperative pharyngocutaneous fistulas in nine male patients during the past 4 years. The mean patient age was 65 years (range, 57 to 75 years). The submental island flap is based on the submental artery, a branch of the facial artery. The inner aspect of the fistula was initially formed using hinge flaps on the skin around the fistula. Once a watertight closure of inner side was created, the skin defect was closed with the submental island flap. The maximum flap size was 6 x 3 cm and the minimum size was 4 x 2 cm (average, 4.8 x 2.7 cm) in this series. Direct closure was achieved at all donor sites. patients were followed for 6 months to 4 years. No major complication was noted in the postoperative period. All patients have successfully recovered their swallowing function. The submental island flap is safe, rapid, and simple to elevate and leaves minimal donor-site morbidity. The authors believe that this technique is a good alternative in the reconstruction of pharyngocutaneous fistulas. Application of the technique and results are discussed.- - - - - - - - - - ranking = 1.6keywords = island (Clic here for more details about this article) |
4/12. Nasolabial myocutaneous island flap for reconstruction of palatal fistula (a case report).With better understanding of microcirculation of the flaps and with the introduction of the concept of myocutaneous flaps, nasolabial flap has regained its past popularity. Although it has been used increasingly for oral defects, its use for reconstruction of palatal defects has not been reported. Large anterior fistulae of palate are commonly produced when a wide cleft of palate is being repaired in an adult patient, especially by a beginner in plastic surgery, and are difficult to treat surgically. We have used superiorly based nasolabial myocutaneous island flap in one such case and report it here.- - - - - - - - - - ranking = 1keywords = island (Clic here for more details about this article) |
5/12. A new approach for repair of oro-antral-nasal fistulae. The anteriorly based buccinator myomucosal island flap.Oral-antral-nasal fistula (OAN) is a commonly encountered clinical problem. The literature is filled with a plethora of methods described for closing a persistent OAN. Local flaps are available to close minor to moderate defects, however, large fistulae can be a very challenging reconstructive problem. Various areas of the oral cavity have been used for closure of OAN. We describe a technique to reconstruct the oral cavity, in this case an OAN. The anteriorly based buccinator myomuosal island pedicle flap (BMIP) provides an alternative method for reconstructing the oral cavity. An extensive review of the literature as well as the anatomy of the buccinator, its reconstructive capabilities, and two case reports are included.- - - - - - - - - - ranking = 1keywords = island (Clic here for more details about this article) |
6/12. Repair of oronasal fistula with mucoperiosteal island flap: report of case.This is a report of a little-known technique of closing an oral nasal fistula and an unusual case of anosmia which resolved after the palatal closure.- - - - - - - - - - ranking = 0.8keywords = island (Clic here for more details about this article) |
7/12. The repair of large oral fistulae.Reports of three cases of large oral fistula following tumour excision are presented. The repairs utilized deltopectoral, forehead, and scalp flaps. Technical points discussed include the de-epithelialization of folded flaps, the preservation of vermilion, the placement of immediate fascial slings and the use of island flaps.- - - - - - - - - - ranking = 0.2keywords = island (Clic here for more details about this article) |
8/12. Management of recalcitrant bronchopleural fistulas with muscle flap obliteration.Use of muscle flap obliteration for bronchopleural fistulas appears to be indicated with (1) failure of a previous thoracoplasty, (2) anticipated failure of a thoracoplasty alone, and (3) the need to obviate a formal debilitating thoracoplasty. With the use of well-vascularized muscle flaps to fully obliterate the densely scarred cavities associated with persistent bronchopleural fistulas, we may hope to see improved healing in the bronchial stump and, in cases of residual infection, better resistance of the flap to necrosis, as well as improved delivery of chemotherapeutic agents to the local tissues. These factors may confer improved cure rates for bronchopleural fistulas similar to those seen in lower extremity salvage surgery for osteomyelitis following the introduction of vascularized pedicle and free muscle flaps. In this article we have described the versatility of the island pedicle latissimus dorsi muscle flap for closure of recalcitrant bronchopleural fistulas and associated empyema cavities. Utilizing either the dominant thoracodorsal or the minor paraspinal pedicle(s), it can reach any intrathoracic cavity by means of the appropriate thoracotomy incision.- - - - - - - - - - ranking = 0.2keywords = island (Clic here for more details about this article) |
9/12. Repair of nasal fistula secondary to radiation therapy for Eales's disease.Eales's disease is characterized by neovascularization and idiopathic retinal and vitreous hemorrhages. Therapy in the past included the use of radiation. A case is reported of a patient who received a dose of 15,000 roentgens (approximately 14,250 rad) to the right eye via temporal and nasal portals. He subsequently lost vision in that eye. Thirty years after the radiation was administered, a nasocutaneous fistula developed, and it was closed with a forehead island flap.- - - - - - - - - - ranking = 0.2keywords = island (Clic here for more details about this article) |
10/12. ear reconstruction with chondrocutaneous postauricular island flap.skin and cartilage defects from the conchal cavity to the external auditory canal were reconstructed with the use of a chondrocutaneous postauricular island flap. Although based on the experience of only one case, the authors believe that this island flap is extremely useful in the repair of skin and cartilage defects of the conchal cavity and the external auditory canal.- - - - - - - - - - ranking = 1.2keywords = island (Clic here for more details about this article) |
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