The inferior trapezius flap (ITF) is useful as a primary means of head and neck reconstruction or as a salvage flap when a previous flap has failed. This report illustrates a neck bypass modification technique which places the pedicle external and lateral to the neck, thereby 1) increasing the flap's reach and 2) decreasing compression from subcutaneous tunneling. It also describes the authors' experience with this technique.

Superficial Back Muscles ; Surgical Flaps

OBJECTIVE: To determine the agreement between Otoacoustic Emission and "Baah" tests for detecting binaural hearing loss in infants referred for hearing evaluation in a local community setting.
METHOD: This is a retrospective review done in a Private Community-based Secondary Specialty Hospital. Bilateral hearing test results of 788 neonates and infants obtained between September 2011 and January 2013 using human voice "BAAH" test and OAE were reviewed from January 2014 to September 2015.
RESULTS: There were 432 males and 356 females (male: female ratio 1.2:1) with a mean age of 11.17 days (range of 0-143 days). Of the 780 infants with bilateral "Pass" using OAE, all were screened as "with response" by "Baah" tests. Five infants with bilateral "refer" results using OAE yielded "no response" on "Baah" test. Sensitivity of 'Baah' test was 100%, specificity was 99.5%, with positive predictive value of 62.5%, and negative predictive value of 100%. There was good agreement noted between OAE and "Baah" (kappa=.77, p<.001).
CONCLUSION: The "Baah" test is a possible alternative to OAE in initially detecting binaural hearing loss in areas where equipment and personnel are limited. Although "Baah" test could only detect 62% of infants with binaural hearing loss and could not detect unilateral hearing loss, infants detected with binaural hearing loss can be immediately referred to centers with more sophisticated equipment.

Hearing Tests ; Hearing Loss, Bilateral