Objective:To investigate the clinical efficacy and safety of transcervical non-inflatable endoscopic thyroidectomy through the posterior inferior sternocleidomastoid approach. Methods:From December 2022 to May 2023, the clinical data of 35 patients with papillary thyroid carcinoma treated by transcervical non-inflatable endoscopic surgery via posterior inferior sternocleidomastoid approach were retrospectively analyzed. There were 14 males and 21 females, with an average age of 44.7 years. The operation time, bleeding volume, postoperative recovery, complications and follow-up were recorded. Results:All 35 patients successfully completed the surgery, with an average operation time of 4 hours and 7 minutes, an average bleeding volume of 14 ml, and an average postoperative hospital stay of 3.5 days. There were no serious complications and no obvious neck discomfort during postoperative follow-up. Conclusion:Transcervical non-inflatable endoscopic thyroidectomy via posterior inferior sternocleidomastoid approach is safe and effective, with fast postoperative recovery,high appearance satisfaction and good neck comfort.
Female ; Male ; Humans ; Adult ; Retrospective Studies ; Neck ; Neck Muscles/surgery* ; Thyroid Neoplasms/surgery*

OBJECTIVEThis study aimed to explore the main features and advantages of the muscle pedicled platysma myocutaneous flap (PMF), the degree of improvement of flap harvest. To evaluate the application value of the flap in the reconstruction of buccal mucosa carcinoma defects.

METHODSTwenty-three patients received PMF with MacFee incision to reconstruct buccal mucosa defects that were caused by the resection of precancer lesions and benign and malignant tumors from August 2012 to April 2015. When elevating the cervical skin from the platysma, most of the subcutaneous tissue was preserved on the muscle. The continuity of the facial vessels was retained. The external jugular vein was preserved on the reverse side of the platysma.

RESULTSTwenty-one flaps survived completely, whereas the other two flaps presented partial skin loss. Two patients showed disturbed wound healing in the neck. Secondary healing was achieved after attentive wound care. All patients were followed up from 11 to 43 months. The function of the recipient sites recovered well. Except for the two patients with large-area scarring in the neck, the remaining cases presented satisfactory neck contours. No relapses were observed during the follow-up period.

CONCLUSIONSCompared with the traditional PMF, the muscle pedicled PMF provides a larger skin paddle and presents a better aesthetic and functional effect. Thus, this approach is a novel and ideal option for the restoration of buccal mucosa defects.

Face ; Humans ; Mouth Mucosa ; Mouth Neoplasms ; surgery ; Myocutaneous Flap ; Neck ; Neck Muscles ; Neoplasm Recurrence, Local ; Postoperative Complications ; Reconstructive Surgical Procedures ; Surgical Flaps

BACKGROUND AND OBJECTIVES: The reconstruction of surgical defects in head and neck cancer patients requires thorough anatomical knowledge and considerable clinical experiences, hence it is a demanding job for un-experienced reconstructive surgeons. We evaluated the appropriateness and the surgical outcome of a one-year experience of head and neck reconstruction carried out in a tertiary hospital setting. SUBJECTS AND METHOD: We performed a retrospective review of the medical records of 73 patients who underwent reconstructive surgery at the Otolaryngology Department and Plastic Surgery from January, 2012 to September, 2016. RESULTS: Twenty-eight of 42 patients underwent free-flap reconstruction, including anterolateral thigh, radial forearm, or fibula free-flap by a head and neck surgeon. The rest of the patients underwent pedicled-flap surgery including pectoralis major or latissimus dorsi myocutanous flap. The mean operation time was 209.5 minutes and an average of 1.2 days intensive care unit- and 37.2 days of hospital stay were required in the free-flap cases. The flap failure happened in three patients, two in free-flap and one in pedicled flap. These surgical outcomes were comparable to those of the plastic surgery patient group. CONCLUSION: The technical appropriacy and acceptable outcome of head and neck reconstruction by head and neck surgeons was proven in this investigation. We propose that reconstructive surgery should be performed by head and neck surgeons as they could reduce operation time or complications because of their familiarity with complex surgical anatomy and early decision making competency.
Critical Care ; Decision Making ; Fibula ; Forearm ; Head and Neck Neoplasms ; Head* ; Humans ; Length of Stay ; Medical Records ; Methods ; Neck* ; Otolaryngology ; Recognition (Psychology) ; Retrospective Studies ; Superficial Back Muscles ; Surgeons ; Surgery, Plastic ; Surgical Flaps ; Tertiary Care Centers ; Thigh

Adult ; Female ; Humans ; Laparoscopy ; methods ; Male ; Muscular Diseases ; surgery ; Neck Muscles ; surgery ; Syndrome

PURPOSE: There have been a few previous reports regarding the distances between the medial borders of the longus colli to expose the disc space. However, to our knowledge, there are no reports concerning longus colli dissection to expose the uncinate processes. This study was undertaken to assess the surgical relationship between the longus colli muscle and the uncinate process in the cervical spine. MATERIALS AND METHODS: This study included 120 Korean patients randomly selected from 333 who had cervical spine MRIs and CTs from January 2003 to October 2013. They consisted of 60 males and 60 females. Each group was subdivided into six groups by age from 20 to 70 years or more. We measured three parameters on MRIs from C3 to T1: left and right longus colli distance and inter-longus colli distance. We also measured three parameters on CT: left and right uncinate distance and inter-uncinate distance. RESULTS: The longus colli distances, uncinate distances, and inter-uncinate distances increased from C3 to T1. The inter-longus colli distances increased from C3 to C7. There was no difference in longus colli distances and uncinate distances between males and females. There was no difference in the six parameters for the different age groups. CONCLUSION: Although approximate guidelines, we recommend the longus colli be dissected approximately 5 mm at C3-5, 6 mm at C5-6, 7 mm at C6-7, and 8 mm at C7-T1 to expose the uncinate process to its lateral edge.
Adult ; Aged ; Cervical Vertebrae/*anatomy & histology/diagnostic imaging/*surgery ; Dissection ; Female ; Humans ; Male ; Middle Aged ; Neck Muscles/*anatomy & histology/diagnostic imaging/*surgery ; Random Allocation ; Young Adult

OBJECTIVE: The purpose of this study was to clarify the pathogenesis of plunging ranulas in regard of the pathway of lesion propagation using CT scans. MATERIALS AND METHODS: We retrospectively reviewed CT scans of 41 patients with plunging ranula. We divided plunging ranulas into two types: type 1 was defined as those directly passing through a defect of the mylohyoid muscle with the presence (type 1A) or absence (type 1B) of the tail sign and type 2 as those through the traditional posterior route along the free edge of the mylohyoid muscle. Images were also analyzed for the extent of the lesion in respect to the spaces involved. As for type 1 lesions, we recorded the location of the defect of the mylohyoid muscle and the position of the sublingual gland in relation to the defect. RESULTS: CT scans demonstrated type 1 lesion in 36 (88%), including type 1A in 14 and type 1B in 22, and type 2 lesion in 5 (12%). Irrespective of the type, the submandibular space was seen to be involved in all cases either alone or in combination with one or more adjacent spaces. Of the 36 patients with type 1 lesions, the anterior one-third was the most common location of the defect of the mylohyoid muscle, seen in 22 patients. The sublingual gland partially herniated in 30 patients. CONCLUSION: Our results suggest that the majority of plunging ranulas take an anterior shortcut through a defect of the mylohyoid muscle.
Adolescent ; Adult ; Aged ; Biopsy, Fine-Needle ; Child ; Child, Preschool ; Female ; Humans ; Male ; Middle Aged ; Neck Muscles/pathology/radiography ; Ranula/pathology/*radiography ; Retrospective Studies ; Sublingual Gland/radiography/surgery ; *Tomography, X-Ray Computed ; Young Adult

OBJECTIVETo explore the clinical effects of ipsilateral lower trapezius myocutaneous flap for repairing cervical ulcer as a result of radiotherapy after radical mastectomy.

METHODSSix patients with cervical ulcers as a result of radiotherapy after radical mastectomy were hospitalized from March 2010 to February 2015, suffering from persistent pain in different degrees. The wound area ranged from 6 cm × 4 cm to 10 cm × 6 cm before debridement, 8 cm × 5 cm to 16 cm × 10 cm after debridement. Ipsilateral lower trapezius myocutaneous flap was used to repair the wound after thorough debridement, with the area ranging from 10 cm × 7 cm to 20 cm × 13 cm. The donor sites were sutured directly or covered with medium-thickness skin graft obtained from the back.

RESULTSPain was obviously relieved in all the patients 2 days after surgery. The wounds in five patients were healed, while necrosis of superficial skin approximately 1 cm in diameter appeared at the distal end of one myocutaneous flap, and it healed after dressing change. During the follow-up period of 3 to 18 months, no recurrence of ulcer was found, the texture of the myocutaneous flaps was soft with good appearance, and the donor sites healed well.

CONCLUSIONSOn the basis of thorough debridement, it is feasible to repair the cervical ulcer as a result of radiotherapy after radical mastectomy with the ipsilateral lower trapezius myocutaneous flap.

Breast Neoplasms ; radiotherapy ; surgery ; Debridement ; Humans ; Mastectomy, Radical ; methods ; Myocutaneous Flap ; Neck Injuries ; surgery ; Necrosis ; Pressure Ulcer ; surgery ; Reconstructive Surgical Procedures ; methods ; Skin ; Skin Transplantation ; Superficial Back Muscles ; Surgical Flaps ; blood supply ; Wound Healing

OBJECTIVETo investigate a new endoscopic transaxillary technique for release of the sternocleidomastoid (SCM) in congenital muscular torticollis (CMT).

METHODSFrom May 2008 to March 2014, a total of 25 cases (male 7 and female 18), ranging in age from 14 to 31 years (mean age, 17.6 years), were operated for torticollis by endoscopic-assisted surgery. The sternal and clavicular attachments of the sternocleidomastoid were released by skin lift approach.

RESULTSThe primary healing was achieved in all the 25 cases with no injury of major vessels or nerves. The patients were followed up for 6 months with satisfactory result and invisible scar.

CONCLUSIONSThe subcutaneous endoscopic transaxillary and skin lift approach for the CMT provides good functional and cosmetic outcomes.

Adolescent ; Adult ; Axilla ; Cicatrix ; Clavicle ; Endoscopy ; methods ; Female ; Humans ; Male ; Neck Muscles ; surgery ; Torticollis ; congenital ; surgery ; Treatment Outcome ; Young Adult

OBJECTIVETo investigate the clinical application of expanded flap based on cutaneous branch of transverse cervical artery for reconstruction of cervical cicatricial contracture.

METHODSBased on the clinical anatomy of cutaneous branch of transverse cervical artery flap, we design the corresponding subclavicular area for expansion. The incision was usually located at the anterior axillary fold, 5-8 cm in length. The expander was implanted under the deep fascial layer, without injury of the vascular pedicle. Fixation sutures were put about 1 cm apart from the incision to prevent the expander from transposition and exposure. After expansion, the cervical cicatricial contracture was excised and released. According to the defect, the expanded flap based on the cutaneous branch of transverse cervical artery was designed, with the pedicle located at the posterior margin of sternocleidomastoid and 1. 8 cm above median point of clavicle. "S" shape incision was made at the location of vascular pedicle. Subcutaneous dissection was performed 1.5 cm in width along the incision on both sides. Then the flap was harvested under the deep fascial layer and rotated to cover defect without tension. It was not necessary to dissect the vascular pedicle further. The defect at donor site was closed directly.

RESULTS17 cases were treated with the island flap. The contracture of the cervical scar was corrected completely with aesthetic appearance.

CONCLUSIONSExpanded flap based on cutaneous branch of transverse cervical artery has reliable blood supply. It' s an ideal flap for the treatment of cervical cicatricial contracture.

Arteries ; Cicatrix ; surgery ; Clavicle ; Contracture ; surgery ; Dissection ; methods ; Fasciotomy ; Humans ; Neck ; blood supply ; Neck Muscles ; anatomy & histology ; Surgical Flaps ; blood supply

OBJECTIVE: To investigate the feasibility of utilizing pedicled sternocleidomastoid clavicular periosteocutaneous flap to reconstruct the laryngotracheal defect after tumor resection. METHOD: To review 6 cases of laryngotracheal defect resulting from resction of thyroid papillary carcinoma(4/6) or subglottic laryngeal carcinoma (2/6) (T1~2N1~2M0 , UICC,2002), laryngotracheal stenting was also employed in all cases. Half a year after surgery, the stoma was sutured if no local recurrence took place and safety was proved after tracheal tube had been obstructed for days. The follow-up time lasted from half a year to 3 years. RESULT: Four cases (4/6) were extubated successfully without event, one case could intermittently plug the tracheal tube. One patient couldn't breath with tracheal tube plugging. CONCLUSION To reconstruct the laryngotracheal defect with pedicled sternocleidomastoid clavicular.periosteocutaneous flap after tumor resection is feasible in selected cases and could get satisfactory clinical results either in respiration or phonation.
Back ; Carcinoma ; surgery ; Carcinoma, Papillary ; Carcinoma, Squamous Cell ; Clavicle ; Head and Neck Neoplasms ; Humans ; Laryngeal Neoplasms ; surgery ; Larynx ; Neck Muscles ; Neoplasm Recurrence, Local ; Reconstructive Surgical Procedures ; Squamous Cell Carcinoma of Head and Neck ; Stents ; Surgical Flaps ; Thyroid Cancer, Papillary ; Thyroid Neoplasms ; surgery