Innovations and Future Directions in Head and Neck Microsurgical Reconstruction

Suchyta, Marissa; Mardini, Samir

doi:10.1016/j.cps.2020.06.009

Cited by 10 publications

(12 citation statements)

References 69 publications

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“…The convergence of different medical fields has led to innovation and advances in the new era of head and neck microsurgical reconstruction. The combination of virtual surgical planning and 3D printing allows hands-on examination and evaluation of surgical techniques, bone transplant placement, aesthetics, and troubleshooting approaches using 3D printed models of a patient-specific craniofacial anatomy or defect [ 59 ]. This was proven helpful in congenital cardiothoracic surgery and is now another unique tool for craniofacial surgeons [ 60 ].…”

Section: Main Textmentioning

confidence: 99%

Nanomedicine and nanoparticle-based delivery systems in plastic and reconstructive surgery

Solidum

Ceriales

Ong

et al. 2023

Maxillofac Plast Reconstr Surg

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Background Nanotechnology and nanomedicine are rising novel fields in plastic and reconstructive surgery (PRS). The use of nanomaterials often goes with regenerative medicine. Due to their nanoscale, these materials stimulate repair at the cellular and molecular levels. Nanomaterials may be placed as components of nanocomposite polymers allowing enhancement of overall biochemical and biomechanical properties with improved scaffold properties, cellular attachment, and tissue regeneration. They may also be formulated as nanoparticle-based delivery systems for controlled release of signal factors or antimicrobials, for example. However, more studies on nanoparticle-based delivery systems still need to be done in this field. Nanomaterials are also used as frameworks for nerves, tendons, and other soft tissues. Main body In this mini-review, we focus on nanoparticle-based delivery systems and nanoparticles targeting cells for response and regeneration in PRS. Specifically, we investigate their roles in various tissue regeneration, skin and wound healing, and infection control. Cell surface-targeted, controlled-release, and inorganic nanoparticle formulations with inherent biological properties have enabled enhanced wound healing, tumor visualization/imaging, tissue viability, and decreased infection, and graft/transplantation rejection through immunosuppression. Conclusions Nanomedicine is also now being applied with electronics, theranostics, and advanced bioengineering technologies. Overall, it is a promising field that can improve patient clinical outcomes in PRS.

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Section: Main Textmentioning

confidence: 99%

Nanomedicine and nanoparticle-based delivery systems in plastic and reconstructive surgery

Solidum

Ceriales

Ong

et al. 2023

Maxillofac Plast Reconstr Surg

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“…54 In addition to the apparent benefits of detailed 3D preoperative surgical planning, higher surgical precision and perioperative time saving is observed. [55][56][57][58] When CAD/CAM is used to produce patient-specific mandibular plates, the precision of the reconstruction is maximized. 59,60 One of the biggest advantages of CAD/CAMaided bony reconstruction is the reduction in flap ischemia time because of the ability to perform osteotomies "in situ" while the pedicle is still intact.…”

Section: Cad/cam Planningmentioning

confidence: 99%

The Iliac Crest Osteomuscular Flap for Bony Reconstruction: Beast or Beauty? A Reassessment of the Value and Donor Site Morbidity in the CAD/CAM Era

Hilven

Vranckx

2021

J Reconstr Microsurg

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Background The iliac crest bone flap (ICBF), based on the deep circumflex iliac artery, has a bad reputation regarding donor site morbidity. However, the ICBF has an ideal curvature and shape for occlusion-based hemimandibular reconstructions with rapid dental rehabilitation and for vertical class III maxillary reconstructions that require bony support and muscular bulk to fill cavities and to provide intraoral lining. Is this notorious donor site reputation still valid with modern flap procurement using computer aided design/computer aided manufacturing (CAD/CAM) and recipient-site closure techniques? Materials and Methods We performed a literature search of the public databases PubMed, Cochrane, Google Scholar, and Web of Science for papers using mesh keywords related to donor site morbidity of the ICBF. We report three illustrative case reports using our current protocols for oncologic bony resection and reconstruction, using in-house CAD/CAM and three-dimensional printing to procure a tight-fit ICBF and minimizing donor site morbidity. Results We found 191 articles in the PubMed database of which we considered 176 nonrelevant. Cochrane Library and Google Scholar database searches resulted in the inclusion of 11 additional papers. The second search resulted in 172 articles of which we used five after excluding nonrelevant papers. Accurate preoperative (CAD/CAM) planning, preservation of the anterior superior iliac spine (ASIS), and paying attention to thoroughly donor site closure make the ICBF a very valuable option for accurate maxillofacial reconstructions with very acceptable comorbidities. This corresponds with our clinical findings. Conclusion Dogma never is a good teacher; it remains elementary that routine “knowledge” is (re)questioned. Donor site morbidity of the ICBF is comparable to other bone flaps. The shape and bone stock of the ICBF is ideal and often may be first choice. In combination with CAD/CAM planning, the ICBF is an excellent option for specific maxillofacial reconstructions.

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“…22 For surgical procedures, fEMG can be used to quantify muscle action after surgical procedures including nerve reconstruction, facial reanimation, or after face transplantations. 23,24…”

Section: Areamentioning

confidence: 99%

Signal-To-Noise Ratio Calculations to Validate Sensor Positioning for Facial Muscle Assessment Using Noninvasive Facial Electromyography

et al. 2021

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The evaluation of neuromodulator treatment outcomes can be performed by noninvasive surface-derived facial electromyography (fEMG) which can detect cumulative muscle fiber activity deep to the skin. The objective of the present study is to identify the most reliable facial locations where the motor unit action potentials (MUAPs) of various facial muscles can be quantified during fEMG measurements. The study population consisted of five males and seven females (31.0 [12.9] years, body mass index of 22.15 [1.6] kg/m2). Facial muscle activity was assessed in several facial regions in each patient for their respective muscle activity utilizing noninvasive surface-derived fEMG. Variables of interest were the average root mean square of three performed muscle contractions (= signal) (µV), mean root mean square between those contraction with the face in a relaxed facial expression (= baseline noise) (µV), and the signal to noise ratio (SNR). A total of 1,709 processed fEMG signals revealed one specific reliable location in each investigated region based on each muscle's anatomy, on the highest value of the SNR, on the lowest value for the baseline noise, and on the practicability to position the sensor while performing a facial expression. The results of this exploratory study may help guiding future researchers and practitioners in designing study protocols and measuring individual facial MUAP when utilizing fEMG. The locations presented herein were selected based on the measured parameters (SNR, signal, baseline noise) and on the practicability and reproducibility of sensor placement.

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Innovations and Future Directions in Head and Neck Microsurgical Reconstruction

Cited by 10 publications

References 69 publications

Nanomedicine and nanoparticle-based delivery systems in plastic and reconstructive surgery

Nanomedicine and nanoparticle-based delivery systems in plastic and reconstructive surgery

The Iliac Crest Osteomuscular Flap for Bony Reconstruction: Beast or Beauty? A Reassessment of the Value and Donor Site Morbidity in the CAD/CAM Era

Signal-To-Noise Ratio Calculations to Validate Sensor Positioning for Facial Muscle Assessment Using Noninvasive Facial Electromyography

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