Locoregional recurrence following maxillectomy: implications for microvascular reconstruction

Likhterov, Ilya; Fritz, Michael A.; El‐Sayed, Ivan H.; Seth, Rahul; Rayess, Hani; Knott, P. Daniel

doi:10.1002/lary.26620

Cited by 9 publications

(7 citation statements)

References 13 publications

(30 reference statements)

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“…Over half of these patients achieved successful prosthodontic rehabilitation. Others have reported similar rates of success in their experience using local and free tissue transfer, with the overall conclusion that surgical reconstruction of palatomaxillary defects is a reliable and reproducible treatment option for patients who are appropriately selected based on a combination of factors including age, biology of disease, motivation, and overall health …”

Section: Introductionmentioning

confidence: 87%

Reconstructive and prosthodontic outcomes after multiple palatomaxillary reconstructions

et al. 2019

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Objective A subset of patients who undergo major palatomaxillary reconstruction do not initially achieve their intended oncologic and/or reconstructive goals and require additional surgery. We aim to detail the unique management considerations in this patient population. Methods We performed a retrospective review of patients who underwent palatomaxillary reconstruction by the senior author (m.l.u.) between 1998 and 2016. Results Twenty‐one patients required multiple reconstructions. The median time to second reconstruction was 17 months. The most common reason for a second reconstruction was for recurrent disease (10 of 21), followed by functional/aesthetic reasons (7 of 21) and osteoradionecrosis (4 of 21). Four patients went on to have a third reconstruction, and two underwent a fourth. A total of 27 reconstructions were performed, consisting of 20 soft tissue free flaps, four vascularized bone free flaps, and three locoregional flaps. Conclusion This patient cohort represents unique oncologic and reconstructive challenges. With long‐term follow‐up, multiple reconstructions may be required to optimize oncologic and functional/aesthetic outcomes. This is the first series of its kind that details the reasons for, as well as the outcomes of, patients who required multiple reconstructive procedures following initial palatomaxillary reconstruction. Level of Evidence 2B Laryngoscope, 130:2349–2353, 2020

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Section: Introductionmentioning

confidence: 87%

Reconstructive and prosthodontic outcomes after multiple palatomaxillary reconstructions

et al. 2019

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“…In these cases, a zygomatic implant to hold the obturator or immediate microvascular reconstruction may a better option for very large defects. 29,30 In both maxillary and ethmoid malignancies, orbital exenteration may be required, although the degree of infiltration that necessitates removal is controversial. Although attaining negative margins is very important for local control and survival, limited involvement of orbital structures does not require radical surgery, as in the cases of medial or inferior wall involvement, or adherence to one side of the periorbita.…”

Section: Maxillary Sinus Tumorsmentioning

confidence: 99%

AHNS Series: Do you know your guidelines? Principles for treatment of cancer of the paranasal sinuses: A review of the National Comprehensive Cancer Network guidelines

2018

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This article is a continuation of the "Do You Know Your Guidelines" series. This was launched as an initiative of the American Head and Neck Society to increase the awareness of current best practices pertaining to head and neck cancer. The National Comprehensive Cancer Network (NCCN) guidelines for managing cancer of the paranasal sinuses are reviewed in a systematic fashion. These guidelines outline the workup, treatment, and surveillance of patients with cancer of the maxillary and ethmoid sinuses.

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“…1,3,4 In addition, multiple clinical, radiological, and histopathological factors have been directly and indirectly associated with survival in oral cavity cancer. 1,4,[7][8][9] Currently, the classification of malignant tumors (TNM) system is the preferred method of tumor staging and is mainly based on anatomical tumor characteristics. 6 For MSCC specifically thus far, these factors include posterosuperior tumor extension, perineural invasion, vasoinvasive growth, positive surgical margins, and postoperative large midfacial defects.…”

Section: Introductionmentioning

confidence: 99%

“…6 For MSCC specifically thus far, these factors include posterosuperior tumor extension, perineural invasion, vasoinvasive growth, positive surgical margins, and postoperative large midfacial defects. 1,4,[7][8][9] Currently, the classification of malignant tumors (TNM) system is the preferred method of tumor staging and is mainly based on anatomical tumor characteristics. 10 However, more outcome predictors have been identified over the years and prognostic shortcomings of the TNM classification have become more apparent.…”

Section: Introductionmentioning

confidence: 99%

Predicting individualized mortality probabilities for patients with squamous cell carcinoma of the maxilla: Novel models with clinical and histopathological predictors

2019

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Background The aim of this article was to develop prediction models that calculate postoperative 2‐ and 5‐year mortality probabilities of patients with squamous cell carcinoma of the maxilla (MSCC). Methods Data were collected from the medical records of patients who had been operated between 2000 and 2015 for MSCC. Potential clinical and histopathological predictors were identified. Confounding‐(un)adjusted multivariate Cox and logistic regression models were computed with stepwise backward selection. Internal validation was performed to assess calibration and discriminatory ability. Results Ninety‐five patients with MSCC were included. Two‐year follow‐up was complete, and 85 patients had 5‐year follow‐up. Age, neck treatment, surgical margins, bone invasion, spindle growth, and vasoinvasive growth were associated with mortality. Models were adjusted for confounding with Charlson's comorbidities index. C‐indexes were .841 and .770 respectively, and .838 and .749 after bootstrapping. Conclusion The MSCC‐specific mortality probability can be calculated with new prediction models.

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Locoregional recurrence following maxillectomy: implications for microvascular reconstruction

Abstract: 4. Laryngoscope, 127:2534-2538, 2017.

Cited by 9 publications

References 13 publications

Reconstructive and prosthodontic outcomes after multiple palatomaxillary reconstructions

Reconstructive and prosthodontic outcomes after multiple palatomaxillary reconstructions

AHNS Series: Do you know your guidelines? Principles for treatment of cancer of the paranasal sinuses: A review of the National Comprehensive Cancer Network guidelines

Predicting individualized mortality probabilities for patients with squamous cell carcinoma of the maxilla: Novel models with clinical and histopathological predictors

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