Spector ME

[OBJECTIVE] To improve understanding of the postoperative care challenges of patients with head and neck cancer and to help address these care needs before surgery. [STUDY DESIGN] Qualitative study with intervention development and process…

[OBJECTIVES] Salivary fistula is a known complication following head and neck free flap reconstruction involving the aerodigestive tract. We sought to examine the association between surgical drain fluid amylase and salivary fistula formati…

[BACKGROUND] Minimal donor site morbidity is often cited as one of the main advantages of the medial sural artery perforator (MSAP) free flap; however, few studies have examined functional outcomes. [METHODS] This retrospective cohort stud…

[PURPOSE OF REVIEW] We briefly review the history of surgical innovation in free flap reconstruction of the head and neck. With a specific focus on maximizing patient QoL by prioritizing a 'precision reconstruction', we then posit novel ave…

[PURPOSE OF REVIEW] Two-team approaches to head and neck cancer ablation and free flap reconstruction now occur concurrently in most centers. While the functional outcomes after head and neck ablation and reconstruction are typically examin…

[BACKGROUND] Many options for free tissue transfer have been described for head and neck reconstruction. Although functional outcomes remain paramount, aesthetic considerations such as color match can be equally consequential for patient qu…

[BACKGROUND] Osseous and osteocutaneous fibular free flaps are the workhorse of maxillomandibular reconstruction over 30 years after the initial description. Since 2019, we have routinely used the Spider Limb Positioner, adapted from its us…

[OBJECTIVE] Traditional hospital accounting fails to provide an accurate cost of complex surgical care. Here we describe the application of time-driven activity-based costing (TDABC) to characterize costs of head and neck oncologic procedur…

[OBJECTIVE] Anterior 2/3rds glossectomy results in significant patient morbidity due to speech and swallowing impairment. Microvascular free flap reconstruction compensates for large volume defects. Flap volume is based on the adipose conte…

[OBJECTIVE] Malnutrition is an important risk factor for patient surgical outcomes. This is especially true for head and neck cancer (HNC) patients receiving a total laryngectomy with free flap reconstruction (TLwFFR). Preoperative prealbum…

Microvascular free flap surgery permits single-stage reconstruction of complex head and neck ablative defects. Venous congestion can occur in the early postoperative period, risking partial or total flap loss. While prompt surgical re-explo…

[OBJECTIVE] To assess our institution's experience with botulinum toxin A injection management of pharyngoesophageal (PE) segment dysfunction after laryngectomy in tracheoesophageal voice and swallowing restoration [STUDY DESIGN] A retrosp…

[BACKGROUND] We examined the effect of free tissue neurotization on speech and swallowing outcomes for patients undergoing reconstruction of hemiglossectomy defects with a radial forearm free flap (RFFF). [METHODS] A retrospective study wa…

[IMPORTANCE] Because microvascular free flap reconstruction is increasingly used to restore function in patients with head and neck cancer, there is a growing need for evidence-based perioperative care. [OBJECTIVE] To assess the associatio…

Free tissue transfer from the subscapular system provides a wide array of options for both soft tissue and bony reconstruction. When bone stock is required for head and neck reconstruction, both the lateral scapular border free flap (LSBFF)…

[BACKGROUND AND PURPOSE] Free flap reconstruction in patients with head and neck cancer carries a risk of postoperative complications, and radiologic predictive factors have been limited. The aim of this study was to assess the factors that…

[AIM] To describe a novel technique for the reconstruction of geometrically complex defects of the midface using an osteotomized folded scapular tip-free flap. [METHODS] Five patients underwent maxillectomy with defects disrupting two or m…

[PURPOSE:] Salvage surgical treatment of oropharyngeal cancer is associated with significant morbidity. We aim to identify predictive factors of functional outcomes to improve patient selection and counseling when contemplating salvage orop…

[OBJECTIVE] Three-dimensional (3D) computational modeling represents an invaluable surgical tool for complex reconstructive cases. There exists limited data on 3D imaging to evaluate the use of the scapular tip free flap in complex, anterol…