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Clinical Advances in Head and Neck Plastic, Reconstructive and Aesthetic...
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Clinical Advances in Head and Neck Plastic, Reconstructive and Aesthetic Surgery

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Otolaryngology".

Deadline for manuscript submissions: closed (20 January 2023) | Viewed by 10371

Special Issue Editors

Prof. Dr. Giacomo De Riu

E-Mail Website
Guest Editor
Maxillofacial Surgery Unit, University Hospital of Sassari, 07100 Sassari, Italy
Interests: maxillofacial surgery; oral oncology; reconstructive surgery; plastic surgery; aesthetic surgery
Dr. Luigi Angelo Vaira

E-Mail Website
Guest Editor
1. Maxillofacial Surgery Operative Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari, Italy
2. Biomedical Science Department, PhD School of Biomedical Science, University of Sassari, 07100 Sassari, Italy
Interests: oral and maxillofacial surgery; plastic surgery; otolaryngology
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Head and neck reconstructive surgery represents a difficult challenge. Tumors, trauma, or other pathologies that cause mutilation of facial structures, even if small in size, can cause a significant reduction in the quality of life of patients. For this reason, reconstructive, plastic, and aesthetic surgery of the face is a discipline in continuous evolution. The purpose of this Special Issue is to collect articles focusing on recent advancements in both aesthetic and reconstructive surgery as well as treatment approaches trying to improve aesthetic and functional outcomes after reconstruction. A special section will be reserved for reconstructions of the oral cavity and oropharynx with particular attention to evaluating the functional outcomes of the surgical techniques.

Prof. Dr. Giacomo De Riu
Dr. Luigi Angelo Vaira
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • reconstructive surgery
  • plastic surgery
  • aesthetic surgery
  • head and neck
  • oral cavity
  • facial reconstruction
  • cosmetic surgery

Published Papers (4 papers)

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Research

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10 pages, 1777 KiB  
Article
Electrocautery, Harmonic, and Thunderbeat Instruments in Parotid Surgery: A Retrospective Comparative Study
by Luigi Angelo Vaira, Davide Rizzo, Claudia Murrocu, Caterina Francesca Zullo, Margherita Dessy, Luca Mureddu, Enrica Ligas, Giovanni Salzano, Andrea Biglio, Miguel Mayo-Yáñez, Jerome R. Lechien, Pasquale Piombino, Francesco Bussu and Giacomo De Riu
J. Clin. Med. 2022, 11(24), 7414; https://doi.org/10.3390/jcm11247414 - 14 Dec 2022
Viewed by 2152
Abstract
The aim of this retrospective study has been to compare the surgical outcomes of patients undergoing superficial parotidectomy with three different instruments: bipolar electrocautery, ultrasound, and mixed energy instruments. The clinical records of 102 patients who had undergone superficial parotidectomy for benign tumors [...] Read more.
The aim of this retrospective study has been to compare the surgical outcomes of patients undergoing superficial parotidectomy with three different instruments: bipolar electrocautery, ultrasound, and mixed energy instruments. The clinical records of 102 patients who had undergone superficial parotidectomy for benign tumors between January 2016 and April 2022 were considered. Based on the tool used during the surgery, the patients were divided into three study groups: classic electrocautery hemostasis group (CH group), ultrasonic instrument group (HA group), and combined energy instrument group (TB group). The duration of surgery, the total post-operative drainage volume, and the intra-operative blood loss were significantly higher in the CH group compared to the HA and the TB group, while the differences were not significant between the latter two groups. Facial nerve weakness was detected in 45.9% of the CH group, 12.5% of the HA group, and 21.2% of the TB group. The rate of facial nerve dysfunction in the CH group was significantly higher than in the HA group (0.011). In the patients who experienced post-operative facial nerve dysfunction, the recovery time was significantly shorter in the HA group compared to the CH and the TB group. The HA and TB groups have demonstrated comparable and significantly better surgical outcomes than bipolar electrocautery. Ultrasound instruments have been shown to cause, in comparison with the other techniques, a lower rate of temporary facial nerve dysfunction and, if this is present, lead to a faster spontaneous recovery time. Full article
(This article belongs to the Special Issue Clinical Advances in Head and Neck Plastic, Reconstructive and Aesthetic Surgery)
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13 pages, 5356 KiB  
Article
Deep Learning on Oral Squamous Cell Carcinoma Ex Vivo Fluorescent Confocal Microscopy Data: A Feasibility Study
by Veronika Shavlokhova, Sameena Sandhu, Christa Flechtenmacher, Istvan Koveshazi, Florian Neumeier, Víctor Padrón-Laso, Žan Jonke, Babak Saravi, Michael Vollmer, Andreas Vollmer, Jürgen Hoffmann, Michael Engel, Oliver Ristow and Christian Freudlsperger
J. Clin. Med. 2021, 10(22), 5326; https://doi.org/10.3390/jcm10225326 - 16 Nov 2021
Cited by 27 | Viewed by 2113
Abstract
Background: Ex vivo fluorescent confocal microscopy (FCM) is a novel and effective method for a fast-automatized histological tissue examination. In contrast, conventional diagnostic methods are primarily based on the skills of the histopathologist. In this study, we investigated the potential of convolutional neural [...] Read more.
Background: Ex vivo fluorescent confocal microscopy (FCM) is a novel and effective method for a fast-automatized histological tissue examination. In contrast, conventional diagnostic methods are primarily based on the skills of the histopathologist. In this study, we investigated the potential of convolutional neural networks (CNNs) for automatized classification of oral squamous cell carcinoma via ex vivo FCM imaging for the first time. Material and Methods: Tissue samples from 20 patients were collected, scanned with an ex vivo confocal microscope immediately after resection, and investigated histopathologically. A CNN architecture (MobileNet) was trained and tested for accuracy. Results: The model achieved a sensitivity of 0.47 and specificity of 0.96 in the automated classification of cancerous tissue in our study. Conclusion: In this preliminary work, we trained a CNN model on a limited number of ex vivo FCM images and obtained promising results in the automated classification of cancerous tissue. Further studies using large sample sizes are warranted to introduce this technology into clinics. Full article
(This article belongs to the Special Issue Clinical Advances in Head and Neck Plastic, Reconstructive and Aesthetic Surgery)
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Review

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12 pages, 1738 KiB  
Review
The Supraclavicular Artery Island Flap for Pharynx Reconstruction
by Eirini Nikolaidou, Glykeria Pantazi, Apostolos Sovatzidis, Stella Vakouli, Chrysoula Vardaxi, Iraklis Evangelopoulos and Spyridon Gougousis
J. Clin. Med. 2022, 11(11), 3126; https://doi.org/10.3390/jcm11113126 - 31 May 2022
Cited by 4 | Viewed by 2165
Abstract
The supraclavicular artery island flap (SCAIF) is a reliable, easy-to-harvest and versatile fasciocutaneous flap that can be used for pharynx reconstruction. Instead of free flaps, it requires no microsurgical technique, reduced operating time and postoperative care, making it an ideal option, especially during [...] Read more.
The supraclavicular artery island flap (SCAIF) is a reliable, easy-to-harvest and versatile fasciocutaneous flap that can be used for pharynx reconstruction. Instead of free flaps, it requires no microsurgical technique, reduced operating time and postoperative care, making it an ideal option, especially during the COVID-19 pandemic. The primary aim of our study was to present two cases of a total laryngectomy and reconstruction with the SCAIF during the pandemic. The secondary aim was to review the literature concerning surgical techniques, complications and contradictions of the SCAIF for pharynx reconstruction. A literature search was performed using the PubMed, ScienceDirect, Wiley Online Library, Google Scholar, Scopus and Cochrane Library databases, using MeSH terms: larynx AND reconstruction AND flap. Ten full-text articles comprising 92 patients with 93 supraclavicular flaps were included. The patch graft, pharyngeal interposition graft, tubularization or “U”-shaped SCAIF were the main surgical techniques. Pharyngocutaneous fistula was the most frequent postoperative complication, especially in patients with previous radiotherapy, but just 19% of patients required secondary intervention. The lack of donor-site morbidity, low flap loss rates and stenosis rates favored this reconstructive option. This review underlined that the SCAIF has comparable results with other reconstructive options, consolidating this flap in the workhorse of pharynx reconstruction. Full article
(This article belongs to the Special Issue Clinical Advances in Head and Neck Plastic, Reconstructive and Aesthetic Surgery)
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Other

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11 pages, 878 KiB  
Systematic Review
Facial Fat Grafting (FFG): Worth the Risk? A Systematic Review of Complications and Critical Appraisal
by Luigi Schiraldi, Gianluca Sapino, Joachim Meuli, Michele Maruccia, Mario Cherubino, Wassim Raffoul and Pietro G. di Summa
J. Clin. Med. 2022, 11(16), 4708; https://doi.org/10.3390/jcm11164708 - 11 Aug 2022
Cited by 15 | Viewed by 3064
Abstract
Introduction: Autologous fat is ideal soft tissue filler. It is easily accessible, biocompatible, cheap, and it provides both volume augmentation and skin quality improvement. Fat grafting has been used since 1893, but it has only gained widespread popularity since the development of modern [...] Read more.
Introduction: Autologous fat is ideal soft tissue filler. It is easily accessible, biocompatible, cheap, and it provides both volume augmentation and skin quality improvement. Fat grafting has been used since 1893, but it has only gained widespread popularity since the development of modern liposuction by Colemann and Illouz in the 1980s. Every year more than half a million facial fat grafting procedures are carried out worldwide and the trend is rapidly increasing. Overall, general complications associated with facial fat grafting are assumed to be around 2%. Is that true? Material and Methods: Until July 2021, a systematic search of the literature was performed interrogating PubMed search engines. The following algorithm was used for the research: (fat graft OR lipofilling) AND face AND complications. Exclusion criteria applied hierarchically were review articles, not reporting recipient site complications; not in English and paediatric population. Abstracts were manually screened by LS, GS, JM and PDS separately and subsequently matched for accuracy. Pertinent full-text articles were retrieved and analysed and data were extracted from the database. The flow chart of article selection is described following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Results: In total, 462 papers were identified by PubMed search. A total of 359 were excluded: 38 papers were not in English, 41 were review articles, 279 articles did not report recipient site complications and 1 was not on human subjects. Average complication rate ranged from 1.5% to 81.4%. A total of 298 adverse events were identified: 40 (13.4%) intravascular injections, 13 (4.3%) asymmetry, 57 (19.1%) irregularities, 22 (7.4%) graft hypertrophy, 21 (7%) fat necrosis, 73 (24.5%) prolonged oedema, 1 (0.3%) infection, 6 (2%) prolonged erythema, 15 (5%) telangiectasia and 50 (16.8%) cases of acne activation. Conclusions: FFG related side effects could be resumed in three categories: severe, moderate, and minor. Severe (13.4%) side effects such as intravascular injection or migration require neurological or neurosurgical management and often lead to permanent disability or death. Moderate (38.3%) side effects such as fat hypertrophy, necrosis, cyst formation, irregularities and asymmetries require a retouch operation. Minor (48.3%) side effects such as prolonged oedema or erythema require no surgical management. Despite the fact that the overall general complication rate of facial fat grafting is assumed to be around 2%, the real complication rate of facial fat grafting is unknown due to a lack of reporting and the absence of consensus on side effect definition and identification. More RCTs are necessary to further determine the real complication rate of this procedure. Full article
(This article belongs to the Special Issue Clinical Advances in Head and Neck Plastic, Reconstructive and Aesthetic Surgery)
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