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Maxillary Reconstruction Using a Multi-Element Free Fibula Flap Based on a Three-Dimensional Polyacrylic Resin Model

100%
Jędrzejewski P., Maciejewski A., Szymczyk C., Wierzgoń J.
Polish Journal of Surgery
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2012
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vol. 84
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issue 1
49-55
EN
Preoperative preparation of working models of the skull and free bone flaps using the digital print technology and photocured polyacrylic resins may be of a great benefit to the patient, for whom a virtual resection and reconstruction procedure may be planned in detail and performed. The purpose of mid-facial reconstruction using 3D models is to plan a functional mid-facial reconstruction procedure in order to restore supportive function of intraorbital structures and to make placement of dental implants and further prosthetic rehabilitation possible.Maxillary and mid-facial reconstruction using a free fibula flap based on a three-dimensional working model was performed in a patient diagnosed with a squamous cell carcinoma of the left maxillary sinus penetrating to the orbit, the ethmoid complex, and the pterygopalatine fossa. The use of three-dimensional polyacrylic models allowed for detailed preoperative planning and a virtual resection and reconstruction procedure with a highly satisfying functional and cosmetic effect.A procedure based on methods discussed here may be significantly shorter and more precise.
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Czerniaki złośliwe regionu głowy i szyi w materiale Kliniki Chirurgii Onkologicznej i Rekonstrukcyjnej Centrum Onkologii IMSC w Gliwicach

76%
Krakowczyk Ł., Maciejewski A., Grajek M., Szymczyk C., Wierzgoń J., Jędrzejewski P., Półtorak S.
Polish Journal of Otolaryngology
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2010
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vol. 64
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issue 7
55-59
EN
Introduction: About 25% of melanomas are localized in head and neck skin, and this particular localization is most difficult to treat, and the prognosis is less favorable. The depth of melanoma infiltration (Clark and Breslau grade) into the skin is the main factor of local advancement of the disease. Surgical treatment is an essential therapeutic modality in patients with melanoma. Aim: The aim of this study was to evaluate results of our surgical treatment of melanomas in head and neck localisation, treated from 1997 to 2007 in Department of Oncological and Reconstructive Surgery in Center of Oncology IMSC in Gliwice. Material: We analysed group of 47 patients (aged 26 to 75 years, mean 49), treated by surgical excision of malignant melanoma in the head and neck region. Most of the patiens required to use free fl aps or skin graft technique to close posexcisional defect, on basis of clinical considerations. Results: The 5-year total survival for all patients was 62% and were dependent on depht of melanoma infiltration and regional lymph node metastasis. The significant prognostic factors were: localization of primary focus, local progression of disease, free microscopical excision margins sex and age. Conclusions: Prognosis in the patients with melanoma of the head and neck is unreliable and dependent on local advancement of disease and localization of primary focus. Surgical treatment is an essential therapeutic modality in patients with melanoma. Adiuvant radiotherapy after surgical treatment of melanoma of the head and neck is intended for the patiens with high risk of local or regional recurence of disease.
3
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The Use of Double Independent Free Flaps for Tissue Reconstruction After Extensive Head and Neck Tumors Resection

52%
Maciejewski A., Jędrzejewski P., Szymczyk C., Wierzgoń J., Dobrut M., Szumniak R., Grajek M., Krakowczyk Ł., Półtorak S., Ulczok R., Oleś K.
Polish Journal of Surgery
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2010
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vol. 82
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issue 12
666-676
EN
Malignant tumors of head and neck regions usually need wide radical resections and may cause significant functional and aesthetic deficits. When a surgeon has to deal with extensive 3-D defect in lower or middle face region, double or multiple free flaps can be used.The aim of the study was to present own methods modifications and results of double free flaps techniques in patients with extensive defects of head and neck region. The authors present quality of life evaluation related to different flaps reconstructions.Material and methods. Clinical material consists of 33 patients with locally advanced cancer of lower or middle face region, who underwent surgical treatment in Departmant of Surgical and Reconstructive Surgery, Cancer Center Maria Skłodowska-Curie Instytute, Gliwice, Poland. In all patients double free flaps were chosen.Results. Whole group good functional and aesthetic results have been achieved. The QOL analysis show that the use of double flap in middle of lower face reconstruction gives generally very good results.Conclusions. The use of double free flaps after extensive resections of head and neck tumors is an efficient solution. The above-mentioned technique enables to reconstruct several different anatomical structures, restore optimal functioning, and assure a satisfactory psychosocial effect.
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