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M Patete

Publications and source records attributed to M Patete.

2 recordsLinked to original sources

Use of the melolabial flap in intraoral reconstruction.

Functional reconstruction of the oral cavity after tumor ablation is challenging. A variety of methods are available for reconstruction including primary closure, skin grafts, local cutaneous flaps, musculocutaneous flaps, and free flaps. Appropriate reconstruction addresses the size, location, and tissue needs of the defect. The melolabial flap allows for reliable and effective intraoral reconstruction with minimal donor morbidity, making it ideal for select defects. From 1989 to 1993 16 patients aged 51 to 81 years underwent reconstruction of intraoral defects with 24 melolabial flaps. Twenty-two flaps survived without complication and two flaps failed, for success rate of 91.7%. The two failed flaps occurred in the same patient. Of the remaining patients 8 had prior radiation therapy and 11 had prior or concomitant neck dissections. The flaps were used to reconstruct 13 floor-of-mouth, 1 buccal mucosa, 1 retromolar trigone, and 1 gingival defect. We conclude that the melolabial flap is ideal for select intraoral defects.

Aged↗

Tracheoplasty using titanium reconstructive plates with strap-muscle flap.

The reasons for unsuccessful decannulation after a laryngotracheoplasty may be multifactorial depending on the techniques used. Excessive granulation tissue may develop, necessitating further adjunctive procedures. Cartilaginous grafts may get infected, resorb, or collapse into the tracheal lumen. Bulky regional skin-muscle flaps may dehisce under tension or collapse into the tracheal lumen. Medial migration of the split ends of the anterior cartilaginous tracheal rings ensues with subsequent restenosis. Donor-site morbidity may compound these problems as well. During a 2.5-year period, we have performed laryngotracheoplasty on nine patients with 60% to 100% tracheal stenosis using titanium reconstruction plates. The split anterior tracheal wall is fixed by the plates in its expanded position. A neurovascularized strap-muscle flap is used to reconstruct the anterior tracheal wall. The flap becomes epithelialized with squamous epithelium within 3 weeks. Successful decannulation was possible in seven of the nine (78%) patients with no further respiratory problems. Of these, six required no further procedures. This technique offers a viable simple alternative to other methods of laryngotracheoplasty without the need for donor cartilage grafts or thick bulky skin-muscle flaps.

Adolescent↗