Reply to Carter & Holmes. Re: Stereoscopic lithography: customized implants in orofacial reconstruction - a new surgical technique without flap cover.
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Journal Article↗
Biomedical subjects
N Peckitt
Publications and source records attributed to N Peckitt.
Lymph node micro-metastasis: an investigation, including three-dimensional reconstruction.
The mechanism by which malignant cells metastasis to, and colonise, regional lymph nodes is not known. In an attempt to characterise micro-deposits an affected lymph node associated with a primary intra-oral squamous cell carcinoma was studied. Three-dimensional reconstructions of the node and micro-tumour were made and the relationships and distribution of apparently isolated malignant cells present within the node studied. Semi-serial ethanol-fixed paraffin was sections of the node were stained with monoclonal antibody AE3 (cytokeratin). Outlines of the node and occupying micro-tumour were traced onto polystyrene tiles and onto acetate sheets, permitting the construction of both a solid and a transparent three-dimensional model. Additionally, the positions of apparently 'isolated' AE3-positive malignant cells were noted. The solid reconstruction showed that the micro-tumour deposit grew most quickly into the node via the septa and more slowly around the subcapsular region. The transparent reconstruction was less useful. Most isolated, individual malignant cells were found in the peripheral margin of the node.
Carcinoma, Squamous Cell↗
Pectoralis major muscle flap with bone graft in intra-oral reconstruction.
The use of the pectoralis major muscle only flap in conjunction with a free iliac crest bone graft for reconstruction of the mandible is described. These flaps were raised in 20 cadavers and found to be of consistently adequate length to be used as described.
Aged↗
The pectoralis major muscle flap without skin in intra-oral reconstruction.
There are many methods of reconstructing intra-oral defects following surgical treatment of cancer. A very reliable flap is the pectoralis major myocutaneous flap which has the added advantage of carotid artery protection when a radical neck dissection has also been necessary. However this flap is very bulky, may cause distortion of the female breast and there is also the problem of continued hair growth in male patients. A description of the use of the pectoralis major muscle-only flap without any overlying skin, fascia or breast tissue is given. The advantages of rapid epithelialisation within the mouth of the muscle flap together with the minimal changes to the breasts are emphasised.
Adult↗