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S. Nedrud et al.
ing room. Exposure of the orbital rim is then performed, and the implants are placed in the
standard drilling sequence similar to implants
placed intraorally, torqued to 20–30 Ncm [48,
53]. The implant can then be covered with soft
tissue overlying the cover screw for a two-stage
implant, or placement of a temporary abutment
for one-stage implants [48].
Auricular Reconstruction
Magnet and bar-clip retentions are the two primary forms of implant-retained prosthetics in the
auricular region, and thus the placement of the
implants in the temporal bone must be planned
with the form of retention in mind, with preferably a minimum of three osseous implants placed
[54, 55]. Implant length will depend on the thickness of temporal bone available based on location. Otherwise, the surgical procedure is
identical to those previously described.
Pearls
Implants for facial prostheses pose similar problems to dental implants, with the risk of periimplantitis and surrounding soft tissue
inammation. The authors recommend only
maintaining a thin layer of epidermis around the
implants when and if possible. Facial skin is
innately more movable than keratinized gingiva
and, therefore, more prone to developing granulation tissue surrounding the implant/skin interface. This is more problematic in climates that
are more humid as well.
ing and shaping. However, should ap debulking
and shaping be needed, this should be performed
prior to nal prosthetic delivery, for optimal
emergence prole and adaptation of the intraoral
or facial implant. The original reconstructive surgeon will avoid injury to the pedicle and anastomosis when debulking, and it is wise to debulk in
stages to allow for neo-angiogenesis and avoid
strangulation of the blood supply. Ideally, debulking should not be performed for 6 months
after the initial soft tissue free ap, with an interval of approximately 6-month stages if excision
of tissue is required in multiple directions [56].
For the craniofacial free ap, liposuction, tissue
shaving, and skin grafting, in addition to direct
excision, can be useful for tissue debulking [56].
Conclusion
Management of orofacial defects following ablative surgery poses a unique challenge in terms of
restoring patient form and function. The primary
goal of such treatment is the excision of benign
and/or malignant lesions, and restoration of
patient esthetics and function. In terms of dental
rehabilitation, much has advanced in recent years
with improved technology and customization of
patient-specic implants. This has allowed us to
provide patients with immediate reconstruction
and dental rehabilitation at the time of ablative
surgery. It is imperative to have detailed communication with a team of experts, i.e., prosthodontists and anaplastologists, to achieve an optimal
result.
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timeline as dental implants. The free tissue ap
and reconstruction are ideally esthetically
designed and sized at the initial reconstructive
surgery to avoid the need for future ap debulk-
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Index
A
Abdominal dressing, 124
Ablation and reconstruction of upper gastrointestinal
tract, 279
Academy of Nutrition and Dietetics/American Society
for Enteral Nutrition (AND/ASPEN) criteria,
169
Accreditation Council for Graduate Medical Education-
accredited Otolaryngology residency
programs, 129
ACell, 124
Acetaminophen, 187, 188
Acoustic Doppler sonography, 57, 63
Activities of daily living (ADL) with or without the
assistance of a caregiver, 277
Acupuncture, 191
Acute brain dysfunction, 149
Acute cognitive disturbance, 149
Acute delirium (AD), 150
Acute hand ischaemia, 265
Acute pain services, 191
ADAPTIC®, 118, 119
Adhesive capsulitis (AC), 204
Adipofascial ap, 25
Adult comorbidity evaluation (ACE-27) score, 5
elastic bandage, 121
Aeromonas hydrophila, 106
Age-related loss of muscle mass, 170
Agitation, 149
Airway management, 65
Albumin, 168
Alcohol and tobacco use, 170
Alcohol dependence and abuse, 161
Alcohol withdrawal symptoms (AWSs), 152
Alginate dressings, 118
Algisite®, 118
Allen’s test, 25
Allevyn®, 118
AlloDerm™, 124
Alpha agonists, 51
American College of Critical Care Medicine (ACCM),
152
American College of Surgeons (ACS), 5
American Geriatrics Society Beers Criteria, 152
American Head and Neck Society, 188
fellowship sites, 129
American Psychiatric Association, 150
American Society for Enhanced Recovery and
Perioperative Quality Initiative, 153
American Society of Anesthesiologist (ASA) score, 5,
160
American Society of Clinical Oncology (ASCO), 196
American Society of Health-Systems Pharmacists
(ASHP), 160
Amylase concentrations in neck drainage uid, 250
Anastomosis, 97
site, 97
Anesthetic drugs, 9
Angiogenesis, 253
Ankle movement, 207
Anterior helix free ap, 88
Anterior lateral thigh (ALT), 44, 73, 74
Anterolateral thigh ap (ALT), 30, 207, 266
free ap, 25
Antibiotic based ointment, 118
Antibiotic ointment, 121
Antibiotic prophylaxis, 160
in microvascular free ap reconstruction, 160
Anticholinergics, 151
Anticoagulants, 105
Anticoagulation
in hypercoagulable patients, 159
medications, 6
Anti-phospholipid Syndrome, 6
Antiplatelet and anticoagulation prophylaxis, 158
agents for ap thrombosis prophylaxis, 157, 158
Antipsychotic medications, 154
Aquacel Ag hydrober, 119
Arginine, 173
Arterial anastomosis, 104
Arterial ow, 136, 143
Arterial insufciency, 100
Arterial monitoring, 137
Arterial pulses, 137
Arterial reanastomosis, 104
Arterial thromboembolism (ATE), 6
© The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature
Switzerland AG 2023
A. Quimby et al. (eds.), Complex Head and Neck Microvascular Surgery,
https://doi.org/10.1007/978-3-031-38898-9
305
306
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Index
Arterial thrombosis, 100
Articial larynx, 236
Articial speech methods, 236
Assessment of Intelligibility of Dysarthric Speech
(ASSIDS), 232
Augmentative and alternative communication (AAC),
237
devices, 233
Augmented reality, 57
Auricular reconstruction, 300, 302
Autonomic reexes, 107
B
Basic metabolic panel (BMP), 4
Behavioral strategies, 240
Benzodiazepines, 151, 154
prophylaxis with lorazepam and diazepam, 162
Biofeedback in swallowing therapy, 242–243
Biomechanics of swallowing, 280
Bledsoe boot, 284
Bleeding disorder, 96
Blood loss, 150
Blood transfusion, 150
Blue dye test for orocutaneous and pharyngocutaneous
stula, 251
Blunt spreading dissection technique, 262
Body mass index (BMI), 10
and weight loss, 167
Bolster dressing, 122
Bone effects, 217
Bone vascularized free ap, 84
Bony reconstruction, 25
British Association of Head and Neck Oncologists, 130
British Association of Oral-Maxillofacial Surgeons, 130
Brown classication, 293
class III defect, 290
of mandibular defects, 289
of maxillary defects, 287, 288
C
Cachexia, 10, 170
Calcium, 152
Cancer cachexia, 170, 173
Cancer care, multidisciplinary team, 245
Cancer Council Australia, 172
Cancer management, 37
Cancer site specic discharge planning
communication and documentation, 283
discharge planning, 283
Jackson-pratt drain, 284
lower socioeconomic status, 278
medication discrepancies, 283
nutritional supplements/feeds, 283
oral intake, 283
oral/oropharyngeal cancer, 279, 284
patient-centered plan, 284
patient's home and family support, 278
postoperative needs, 278
preventing readmissions, 278
screening tools, 278
surgical patients expected hospital course and
discharge needs, 278
unplanned readmission rates, 279
to hospital, 277
Carbohydrate
loading, 174, 175
starvation, 253
Cardiac risk assessment, 5
Care coordination, 278
Case Management Society of America, 278
Cefuroxime, 160
Cell migration, 119
Center for Disease Control (CDC), 159
Center for Medicare and Medicaid Services (CMS), 150
Central nervous system (CNS) using neurotransmitters, 186
Cephalic vein, 23
transposition, 24
Cervical radiculopathy, 220
Cervical range of motion (CROM) device, 219, 220
Cervical vertebrae, 20
Charleston comorbidity index (CCI), 5
Chemical prophylaxis, 141
Chemoradiation, 39
Chimeric free ap, 82
Chimeric osseo-muscular bula free ap, 83
Chronic aspiration due to swallowing dysfunction, 241
Chronic cardiopulmonary sequelae, 128
Chronic obstructive pulmonary disease (COPD), 7
Chronic opioid maintenance therapy, 185
Chronic postoperative opioid use, 184
Chronic postoperative pain, 184
Chronic sinusitis, 293
Chyle leaks, 261–263
Circumferential anastomotic shrinkage at distal
(oesophageal) end of tubed fasciocutaneous
ap, 258
Clindamycin monotherapy, 160
Clinical and biologic markers, 169
Clinical Institute Withdrawal Assessment (CIWA), 153
Clinical monitoring, 135, 136
Clock Draw Test, 150
Coagulation disorders, 6
Cognitive impairment, 152
Collagen synthesis, 253
Collateral revascularization, 100
Color Duplex Doppler dual-process, 57, 63
Color Duplex ultrasound assessment, 136
Combined femoral and common peroneal nerve blocks/
catheters, 190
Comfeel®, 118
Common carotid artery (CCA), 22
Compensatory strategies/postural maneuvers during
swallowing, 240
Composite defects, 202
Composite radial forearm free ap, 28
Comprehensive blood count (CBC), 4
Comprehensive geriatric assessment, modied frailty
index, 5
Index
307
Comprehensive nutrition management for HNC patients,
176
Compression, 216
garments, 218
use, 214
Computed tomography, 7
Computer aided design (CAD), 25, 31, 296
Computer aided manufacturing (CAM), 25, 31, 296
Computer-aided surgical simulation and planning, 291
Computer-assisted surgical planning, 292
Computer-based planning, 293
Cone beam computed tomography scan (CBCT), 293
primary reconstruction of self-inicted gunshot
wound, 297
Confusion assessment method, 152
Congestive heart failure, hypertension, age, diabetes,
previous stroke/transient ischemic attack
(CHADS2), 6
Connective diseases, 9
Consensus auditory perceptual evaluation-voice
(CAPE-V), 232
Constant-Murley score, 208
Continued speech and swallow therapy long term, 280
Continuous monitoring, 138
Contralateral neck, 21
arteries, 23
vessels, 97, 110
Contrast enhanced computerised tomography (CT), 20
Controlled ankle movement boot, 206
Coping mechanisms, 233
Corlett loop, 23, 66
Coronary artery disease, 5
COVID 19 pandemic masks, 40
Craniofacial implants, 301
Creatinine, 152
CROM device, see Cervical range of motion device
Cross-tolerance, 185
CSF leak management algorithm, 251
Curved incision, 23
Cutaneous incision sites, 281
Cutaneous resections, 40
Cyanoacrylate glue (‘skin glue’ or medical grade
‘superglue’), 262
Cyclooxygenase (COX) inhibitors, 186
Cytokine-mediated disruption of neuroendocrine, 170
D
Deep circumex iliac artery (DCIA), 25
ap, 27, 30, 267, 268
free ap, 45, 85–87, 208
Deep inferior epigastric artery (DIEP) aps, 99
Deep venous thrombosis (DVT), 141, 157, 159
Delayed phenomenon, 88
Delays in discharge, 274
Delicate tissue handling, 158
Delirium Tremens (DT), 150, 154, 157, 161, 162
Dental implants
placement in irradiated patient, 290, 291
and restoration, 299
Dental rehabilitation with prosthodontics, 292–294
Depressive/anxiety symptoms in HNC Patients, 197
Dermabond®, 120
Diabetes, 7
Diadochokinesis, 232
Diazepam, 162
Diet allocation, 240
Diet consistency, 240
Diet modications, 240
Diet supplementation with immune modulating nutrients,
176
Digital photography, 211
Direct laryngoscopy, 38
Disability of arm, shoulder, and hand (DASH) test, 208
Discharge planning, 277
Docosahexaenoic acid (DHA), 174
Donor sites, 96
morbidity, 205
re-epithelization, 118
Donor skin graft sites, 190
Doppler dislodgement, 137
Dorsalis Pedis Free Flap (DPFF), 70
Duoderm®, 118
Durable medical devices (DME), 278
Dysfunctional larynx, 243
Dysphagia, 244
assessment, 237
intervention, 239
E
Ear resection and reconstruction, 40
Early ambulation, 282
Early coordination and communication with social
worker/case manager, 275
Early feeding, 280
Early mobilization, 201
Early oral feeding, 175, 176
Efferent pain pathway, 186
Effortful swallow maneuver, 240
Eicosapentaenoic acid (EPA), 174
Elastic and non-elastic compression, 214, 215
Elastic tape, 214
Electrolarynx (EL), 42, 236, 237
Electrolyte abnormality, 8
Electromyography testing, 204
Electronic medical record (EMR), 211
Endocrine pathology and disorders of immunity, 252
Endoluminal stent, 22
Endoscopy, 242
Endosseous implants in vascularized bone graft, 298
End-stage dysphagia, 243
End-stage renal disease (ESRD), 8
End-to-side anastomoses, 110
Enhanced recovery after surgery (ERAS) protocol, 52,
171, 172, 186
carbohydrate loading, 174, 175
pre-hospital patient assessment, 172
recommendations, 201
Society, 132
308
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Index
Enteral nutrition, 173
Enteral tube feeding, 254
Epinephrine, 119
Equianalgesic opioid dosage, 185
Esophageal speech, 42, 236
Esophagectomy, 175
European Society of Clinical Nutrition and Metabolism
(ESPEN) consensus statement, 168
Evidence-based management of failed wound healing
(dehiscence and stula formation), 249
Expiratory muscle strength training, 241–242
External beam radiation, 216
External carotid artery (ECA), 97
branches, 22
External compression, 100
External jugular vein (EJV), 20, 21
Extracorporeal perfusion devices, 24
Extreme circumstances, 24
F
Facial cutaneous perforator, 78
Facial defects after ablative surgery, 288
Facial nerve blocks in head and neck, 190
Facial nerve functional decits, 40
Facial pedicle, 87
Factor V Leiden, 6
Family engagement and participation, 275
Family training, 233
Fasciocutaneous perforator ap, 261
Fat free mass index (FFMI), 168
Feeding tube at discharge, 280
FEES, see Flexible endoscopic evaluation of swallowing
Fiberoptic endoscopic evaluation, 238
Fibroblast proliferation, 253
Fibula free aps (FFF), 26, 27, 31, 44, 78, 206, 207
postoperative recommendations, 284
Fibular ap, 266, 267
Flap compromise, 127
Flap congestion, 101
Flap donor sites, 43
Flap monitoring
early bedside interventions, 143
ap failure, causes of, 138–142
implantable doppler monitoring, 138
non-surgical interventions, 143, 144
recognizing venous vs. arterial failure, 142, 143
return to operating room, 143
Flap outcomes, 140
Flap reconstruction, 150
Flap selection, 24, 25
Flexible endoscopic evaluation of swallowing (FEES),
232, 239
Flexible nasoendoscopy, 19
Floor of Mouth (FOM), 236
“Flow-through” anastomosis, 24
Foam dressings, 118
Fogarty catheter, 103
Food and Drug Administration (FDA), 12
Free ap consideration and complications
intraoperative period, 96–98
post-operative phase, 99–101, 103–108, 110
pre-operative period, 95, 96
Free ap donor sites
dressing, 120–122
morbidity: prevention and management for specic
problems, 264–268
physical therapy treatment, 221–222
Free ap monitoring techniques, 136
Free ap reconstruction, 45, 151, 244
of stula defect, 261
Free aps, 157
Free ap salvage, 144
Free ap selection, 205
Free ap surgery, 128
Free ap vascular pedicle, 118
Free posterior tibial ap, 207
Free tissue transfer, 127, 144
Freestyle harvest, 66
Frenchay dysarthria assessment (FDA), 232
Fried’s frailty score, 5
Functional rehabilitation of orofacial complex
anterior-lateral thigh or radial forearm free ap,
296–297
autologous bone grafting, 290
forces of mastication, 290
functional and quality-of-life outcomes of maxillary
defects, 290
functional decits, 290
mandibular defects, 288
maxillofacial prosthesis, 290
obturator or maxillofacial prosthetic, 290
palatomaxillary obturator, 290
prosthodontists and anaplastologists, 291, 292
G
Gabapentin, 53, 187, 188
Gabapentinoids, 188
Gamma-aminobutyric acid (GABA), 152
Gastroesophageal reux (GER), 160
Gastroesophageal reux disease (GERD), 157
Gastrostomy placement, 173
General therapeutic interventions, 234
Geriatric nutritional risk index (GNRI), 12
Glucose, 152
Goal-directed uid management, 140
Gracilis muscle/PAP free aps, 74
Gunshot wound (GSW), 59
H
Haematinics and nutrition, 253
Haloperidol, 154
Hand-held Doppler, 136
monitoring, 136
Hawkes and Stell’s classication of pharyngocutanous
stulae, 260
Head and neck ablative and reconstruction site, 281
Head and neck cancer, 127
Index
309
Head and neck free-ap reconstructive procedures, 253
Head and neck microvascular reconstruction (HNMVR),
3, 5
Healthcare systems, 275
Heat and moisture exchange (HME) system, 234, 236
Heavy alcohol, 9
consumption, 131
Hematoma, 103, 107
development, 140
formation, 100, 107, 108
Hemiglossectomy, 24
Hemodynamic management, 51–53
Heparin, 158, 162
Heparin-induced thrombocytopenia and thrombosis
(HITT), 105
Hereditary thrombophilia, 65, 66
Higher ASA score, 150
High-water bridge reconstruction, 300
Hirudin, 144
HNMVR, see Head and neck microvascular
reconstruction
Home health care (HHC), 274, 278
Hospital care for head and neck patients, 275
Hospital discharge planning
abdominal surgical oncology, 275
early preparation and coordination of discharge
supplies, 275
efciency in, 275
home care supplies/equipment, 275
medical optimization, 275
microvascular reconstruction, 274, 275
patient’s insurance, 275
post-acute care facility, 275
post-operative improvement initiatives, 275
Humidication, 281
Hydrocolloid dressings, 118
5-Hydroxytryptamine (5-HT3) receptor antagonists, 162
Hyperactivity, 149
delirium, 149
Hyperbaric oxygen therapy (HBOT), 105
Hyperbilirubinaemia, 253
Hypercoagulability, 139, 158
Hypertrophic scar, 218
Hypoactive delirium, 149
Hyponatremia, 8
Hypotension, 143
Hypothyroidism, 8
Hypovolemia, 143
Implantable Doppler monitoring, 136–138
Implant-retained nasal prostheses, 301
Indocyanine green (ICG) angiography, 57, 69
Inferiorly-based omohyoid muscle ap, 262
Inpatient rehabilitation facility (IRF), 274
Insurance status, 274
Intact platysma-skin ap, 261
Integra®, 124
Intensity modulated radiation therapy (IMRT), 291
Intensive Care Delirium Screening Checklist (ICDSC),
152
Intensive care unit (ICU), 105, 128
Intermediate care like skilled nursing facility (SNF), 274
Intermediate care unit (IMCU), 130
Intermittent monitoring technique, 135
Internal mammary artery (IMA), 22
Internal mammary artery perforator (IMAP) ap, 78, 261
Internal mammary vessels, 97
International normalized radio (INR), 4
International Phonetic Alphabet (IPA), 234
Interpositional grafts, 256
Intraoperative uid administration, 139
Intra-operative temperature management, 53
Intraoperative vasopressors, 98
Intraoperative vasospasm, 141
Intravascular pressure, 98
Intravenous heparin, 104
Intravenous pain medications, 45
Intravenous PCA, 186
Ipsilateral neck dissection, 91
Ipsilateral transverse cervical vessels, 97
Iron replacement therapy and blood transfusion, 253
Ischemia, 138
time, 141
J
Jaw in day technique, 292
Jejunum free ap, 61
K
Kerlix™, 119
bandage rolls, 124
gauze, 120, 121
Ketamine, 189
Kinesiotape, 214
of lateral neck, 215
of neck and axilla, 215
I
Iliac crest free aps, 73, 74
Immediate implants, 295
Immobilization, 107
Immunonutrition, 12, 173
in head and neck surgery, 174
Immunosuppressant medications, 9
Impaired wound healing in liver cirrhosis, 253
Implant uncovering and soft tissue management for
maxillofacial prosthetics, 302
L
Laboratory markers, 11
Laboratory tests, 152
Laryngeal defect, 42, 43
Laryngeal oncologic surgery, 203
Laryngectomy, 22
Late-radiation dysphagia, 243
Lateral arm ap, 24
Lateral arm free ap (LAFF), 75, 205
310
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Index
Lateral femoral cutaneous nerve (LFCN), 190
Late thrombosis, 143
Latissimus dorsi ap, 208
Latissimus ap, 223–224
Lee Cardiac Risk Index (LCRI), 5
Leeches (Hirudotherapy), 106
Left maxillary defect for scapula, 88
Lidocaine, 141, 189, 190
and ketamine infusions, 187
LigaSure™ (bipolar shears) resection, 262
Limb reconstruction, 24
Lip and cheek cancer, 203
Lip-split mandibulotomy for ablative access to posterior
maxillary tumor, 294
Liver function tests (LFTs), 4
Local inltration of sclerosant agents, 264
Local skin effect, 217
Local tissue rearrangement, 108
Locoregional pedicled ap, 62
Loupe magnication, 262
Lower extremity in head and neck microvascular
reconstruction, 206, 207
Low intensity, 129
Low-molecular weight heparin (LMWH), 141
Lung and cardiac involvement, 217
Lymphatic system, 209, 210
and non-lymphatic structures, 204
Lymphatouch®, 215
Lymphedema, 205, 210
staging, 211
M
Malnutrition, 9, 167, 168
and nutritional risk, in HNC patients, 169, 170
on head and neck free ap reconstruction, 171
Malnutrition Universal Screening Tool (MUST), 169
Mandibular (angle to angle) reconstruction, 82, 300
Mandibulectomy, 235–236
Manual assisted stretching of neck, 217
Manual lymph drainage (MLD), 213, 214
Manual therapy, 217
Manual thrombectomy, 143
Marginal mandibulectomy, 30
Masako maneuver, 241
Maxillary dentition, 300
Maxillary reconstruction, 84
Maxillary zygomatic implants, 295
Maxillectomy, 235
Maxillofacial rehabilitation, 300
prosthetics, 301
Maxillomandibular reconstruction, 110
Mean arterial pressure (MAP), 140
Mechanical prophylaxis, 159
Mechanical thrombectomy, 103
Medial condyle free ap, 87
Medial sural artery perforator (MSAP) free aps, 24, 72
Medicaid, 274
Medical assessment
medical comorbidities and preoperative management,
4–8
mental health assessment, 12, 13
nutritional assessment and intervention, 9–12
preoperative considerations for substance use, 9
Medical complication rates, 9
Medical healthcare systems, 278
Medical management of OCF, 256
Medical necessary hospital LOS, 273
Medical optimization, 11
hemodynamic management, 51–53
intra-operative temperature management, 53
pain management, 53, 54
Medicare, 275
Medication errors, 283
Medication-related osteonecrosis of the jaw (MRONJ),
293
Medicinal leeches, 106, 144
Medium-chain triglyceride (MCT) enteral feed, 263
Mendelsohn maneuver, 241
Mental health
assessment, 12, 13
engagement with supportive care, 197
in HNC patients, 198, 199
maladaptive substance use, 198
management of anxiety and depression, 197
management of substance use within head and neck
cancers, 198
patient evaluation and symptom recognition, 196–197
pre and post-operative anxiety and depression risk
factors, 195–196
preoperative factors, 196
supportive, complementary therapies, 198
treatment for anxiety, depression, and other concerns
among cancer patients, 198
Mepilex®, 118
Metabolic equivalent tasks (METs), 5
Methicillin resistant staphylococcus aureus (MRSA), 160
Methylenetetrahydrofolate reductase (MTHFR)
mutations, 159
Microcirculation issues, 137
Microsurgery, 62
reconstruction, 129, 293
Microvascular anastomosis site, 118
Microvascular factors, 141
Microvascular ap protocol, 45
Microvascular free ap reconstruction, 160
Microvascular free ap transfer, 157, 162
Microvascular free tissue reconstruction, 201
Microvascular free tissue transfer, 3
Microvascular loupes, 70
Microvascular reconstruction, 37
Microvascular surgeries, 190
Mobile devices, 233
Modied radical neck dissection, 204
MoistureMeterD, 211
Monitoring technique, 135
Monocortical osteotomies, 85
Monocryl® suture, 120
MR angiogram, 27
Index
311
Multimodal analgesia (MMA) regimens, 53, 186, 187
Musculoskeletal complications of this ap, 267
Music therapy, 191
Myofascial release, 235
N
Nasal airway difculties, 40
Nasal reconstruction, 301
Nasogastric tubes, 280
National Comprehensive Cancer Network (NCCN)
guidelines, 38, 172
National Surgical Quality Improvement Program
(NSQIP), 5
2010 National Institute for Health and Care Excellence,
150
Navigation-guided surgery, 293
Near-infrared spectroscopy (NIR), 137
Neck dissection, 203–205
Neck wound dehiscence/stula, 260
Negative pressure medical devices, 215
Negative pressure wound therapy (NPWT), 258
Negative pressure wound vac therapy, 43
Nerve catheters, 190
Nerve damage, 217
Nerve root involvement, 217
Neurocognitive disorder, 152
Neuropathic pain, 183
Neutrophils, 100
Nicotine replacement therapy (NRT) on wound healing,
254
Nociceptive pain, 183
Non-adherent dressings, 118
Non-emergent surgery, 6
Non-osteocutaneous free aps, 141
Non-pharmacologic interventions, 153, 154
Non-selective smooth muscle relaxation, 98
Non-steroidal anti-inammatory drugs (NSAIDs), 188
Non-surgical organ preservation treatment, laryngeal and
hypopharyngeal SCC, 258
Normal protrusion, 225
Normovolemic hemodilution, 98
Nutrition, 279
screening, 176
Nutritional impact symptoms (NIS), 10
Nutritional indices, 12
Nutritional management, 9
Nutritional optimization, 167
Nutritional Risk Screening—2002 (NRS 2002), 169
O
OAF, see Oroantral stula
Occlusion-driven planning model, 292
Occupational therapy (OT), 132, 278, 282
for head and neck cancer, 282
OCF, see Orocutaneous stula
Oncologic resection, 203
Operating room (OR), 128
Opioid-related adverse events (ORAEs), 187
Opioids, 151, 184, 185
Opsite™, 118
Optimal nutritional management of HNC patients, 175
Oral and maxillofacial prosthetics fabrication and
delivery, 302
Oral and pharyngeal anatomy, 20, 279
Oral caloric intake, 173
Oral cancer ablation and reconstruction patients, 279
Oral cavity, 40
tumors, 202
Oral/oropharyngeal cancer, 279, 284
discharge planning, 279
Oral tongue malignancy, 203
Orbital implants, 301
Orbital reconstruction, 300–302
Oroantral communication (OAC), 255
Oroantral stula (OAF), 255
optimum strategy for closure, 256
surgical management, 256
Orocutaneous stula (OCF), 20, 255, 256
denitive surgery, 257
Osseous/osteocutaneous bula free ap reconstruction, 222
Osteocutaneous free bula ap (OFFF), 123, 222
donor site defects, 123, 124
Osteocutaneous free ap, 299
Osteocutaneous radial forearm free ap, 123
Osteocutaneous vascularized reconstruction, 298, 299
Osteomyocutaneous scapula free ap, 124
Otolaryngology programs, 138
Outpatient speech, 46
Oxandralone, 12
P
Pain-inhibiting system, 186
Pain management, 53, 54
biopsychosocial model, 184, 192
cerebral function and perception of pain, 184
clinical pathways, 184
nociceptive and neuropathic pain types, 183
postoperative analgesia, 184
postoperative interpretation, 184
preoperative opioid use, 184
preoperative planning and counseling, 184
psychodynamic, behavioral, and pharmacologic
modes, 184
unpleasant sensory and emotional experience, 183
Pain management service consultation, 191
Papaverine, 141
Paracetamol, 187
Parascapular ap, 28
Parenteral nutrition, 173
Parenteral opioids, 185
Partial glossectomy defects, 24
Partial thromboplastin (PTT), 4
Partial/total laryngectomies, 283
Patch technique for dural tears, 255
Patient and hospital system, 278
Patient care and outcomes, 183
Patient-controlled analgesia (PCA), 185
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