Otolaryngology is among the more highly compensated surgical specialties in the United States ($461,000 2019 Average Annual Income).

Microvascular head and neck reconstruction is used to treat head and neck cancers, including those of the larynx and pharynx, oral cavity, salivary glands, jaws, calvarium, sinuses, tongue and skin.

Patients seek treatment from an otorhinolaryngologist for diseases of … If for some reason the fibula is not available for transfer, another option the team may go is using the back rib free flap. The muscle is sometimes useful for sealing off the central nervous system in one's body and allowing it to heal the complex wounds.

In the United States and Canada, otorhinolaryngology is one of the most competitive specialties in medicine in which to obtain a residency position following medical school.In the United Kingdom entrance to otorhinolaryngology higher surgical training is highly competitive and involves a rigorous national selection process.The typical total length of education and training, post-secondary school is 12–14 years.
Microvascular reconstruction repair is a surgical procedure that involves moving a composite piece of tissue from the patient's body and moves it to the head and or neck.
Following residency training, some otolaryngologist-head & neck surgeons complete an advanced sub-specialty fellowship, where training can be one to two years in duration. The submental artery provided an excellent size match in all cases, ranging in size from 1.0 to 1.5 mm"(Faltaous AA, Yetman RJ).Bone defects are often the most difficult reconstructions as it requires precise alignment. In three of the cases, they used a submental vein, and in all the cases they used a donor submental artery. If a surgeon chose to remove/harvest the tissue, safe places are the following; skin, skin and fat, fat and fascia, or just the fascia by itself. In this type of surgery, a surgeon harvests a muscle from the back or from the abdominal region for reconstruction of the skull or the cranial vault. Otorhinolaryngology /oʊtoʊˌraɪnoʊˌlærənˈɡɒlədʒi/(ORL, also called Otolaryngology, Otolaryngology–Head and Neck Surgery (ORL-H&N), or Ear, Nose, and Throat (ENT)) is a surgical subspecialty within medicine that deals with the surgical and medical management of conditions of the head and neck. A study was done with five patients who underwent the free muscle transfer for a smile reconstruction. The earliest first bone transfer was done all the way back in 2000 BCE when the Peruvian priest implanted a metallic plate to reconstruct the contour defects of the religious trephination. Latissimus is another word for back in the medical field as well as rectus abdominis which is your abdominal area. (* Currently recognized by American Board of Medical Subspecialties) Study of diseases of the outer ear, middle ear and mastoid, and inner ear, and surrounding structures (such as the facial nerve and lateral skull base)

In 1668, a man by the name of Jobs van Meekeren reported the use of dog bone grafts to reconstruct the calvarium in the soldier. Today, the anterolateral thigh flap is being used on patients for the head and the neck because it has an ideal match for the site and it is easy to harvest. Microvascular reconstruction repair is a common operation that is done on patients who see an Otorhinolaryngologist. "…the ideal of the future: the insertion of a piece of living bone which will exactly fill the gap and will continue to live without absorption." Facial Plastic and Reconstructive Surgery is a one-year fellowship open to otorhinolaryngologists and plastic surgeons who wish to specialize in the aesthetic and reconstructive surgery of the head, face, and neck. Two of the five patients prior to this surgery had failed their first free muscle transfer. Fellowships include head and neck surgical oncology, facial plastic surgery, rhinology and sinus surgery, neuro-otology, pediatric otolaryngology, and laryngology. "In all 5 the gracilis vascular pedicle comprised a muscular branch of the profunda femoris together with its venae comitantes, with the artery and vein ranging in size from 1.0 to 1.5 mm and 2.0 to 2.5 mm, respectively. The radial forearm is the most commonly dominant use of flap to be used to coverage up damages. This allows the transfer to give the bone volume for the patients. Doctors who specialize in this area are called otorhinolaryngologists, otolaryngologists, head and neck surgeons, or ear, nose, throat (ENT) surgeons. Rhinology includes nasal dysfunction and sinus diseases. Bone transfer is commonly used for the mandibular reconstruction, but it now allows surgeons to use it for the midface and the orbito maxillary. (The Epitome of Medicine).

The tissue that is most common moved during this procedure is from the arms, legs, back, and can come from the skin, bone, fat, and or muscle.

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