DR. ALLEN LEE FENG, MD

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Researchers developed an artificial intelligence tool that predicts whether head and neck cancer patients will have cancer return or die within the next five years after surgery, using patient information like age, tumor characteristics, and blood test results collected over time. The AI tool was 70-80% accurate at making these predictions across different time points, and worked especially well for a specific type of throat cancer caused by HPV (93% accurate at one year). This matters because doctors can now identify patients at high risk of recurrence or death earlier, allowing them to adjust treatment plans—either intensifying care for those most likely to relapse or reducing harsh treatments for those with better odds.

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Surgeons reconstructing head and neck cancer often take tissue from patients' legs to use as grafts, but this creates damage at the donor site on the leg. Researchers compared how well patients recovered from three different types of leg grafts (fibula, thigh, and calf) by measuring their leg function over a year using a standardized questionnaire. Patients who received calf grafts recovered their leg function faster and had better mobility at one year than those who received thigh or fibula grafts. When choosing which type of graft to use, doctors should factor in how much damage each one causes to the leg, since the calf graft appears to cause the least long-term problems.

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Researchers looked at patients who had already been treated for a type of throat cancer linked to HPV to see if they developed other types of head and neck cancers that were not connected to HPV. They found that about 2.5% of patients did develop these second cancers years later, often in different areas of the mouth or throat, and many had received radiation and chemotherapy for their first cancer. This is important because it shows that these new cancers can have different causes than the original one, suggesting that doctors should monitor these patients long-term and consider retesting for HPV.

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Researchers examined a blood test that detects tumor DNA in patients with a specific type of head and neck cancer that doesn't involve HPV. They found that when the test showed positive results after treatment, it indicated a higher chance of cancer recurrence and lower survival rates. This finding is important because it suggests that this blood test could help doctors identify patients at greater risk after treatment, potentially leading to more tailored monitoring and care.

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Researchers studied a blood test that detects tiny amounts of tumor DNA in patients with a specific type of throat cancer that is not linked to HPV. They found that when this DNA was present, patients were more likely to experience a recurrence of their cancer and had a shorter survival time. This finding is important because it suggests that this blood test could help doctors predict outcomes and make better treatment decisions for patients with this type of cancer.

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Researchers created a new questionnaire called LARY-Q to measure how total laryngectomy (complete removal of the voice box) affects patients' lives—covering physical issues like breathing through a stoma, ability to function, quality of life, use of devices, and satisfaction with care. They interviewed 15 laryngectomy patients to understand their main concerns, then refined the questionnaire through multiple rounds of feedback from additional patients and medical experts until they had 18 sections with 277 total questions. This questionnaire will help doctors and researchers better understand and track how well laryngectomy patients are doing after surgery.

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Surgeons removed cancer from three patients' noses, leaving large defects that required reconstruction of skin, bone, and internal structures. They used a single surgical procedure to rebuild the nose by transplanting tissue from the patients' forearms, which contained skin, bone, and connective tissue all together. All three patients recovered successfully with good-looking, functioning noses and no major complications, avoiding the need for multiple surgeries that traditional approaches would have required.

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Surgeons use skin and tissue from the calf (called an MSAP flap) to reconstruct damaged areas of the head and neck after cancer or injury. This study tracked 22 patients who received this surgery and tested their leg function over time using a standard mobility test. Patients' leg function was significantly impaired immediately after surgery but steadily improved, reaching nearly normal levels within 6-12 months and fully recovering by one year. This proves the surgery causes minimal lasting damage to the donor leg, making it a safe and effective choice for head and neck reconstruction.

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Doctors can now use a thin piece of tissue from the calf (called the medial sural artery perforator flap) to rebuild the head and neck after cancer surgery or injury, and it works better than older methods because it's thinner, causes less damage to the donor site, and produces better-looking results. Recent research has mapped out exactly where the blood vessels are in this flap, making the surgery more reliable and predictable. Compared to other tissue grafts, this flap leaves patients with fewer problems at the donation site and better function in areas like the mouth and throat.

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Researchers studied 8 patients with throat cancer that had returned after initial treatment, whom doctors treated by removing the cancer with robotic surgery and then reconstructing the surgical site using a skin flap taken from under the chin. The surgery took about 5 hours on average, most patients went home within a week, and importantly, patients' ability to swallow remained normal or nearly normal even months after surgery. This approach works well because the chin flap is readily available, doesn't require specialized microsurgery skills, and produces good long-term results with low complication rates.

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Researchers tested a new bendable camera (endoscope) designed for sinus surgery against standard straight cameras to see which one could see inside the sinuses better. The new bendable camera could see significantly more of the sinus anatomy than traditional straight cameras or flexible cameras—for example, it could see 92.5% of landmarks in one sinus compared to just 27.5% for the straight camera. This matters because better visualization during sinus surgery means surgeons can operate more safely and effectively, potentially improving outcomes for patients with sinus problems.

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Researchers developed a new blood test using advanced DNA sequencing to detect HPV-associated head and neck cancers early, before symptoms appear, and compared it to three other blood-based detection methods. The new sequencing test detected cancer 98.7% of the time it was present and correctly identified healthy people 98.7% of the time—significantly better than existing blood tests. This breakthrough matters because HPV-related head and neck cancers are becoming more common, yet doctors currently have no way to catch them early when treatment is most effective.

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Researchers developed a highly sensitive blood test that detects tiny amounts of HPV cancer DNA left in patients after surgery for HPV-related head and neck cancer. They found that patients whose blood still contained this cancer DNA had much worse outcomes—only 60% stayed cancer-free for 2 years compared to 100% of patients with no detectable DNA—and this blood test was better at predicting who would relapse than current methods doctors use. The test could also spot cancer coming back up to 17 months before it shows up on scans or causes symptoms, giving doctors an early warning system to decide whether patients need additional treatment like chemotherapy or radiation.

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Doctors performed a study comparing how well different types of donated tissue matched the skin color of patients' faces and necks after cancer surgery. They measured color differences objectively and found that tissue taken from the inner calf (medial sural artery perforator), upper arm, and shoulder blade areas matched the patient's original skin color better than tissue from the thigh, especially on the face and jaw. The good news is that color mismatches naturally improved over time—by six months after surgery, the differences were barely noticeable—and radiation therapy applied to the surgical area also helped the colors blend together better.

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Researchers surveyed 67 cancer patients who had neck surgery to remove lymph nodes as part of treatment for throat cancer, asking them how much their surgical scars bothered them at least six months after surgery. Most patients reported that their neck scars had little to no impact on their daily life or quality of life, and their concerns about the scars stayed roughly the same regardless of differences in their age, insurance type, or specific surgical approach.

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Researchers looked at 49 patients who had their larynx (voice box) surgically removed and then developed scarring in their throat that needed to be stretched open. They found that 71% of these patients needed the procedure done multiple times instead of just once, and three things predicted who would need repeated treatments: having a fistula (an unwanted hole), receiving chemotherapy and radiation before surgery, and developing the scarring quickly after their initial surgery. Patients who needed multiple stretching procedures ended up with worse long-term swallowing problems—they had to eat softer foods or rely on feeding tubes—compared to those who only needed one procedure. This means that if scarring develops fast after larynx removal surgery, patients are likely to struggle with swallowing for years to come.

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Doctors use fibula free flap surgery to rebuild the head and neck after cancer or injury, but they disagreed about when patients should start putting weight on their legs afterward. This study of 152 patients found that those who started walking the day after surgery had shorter hospital stays, were more likely to go home (rather than to rehabilitation), and had fewer complications at the surgery site—while patients who waited 3+ days to walk had a higher risk of pneumonia. Early weight-bearing after this surgery should become standard practice because it measurably improves recovery and reduces complications.

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Surgeons need to rebuild jaw and face bones after cancer or injury, and they do this by moving bone from the fibula (a leg bone) to the head and neck area. This team used a special positioning device called the Spider Limb Positioner—originally designed for shoulder surgery—to hold the patient's leg steady during 61 of these procedures, and found it worked better than traditional methods because it gave surgeons a clearer view, was more comfortable for them to work with, and made it easier to reposition the patient without causing nerve injuries.

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Surgeons sometimes use a piece of skin and tissue from the calf called an MSA flap to reconstruct areas of the head and neck after cancer surgery, but they didn't fully understand exactly where the blood vessels supplying this flap are located. Researchers dissected 13 cadavers, created detailed 3D maps of these blood vessels, and found that most flaps have three small blood vessels branching off in predictable locations, with an average pedicle (the stalk connecting the flap to its blood supply) about 19 centimeters long. This information helps surgeons know exactly where to cut and how much tissue they can safely take without damaging the blood supply, making the surgery faster and more successful.

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Researchers reviewed studies on using ultrasound during surgery to treat tongue cancer and found that ultrasound measurements of tumor thickness matched pathology lab measurements almost perfectly. Surgeons using ultrasound during the operation achieved wider safety margins around the tumor compared to surgeons operating without ultrasound, because they could see how deep the cancer extended into the tissue. This means ultrasound-guided surgery may be a better way to ensure doctors remove all the cancer while preserving as much healthy tongue as possible.

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Researchers tested whether giving advanced laryngeal cancer patients (stage T4) chemotherapy first to shrink their tumors could help them keep their voice box instead of having it surgically removed. About 72% of T4 patients responded well enough to chemotherapy and radiation to avoid surgery, and these patients lived just as long as those who had their voice boxes removed upfront.

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Surgeons often need to reconstruct the front two-thirds of a patient's tongue after cancer removal, and they do this by moving tissue from elsewhere in the body. Researchers used CT scans to measure how much tissue different donor sites (belly, back, shoulder, and thigh) could provide and compared this to how much tongue volume needed to be replaced, finding that the best donor site depends on the patient's weight. They discovered that for normal-weight patients (BMI ≤ 30), belly tissue provides the ideal amount, but for heavier patients (BMI > 30), back and shoulder tissue works better because belly tissue would create excess bulk that needs trimming down. This matters because using the right donor site for each patient means better surgical outcomes and fewer complications from having too much or too little reconstructed tissue.

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Researchers reviewed 33 studies about mouth cancer in people who don't smoke or drink, focusing on whether damage from bad teeth or poorly fitting dentures causes cancer. They found that chronic irritation from broken teeth, sharp edges, ill-fitting dentures, and poor oral hygiene likely increases the risk of mouth cancer, though the exact biological mechanism still needs more research. The findings matter because they suggest that simply fixing dental problems and improving oral care could help prevent a common type of cancer, especially in women without traditional risk factors like smoking.

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Researchers studied 131 patients with HPV-positive throat cancer who had surgery to remove lymph nodes from their necks, looking at where the cancer had spread. They found that unusual spread patterns—where cancer appears in lower neck levels while skipping the upper levels—happened in only 5% of patients. These results suggest surgeons may be able to safely skip removing lymph nodes from the lowest neck level in some HPV-positive throat cancer patients, potentially reducing surgery complications without compromising cancer treatment.

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Surgeons use a small piece of tissue from the calf called a medial sural artery perforator flap to repair damaged areas elsewhere on the body—it's thin, flexible, and doesn't cause much damage to the donor site. The problem is that the traditional way of positioning the patient (with the leg bent outward like a frog) makes it awkward and uncomfortable for the surgeon to work. Researchers showed that crossing the patient's legs instead makes the surgery easier, gives the surgeon a better view, and provides better support for the tissue being harvested.

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Researchers tested whether a force-measuring device used during throat surgery gives consistent readings across multiple procedures in the same patient. They found that the device's measurements were reliable and repeatable—except when surgeons switched from not seeing the force readings to seeing them, which caused them to use significantly less force in the second procedure. The findings matter because doctors use this device to predict which patients will have problems after throat surgery, so they need to know the measurements are trustworthy and not influenced by whether the surgeon knows what the numbers are.

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Researchers looked at what questions people ask Google about laryngectomy (surgical removal of the voice box) between 2017 and 2022, finding that people most want to know about how to speak afterward, how to eat, survival rates, stoma care, and how it differs from a tracheostomy. They discovered that most websites answering these questions are too difficult to read—only about one-third are written at an 8th-grade level or below. The findings show that doctors and hospitals should focus their patient education materials on these five key topics and make sure the information is easy enough for average patients to understand.

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Researchers studied 145 patients who had surgery to remove skin cancer that had spread to the parotid gland (a salivary gland in front of the ear), tracking how many survived over three years and which surgical factors made a difference. The surgery worked reasonably well—about three-quarters of patients survived overall—but patients who were immunosuppressed (had weakened immune systems) or whose cancer showed signs of invading blood vessels did much worse, as did patients whose surgeons couldn't completely remove all the cancer or didn't remove enough lymph nodes. This matters because it shows which patients with this type of advanced skin cancer need the most aggressive treatment and closest monitoring, and that completely removing the cancer and a sufficient number of lymph nodes is critical to survival.

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Surgeons sometimes rebuild the head and neck after cancer or injury by taking tissue from the arm or chest and grafting it to the damaged area. This study compared how well patients' arms and shoulders work after four different types of these grafts, measuring disability using a standard questionnaire given an average of 20 months after surgery. All four graft types resulted in similar outcomes: patients reported minimal to mild arm problems and generally functioned well, meaning the choice of graft type doesn't significantly affect how much your arm gets worse after surgery.

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Researchers studied 64 tongue cancer patients who had surgery to remove part of their tongue, tracking whether they lost sensation in their tongue tip after healing. They discovered that removing more than 1.3 centimeters of tongue tissue significantly increased the risk of permanent loss of feeling in the tongue tip, which also made it harder for patients to speak clearly and reduced their quality of life. This finding helps doctors predict which patients will lose tongue sensation after surgery and plan better reconstruction techniques to minimize this damage.

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Researchers injected a near-infrared dye called indocyanine green into cancer patients and found that cancer cells glow differently than healthy cells when measured by how long the glow lasts (rather than how bright it is). This difference in glow duration remained consistent across different cancer types and could identify tumors with over 97% accuracy, even at the cellular level. This matters because current surgical imaging techniques rely on brightness, which varies depending on how much dye the tumor absorbed and how deep it is in the body—making it hard to distinguish cancer from healthy tissue. Since the glow duration is a stable property of the dye itself, it could help surgeons more reliably spot and remove all cancerous tissue during operations.

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Researchers analyzed 70 rare cases of cancer in the nasopharynx (the space behind the nose) that spread into the skull base, finding that when the cancer invaded the skull bone, patient survival dropped from 67% to 40% over five years. Most patients received radiation therapy as their main treatment, and radiation worked equally well regardless of whether patients were wealthy or lived near specialized medical centers. The study shows that skull base invasion is the key factor determining whether patients survive this cancer—not their access to care or economic resources.

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Researchers reviewed 138 patients who had robotic surgery to remove throat cancer and tracked how many needed feeding tubes afterward. Only 5 patients (3.6%) needed feeding tubes in the first month after surgery, and just 1 person still needed one a year later, showing that most patients could eat normally again quickly. The study found no specific patient or tumor characteristics that could predict who would need a feeding tube, meaning doctors can't use pre-surgery factors to identify high-risk patients—but the good news is that feeding tubes are rarely necessary anyway when patients receive coordinated care from multiple specialists.

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Surgeons can take bone from two different parts of the shoulder blade to rebuild bone in the head and neck after cancer or injury—one from the outer edge and one from the tip. For years, these procedures were difficult because of how patients had to be positioned during surgery, but new positioning equipment now makes both operations practical and allows surgical teams to work simultaneously on the patient and the donor site, saving time.

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Researchers reviewed 15 years of cases where people broke their voice box (larynx) to understand what causes these injuries, what doctors see when they examine patients, and how well patients recover. They found that sports injuries cause most laryngeal fractures, usually at the thyroid cartilage, and that patients with fractures in multiple locations were more likely to need a breathing tube—but the type of injury didn't reliably predict what doctors would find on X-rays or during examination. The key takeaway is that doctors can't assume what a laryngeal fracture looks like or how serious it is just by knowing how the injury happened, so they need to do a thorough exam every time to catch all the damage.

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Researchers created a special laryngoscope (a tool doctors use to look down the throat during intubation) that measures exactly how much force a doctor applies during the procedure, and they tested whether it works accurately. When three experienced doctors used the device, they found that the Miller blade required significantly more force than the Mac blade, with measurements showing the Miller blade needed about 7 newtons more maximum force. The doctors said the device worked well and could be useful for training new doctors on proper intubation technique, though they noted it was somewhat bulky.

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Researchers reviewed which molecular changes in pre-cancerous mouth and throat lesions can predict which patients will develop cancer. They identified dozens of biological markers—including those controlling cell growth, cell death, and how cells stick together—that show up in these lesions and indicate whether cancer is likely to develop. Finding these markers matters because doctors could use them to identify high-risk patients early and treat them more aggressively, potentially saving lives from head and neck cancers that currently have survival rates below 70%.

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Researchers analyzed nearly 59,000 head and neck cancer patients to see whether having more doctors in an area affected when cancer was caught and how long patients survived. They found that the number of doctors in a region had no real impact on these outcomes, but Black patients and uninsured patients were diagnosed at later stages and died at higher rates.

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People who have had their larynx (voice box) removed can speak again using a small one-way valve called a tracheoesophageal prosthesis, which is surgically placed in the throat. Sometimes this valve gets stuck or embedded in the tissue and needs to be removed and replaced, which normally requires multiple surgeries. Researchers developed a simpler technique where they thread a wire through the old valve, pull it out through the mouth while stretching the surgical tract, and then immediately thread a new valve back in the same path—all in one procedure. This method worked safely and let patients regain their voice without needing extra surgeries.

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Surgeons removed tumors from the parotid gland (a salivary gland near the ear) using a small incision near the ear, and compared this method to traditional larger incisions that extend into the neck. Both approaches worked equally well—patients had similar recovery times, complication rates, and nerve damage—but the new method left smaller, less visible scars because the incision stayed hidden near the ear rather than extending down the neck. This finding matters because it shows doctors can safely treat parotid tumors with a cosmetically superior approach, meaning patients heal just as well while getting a better-looking result.

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Researchers tracked how much pain medication patients needed after robotic surgery for throat cancer, finding that most patients used opioids for only a short time—but those who also received radiation therapy afterward needed significantly more medication for much longer. Patients who were older, frailer, or received radiation alongside surgery were at highest risk for prolonged opioid use, with some still taking pain pills a year after treatment. This matters because it helps doctors predict which patients will struggle most with pain after this surgery and could guide them to use other pain management strategies upfront, potentially reducing unnecessary long-term opioid prescriptions.

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Researchers tested a new device designed to help cancer patients who have had their voice box removed speak with a more natural-sounding pitch. They implanted the device into two cadavers that had undergone larynx removal surgery and found it successfully produced sound and maintained proper structure in the reconstructed throat area. The device required minimal air pressure to generate clear speech at a reasonable volume and pitch, suggesting it could be a practical option for patients frustrated with the artificially low voice that current treatments provide.

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Researchers tested a new device that measures how much force surgeons apply to the larynx (voice box) during throat surgery. When surgeons could see real-time force measurements on a monitor during surgery, patients experienced significantly fewer complications after surgery—including less tongue pain, numbness, weakness, and swallowing problems—compared to when surgeons operated without this feedback. The key finding is straightforward: the more force applied during surgery, the more likely patients are to have problems afterward, but surgeons who actively monitored their force levels and adjusted accordingly cut complication rates by nearly 30 percent.

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Researchers studied a protein called LETM1 that sits in mitochondria (the cell's power plants) and helps regulate calcium levels. They focused on a specific part of this protein called EF1, which acts like a sensor that can detect calcium, temperature, and acidity changes. The team found that EF1 binds calcium weakly but specifically, and its ability to grab calcium changes depending on how acidic or hot its environment is—exactly what you'd expect from a sensor that needs to respond to different cellular conditions. When calcium attaches to EF1, the protein clumps together with copies of itself rather than staying alone. This matters because it shows how mitochondria sense and respond to their internal environment, which is fundamental to how cells produce energy and stay healthy.

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Researchers compared cancer outcomes in 99 patients with HPV-related throat cancer who had robot-assisted surgery, looking specifically at whether leaving tiny amounts of cancer cells at the edge of the surgical site (close margins) versus completely clean edges affected whether the cancer came back. They found no difference in cancer recurrence, survival, or disease-free survival between the two groups over an average follow-up of 21 months. This matters because it suggests doctors don't necessarily need to give additional radiation or chemotherapy after surgery if the surgical margins are very close—they can simply watch these patients closely instead, potentially sparing them from the serious side effects of extra treatment.

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Surgeons use tissue flaps to reconstruct damaged areas in the head and neck after cancer removal or injury, and this paper compares different muscle-based flaps to see which causes the least damage to the donor site (where the tissue is taken from). The latissimus dorsi flap—a muscle from the back—works just as well as other commonly used flaps like the pectoralis major (chest muscle) or trapezius (shoulder muscle), but it causes significantly less pain, weakness, and functional problems for patients after surgery. This matters because patients recover better and have fewer long-term complications when surgeons choose the latissimus dorsi flap instead of the alternatives.

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Researchers measured how many tiny particles float into the air during facial surgery procedures, which is important because COVID-19 spreads through the nose and mouth. They tested five different surgical techniques on cadavers and found that drilling into the jaw and skull creates significant airborne particles, but using water irrigation during drilling reduces this risk; hand tools like rasps created almost no particles, while electric saws created a lot. The key takeaway: surgeons should use water irrigation when drilling bone and avoid electric saws during nose surgery if they're concerned about spreading airborne infections.

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Researchers examined 1,646 patients with stuffy noses to see whether having obstruction on just one side of the nose caused as much discomfort as having it on both sides. They found that patients with a deviated septum or narrowed nasal valve on one side reported the same level of nasal obstruction symptoms as patients with problems on both sides. This matters because doctors might overlook a one-sided nasal problem if the other side looks normal, but the research shows that even isolated obstruction on one side can cause significant symptoms and should be treated.

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Professional and semiprofessional ice hockey players rarely suffer voice box injuries, but when they do—caused by getting hit in the neck with a puck—these injuries can be serious enough to require surgery and emergency breathing support. Players who needed surgery took about six weeks to return to playing, while those who didn't needed surgery returned in four weeks, though one player continued to have a hoarse voice afterward. None of the injured players were wearing neck protection at the time of their injuries, so the researchers recommend that hockey players wear better protective gear to prevent these potentially life-threatening injuries.