{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T21:53:36Z","timestamp":1781646816010,"version":"3.54.5"},"reference-count":32,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T00:00:00Z","timestamp":1774828800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T00:00:00Z","timestamp":1774828800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e0 degli Studi di Roma La Sapienza"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Oral Maxillofac Surg"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Reconstruction of the parotid region presents challenges due to the area\u2019s complex anatomy. A classification of defects from ablative surgery can simplify and systematize the reconstructive approach. This study aims to propose a structured decision-making framework to guide reconstructive planning.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>A retrospective study was conducted on patients with malignant parotid tumors treated at Policlinico Umberto I between 2013 and 2023. Non-malignant tumors were excluded. The analysis focused on the involvement of skin, soft tissue, bone, and nerves, the type of parotidectomy (superficial, total, extended), whether neck dissection was performed, and the type of reconstruction used.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Sixty-seven patients (mean age 55\u2009\u00b1\u200916 years) were included. Primary closure was performed in 42 cases (62.7%). Thirteen patients (19.4%) required reconstruction of soft tissue and\/or bony defects, including local cervicofacial flaps (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20092), pedicled locoregional flaps (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20094), free flaps (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20092), deep circumflex iliac artery free flaps (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20092), and pectoralis major myocutaneous flaps (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20093), with one secondary free scapular flap after iliac crest failure. Facial nerve resection was necessary in 25 patients (37%). Immediate facial nerve reconstruction was achieved with direct neurorrhaphy or interposition grafting in 11 cases and with nerve transfers (masseteric-to-facial or hypoglossal-to-facial) in 5 cases. Static facial reanimation procedures were performed in 9 patients, either alone or in combination.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Successful parotid reconstruction focuses on minimizing skin tension, addressing color mismatch, restoring volume, and preserving nerve function. Based on this experience, we propose a practical decision-making framework tailored to defect volume and functional loss involving skin\/soft tissue, bone, and nerve.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10006-026-01541-9","type":"journal-article","created":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T02:35:47Z","timestamp":1774838147000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Challenging reconstruction of oncologic defects of the parotid region: a single-institution experience and decision-making framework proposal"],"prefix":"10.1007","volume":"30","author":[{"given":"Andrea","family":"Cassoni","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Resi","family":"Pucci","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicol\u00f2","family":"Mangini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelica","family":"Meriano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Palma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashleigh","family":"Weyh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rui P.","family":"Fernandes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco Della","family":"Monaca","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentino","family":"Valentini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,3,30]]},"reference":[{"key":"1541_CR1","doi-asserted-by":"publisher","first-page":"102","DOI":"10.1016\/j.oraloncology.2016.12.007","volume":"65","author":"D Lombardi","year":"2017","unstructured":"Lombardi D, McGurk M, Vander Poorten V, Guzzo M, Accorona R, Rampinelli V, Nicolai P (2017) Surgical treatment of salivary malignant tumors. Oral Oncol 65:102\u2013113. https:\/\/doi.org\/10.1016\/j.oraloncology.2016.12.007","journal-title":"Oral Oncol"},{"issue":"7","key":"1541_CR2","doi-asserted-by":"publisher","first-page":"706","DOI":"10.1016\/S1368-8375(02)00007-6","volume":"38","author":"P Wahlberg","year":"2002","unstructured":"Wahlberg P, Anderson H, Bi\u00f6rklund A, M\u00f6ller T, Perfekt R (2002) Carcinoma of the parotid and submandibular glands\u2014a study of survival in 2465 patients. Oral Oncol 38(7):706\u2013713. https:\/\/doi.org\/10.1016\/S1368-8375(02)00007-6","journal-title":"Oral Oncol"},{"issue":"9","key":"1541_CR3","doi-asserted-by":"publisher","first-page":"1679","DOI":"10.1007\/s00432-015-1961-y","volume":"141","author":"O Guntinas-Lichius","year":"2015","unstructured":"Guntinas-Lichius O, Thielker J, Klussmann JP, Stennert E (2015) Incidence, treatment, and outcome of parotid carcinoma, 1996\u20132011: a population-based study in Thuringia, Germany. J Cancer Res Clin Oncol 141(9):1679\u20131688. https:\/\/doi.org\/10.1007\/s00432-015-1961-y","journal-title":"J Cancer Res Clin Oncol"},{"key":"1541_CR4","doi-asserted-by":"publisher","first-page":"39","DOI":"10.3389\/fsurg.2018.00039","volume":"5","author":"J Thielker","year":"2018","unstructured":"Thielker J, Grosheva M, Ihrler S, Wittig A, Guntinas-Lichius O (2018) Contemporary management of benign and malignant parotid tumors. Front Surg 5:39. https:\/\/doi.org\/10.3389\/fsurg.2018.00039","journal-title":"Front Surg"},{"issue":"1","key":"1541_CR5","doi-asserted-by":"publisher","first-page":"8","DOI":"10.11648\/j.jctr.20130101.12","volume":"1","author":"R Arrangoiz","year":"2013","unstructured":"Arrangoiz R (2013) Current thinking on malignant salivary gland neoplasms. J Cancer Treat Res 1(1):8\u201312. https:\/\/doi.org\/10.11648\/j.jctr.20130101.12","journal-title":"J Cancer Treat Res"},{"issue":"11","key":"1541_CR6","doi-asserted-by":"publisher","first-page":"2615","DOI":"10.1007\/s00405-018-5154-6","volume":"275","author":"O Guntinas-Lichius","year":"2018","unstructured":"Guntinas-Lichius O, Gabriel B, Klussmann JP, Beutner D (2018) Management of the facial nerve in parotid cancer: preservation or resection and reconstruction. Eur Arch Otorhinolaryngol 275(11):2615\u20132626. https:\/\/doi.org\/10.1007\/s00405-018-5154-6","journal-title":"Eur Arch Otorhinolaryngol"},{"issue":"2","key":"1541_CR7","doi-asserted-by":"publisher","first-page":"134","DOI":"10.1016\/j.critrevonc.2009.10.004","volume":"74","author":"M Guzzo","year":"2010","unstructured":"Guzzo M, Locati LD, Prott FJ, Gatta G, McGurk M, Licitra L (2010) Major and minor salivary gland tumors. Crit Rev Oncol Hematol 74(2):134\u2013148. https:\/\/doi.org\/10.1016\/j.critrevonc.2009.10.004","journal-title":"Crit Rev Oncol Hematol"},{"issue":"4","key":"1541_CR8","doi-asserted-by":"publisher","first-page":"354","DOI":"10.21037\/gs.2019.08.01","volume":"8","author":"YC Cai","year":"2019","unstructured":"Cai YC, Jiang S, Yu GY, Peng X (2019) Primary repair and reconstruction of tumor defects in parotid masseter region: a report of 58 cases. Gland Surg 8(4):354\u2013361. https:\/\/doi.org\/10.21037\/gs.2019.08.01","journal-title":"Gland Surg"},{"issue":"3","key":"1541_CR9","doi-asserted-by":"publisher","first-page":"265","DOI":"10.1016\/j.jcms.2012.10.006","volume":"41","author":"F Biglioli","year":"2013","unstructured":"Biglioli F, Colombo V, Tarabbia F, Mortini P (2013) Reconstruction of complex defects of the parotid region using a lateral thoracic wall donor site. J Craniomaxillofac Surg 41(3):265\u2013269. https:\/\/doi.org\/10.1016\/j.jcms.2012.10.006","journal-title":"J Craniomaxillofac Surg"},{"issue":"7","key":"1541_CR10","doi-asserted-by":"publisher","first-page":"1948","DOI":"10.3390\/cancers12071948","volume":"12","author":"A Cassoni","year":"2020","unstructured":"Cassoni A, Valentini V, Della Monaca M, Longo F, Di Giuli R, Terenzi V et al (2020) Head and neck osteosarcoma\u2014the ongoing challenge about reconstruction and dental rehabilitation. Cancers 12(7):1948. https:\/\/doi.org\/10.3390\/cancers12071948","journal-title":"Cancers"},{"issue":"4","key":"1541_CR11","doi-asserted-by":"publisher","first-page":"1177","DOI":"10.1007\/s00405-011-1882-6","volume":"269","author":"M Wierzbicka","year":"2012","unstructured":"Wierzbicka M, Kope\u0107 T, Szyfter W, Kereiakes T, Bem G (2012) The presence of facial nerve weakness on diagnosis of a parotid gland malignant process. Eur Arch Otorhinolaryngol 269(4):1177\u20131182. https:\/\/doi.org\/10.1007\/s00405-011-1882-6","journal-title":"Eur Arch Otorhinolaryngol"},{"issue":"2","key":"1541_CR12","doi-asserted-by":"publisher","first-page":"415","DOI":"10.1016\/j.otc.2015.10.007","volume":"49","author":"JR Cracchiolo","year":"2016","unstructured":"Cracchiolo JR, Shaha AR (2016) Parotidectomy for parotid cancer. Otolaryngol Clin North Am 49(2):415\u2013424. https:\/\/doi.org\/10.1016\/j.otc.2015.10.007","journal-title":"Otolaryngol Clin North Am"},{"key":"1541_CR13","volume-title":"NCCN Clinical Practice Guidelines in Oncology: Head and Neck Cancers. Version 1.2026","author":"National Comprehensive Cancer Network","year":"2026","unstructured":"National Comprehensive Cancer Network (2026) NCCN Clinical Practice Guidelines in Oncology: Head and Neck Cancers. Version 1.2026. NCCN, Plymouth Meeting (PA)"},{"key":"1541_CR14","volume-title":"AJCC Cancer Staging Manual","year":"2017","unstructured":"Amin MB, Edge SB, Greene FL, Byrd DR, Brookland RK, Washington MK et al (eds) (2017) AJCC Cancer Staging Manual, 8th edn. Springer, New York","edition":"8"},{"issue":"12","key":"1541_CR15","doi-asserted-by":"publisher","first-page":"2708e1","DOI":"10.1016\/j.joms.2017.08.006","volume":"75","author":"AH Al Shetawi","year":"2017","unstructured":"Al Shetawi AH, Quimby A, Fernandes R (2017) The cervicofacial flap in cheek reconstruction: a guide for flap design. J Oral Maxillofac Surg 75(12):2708e1\u2013e6. https:\/\/doi.org\/10.1016\/j.joms.2017.08.006","journal-title":"J Oral Maxillofac Surg"},{"issue":"3","key":"1541_CR16","doi-asserted-by":"publisher","first-page":"455","DOI":"10.1016\/j.fsc.2009.05.004","volume":"17","author":"EJ Dobratz","year":"2009","unstructured":"Dobratz EJ, Hilger PA (2009) Cheek defects. Facial Plast Surg Clin North Am 17(3):455\u2013467. https:\/\/doi.org\/10.1016\/j.fsc.2009.05.004","journal-title":"Facial Plast Surg Clin North Am"},{"issue":"11","key":"1541_CR17","doi-asserted-by":"publisher","first-page":"1822","DOI":"10.1111\/j.1524-4725.2009.01298.x","volume":"35","author":"LT Pontes","year":"2009","unstructured":"Pontes LT, Aluma-Tenorio MS, Firoz BF, Goldberg LH, Jih MH, Kimyai-Asadi A (2009) Plication of the superficial musculoaponeurotic system in reconstruction of cheek defects. Dermatol Surg 35(11):1822\u20131825. https:\/\/doi.org\/10.1111\/j.1524-4725.2009.01298.x","journal-title":"Dermatol Surg"},{"issue":"2","key":"1541_CR18","doi-asserted-by":"publisher","first-page":"267","DOI":"10.1016\/j.fsc.2004.11.004","volume":"13","author":"SD Pletcher","year":"2005","unstructured":"Pletcher SD, Kim DW (2005) Current concepts in cheek reconstruction. Facial Plast Surg Clin North Am 13(2):267\u2013281. https:\/\/doi.org\/10.1016\/j.fsc.2004.11.004","journal-title":"Facial Plast Surg Clin North Am"},{"issue":"2","key":"1541_CR19","doi-asserted-by":"publisher","first-page":"496","DOI":"10.1097\/00006534-200108000-00033","volume":"108","author":"FJ Menick","year":"2001","unstructured":"Menick FJ (2001) Reconstruction of the cheek. Plast Reconstr Surg 108(2):496\u2013504. https:\/\/doi.org\/10.1097\/00006534-200108000-00033","journal-title":"Plast Reconstr Surg"},{"issue":"3","key":"1541_CR20","doi-asserted-by":"publisher","first-page":"421","DOI":"10.1016\/j.coms.2014.05.010","volume":"26","author":"K Patel","year":"2014","unstructured":"Patel K, Lyu DJH, Kademani D (2014) Pectoralis major myocutaneous flap. Oral Maxillofac Surg Clin North Am 26(3):421\u2013426. https:\/\/doi.org\/10.1016\/j.coms.2014.05.010","journal-title":"Oral Maxillofac Surg Clin North Am"},{"issue":"5","key":"1541_CR21","doi-asserted-by":"publisher","first-page":"343","DOI":"10.1055\/s-0041-1733922","volume":"38","author":"JY Katsnelson","year":"2022","unstructured":"Katsnelson JY, Lam AC, Deschler DG, Emerick KS, Curry WT, Lin DT et al (2022) Postoperative complications associated with the choice of reconstruction in head and neck cancer: an outcome analysis of 4,712 patients from the ACS-NSQIP database. J Reconstr Microsurg 38(5):343\u2013360. https:\/\/doi.org\/10.1055\/s-0041-1733922","journal-title":"J Reconstr Microsurg"},{"issue":"12","key":"1541_CR22","doi-asserted-by":"publisher","first-page":"2694","DOI":"10.1002\/lary.29666","volume":"131","author":"J Thielker","year":"2021","unstructured":"Thielker J, Grosheva M, Ihrler S, Wittekindt C, Guntinas-Lichius O (2021) Long-term facial nerve outcome in primary parotid cancer surgery: a population-based analysis. Laryngoscope 131(12):2694\u20132700. https:\/\/doi.org\/10.1002\/lary.29666","journal-title":"Laryngoscope"},{"issue":"2","key":"1541_CR23","doi-asserted-by":"publisher","first-page":"133","DOI":"10.1097\/00020840-200404000-00014","volume":"12","author":"O Guntinas-Lichius","year":"2004","unstructured":"Guntinas-Lichius O (2004) The facial nerve in the presence of a head and neck neoplasm: assessment and outcome after surgical management. Curr Opin Otolaryngol Head Neck Surg 12(2):133\u2013141. https:\/\/doi.org\/10.1097\/00020840-200404000-00014","journal-title":"Curr Opin Otolaryngol Head Neck Surg"},{"issue":"1","key":"1541_CR24","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1002\/ca.21286","volume":"25","author":"V Divi","year":"2012","unstructured":"Divi V, Deschler DG (2012) Re-animation and rehabilitation of the paralyzed face in head and neck cancer patients. Clin Anat 25(1):99\u2013107. https:\/\/doi.org\/10.1002\/ca.21286","journal-title":"Clin Anat"},{"issue":"8","key":"1541_CR25","doi-asserted-by":"publisher","first-page":"2315","DOI":"10.1007\/s00405-020-05931-x","volume":"277","author":"SH Jeong","year":"2020","unstructured":"Jeong SH, Kim HY, Lee DH, Lee JK, Lim SC (2020) Facial nerve neurorrhaphy due to unexpected facial nerve injury during parotid gland tumor surgery. Eur Arch Otorhinolaryngol 277(8):2315\u20132318. https:\/\/doi.org\/10.1007\/s00405-020-05931-x","journal-title":"Eur Arch Otorhinolaryngol"},{"issue":"2","key":"1541_CR26","doi-asserted-by":"publisher","first-page":"459","DOI":"10.1016\/j.otc.2015.12.002","volume":"49","author":"A Razfar","year":"2016","unstructured":"Razfar A, Lee MK, Massry GG, Azizzadeh B (2016) Facial paralysis reconstruction. Otolaryngol Clin North Am 49(2):459\u2013473. https:\/\/doi.org\/10.1016\/j.otc.2015.12.002","journal-title":"Otolaryngol Clin North Am"},{"issue":"1","key":"1541_CR27","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1186\/s40463-019-0387-y","volume":"48","author":"CD Bovenzi","year":"2019","unstructured":"Bovenzi CD, Ciolek P, Crippen M, Curry JM, Krein H, Heffelfinger R (2019) Reconstructive trends and complications following parotidectomy: incidence and predictors in 11,057 cases. J Otolaryngol Head Neck Surg 48(1):14. https:\/\/doi.org\/10.1186\/s40463-019-0387-y","journal-title":"J Otolaryngol Head Neck Surg"},{"issue":"1","key":"1541_CR28","doi-asserted-by":"publisher","first-page":"106","DOI":"10.1186\/s12903-024-03872-z","volume":"24","author":"CB Dou","year":"2024","unstructured":"Dou CB, Ma SR, Zhang SL, Su H, Yu ZL, Jia J (2024) Algorithm for the reconstruction of the parotid region: a single institution experience. BMC Oral Health 24(1):106. https:\/\/doi.org\/10.1186\/s12903-024-03872-z","journal-title":"BMC Oral Health"},{"issue":"3","key":"1541_CR29","doi-asserted-by":"publisher","first-page":"282","DOI":"10.1055\/s-0040-1719050","volume":"37","author":"ML Mangialardi","year":"2021","unstructured":"Mangialardi ML, Honart JF, Qassemyar Q, Testelin S, Faivre J, Herlin C et al (2021) Reconstruction of extensive composite parotid region oncologic defects with immediate facial nerve reconstruction using a chimeric scapulodorsal vascularized nerve free flap. J Reconstr Microsurg 37(3):282\u2013291. https:\/\/doi.org\/10.1055\/s-0040-1719050","journal-title":"J Reconstr Microsurg"},{"issue":"1","key":"1541_CR30","doi-asserted-by":"publisher","first-page":"346","DOI":"10.1186\/s12903-025-05734-8","volume":"25","author":"W Wang","year":"2025","unstructured":"Wang W, Zhong YW, Zhang J, Shi Y, Lyu XM, Liu SM (2025) Reconstructing defects following radical parotidectomy using superficial circumflex iliac perforator flaps. BMC Oral Health 25(1):346. https:\/\/doi.org\/10.1186\/s12903-025-05734-8","journal-title":"BMC Oral Health"},{"issue":"2","key":"1541_CR31","doi-asserted-by":"publisher","first-page":"151","DOI":"10.1016\/j.ijom.2020.06.010","volume":"50","author":"M Xiao","year":"2021","unstructured":"Xiao M, Liu J, You Y, Yang X, Wang Y (2021) Primary squamous cell carcinoma of the parotid gland: clinicopathological characteristics, treatment, and prognosis. Int J Oral Maxillofac Surg 50(2):151\u2013157. https:\/\/doi.org\/10.1016\/j.ijom.2020.06.010","journal-title":"Int J Oral Maxillofac Surg"},{"issue":"2","key":"1541_CR32","doi-asserted-by":"publisher","first-page":"275e","DOI":"10.1097\/PRS.0b013e318213a11a","volume":"129","author":"S Ch\u2019ng","year":"2012","unstructured":"Ch\u2019ng S, Ashford BG, Gao K, McGuinness J, Clark JR (2012) Reconstruction of post-radical parotidectomy defects. Plast Reconstr Surg 129(2):275e\u201387e. https:\/\/doi.org\/10.1097\/PRS.0b013e318213a11a","journal-title":"Plast Reconstr Surg"}],"container-title":["Oral and Maxillofacial Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10006-026-01541-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10006-026-01541-9","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10006-026-01541-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T21:06:38Z","timestamp":1781643998000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10006-026-01541-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,30]]},"references-count":32,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["1541"],"URL":"https:\/\/doi.org\/10.1007\/s10006-026-01541-9","relation":{},"ISSN":["1865-1569"],"issn-type":[{"value":"1865-1569","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,30]]},"assertion":[{"value":"30 August 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 February 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 March 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Ethical approval was obtained from the Ethics Committee of Sapienza University of Rome, Italy (Prot. n. 0000209). Informed consent was obtained from all individual participants included in the study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Patients provided written informed consent for publication of anonymized clinical data and images.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors have no relevant financial or non-financial interests to disclose.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"65"}}