Postcricoid Area, Malignant Tumors: Multimedia

References

1. Akin I, Torkut A, Ustunsoy E, et al. Results of reconstruction with free forearm flap following laryngopharyngo-oesophageal resection. J Laryngol Otol. Jan 1997;111(1):48-53. [Medline].

2. Arden RL, Rachel JD, Marks SC, Dang K. Volume-length impact of lateral jaw resections on complication rates. Arch Otolaryngol Head Neck Surg. Jan 1999;125(1):68-72. [Medline].

3. Axon PR, Woolford TJ, Hargreaves SP, et al. A comparison of surgery and radiotherapy in the management of post- cricoid carcinoma. Clin Otolaryngol. Aug 1997;22(4):370-4. [Medline].

4. Ayshford CA, Walsh RM, Watkinson JC. Reconstructive techniques currently used following resection of hypopharyngeal carcinoma. J Laryngol Otol. Feb 1999;113(2):145-8. [Medline].

5. Bakamjian VY. Total reconstruction of pharynx with medially based deltopectoral skin flap. N Y State J Med. Nov 1 1968;68(21):2771-8. [Medline].

6. Bardsley AF, Soutar DS, Elliot D, Batchelor AG. Reducing morbidity in the radial forearm flap donor site. Plast Reconstr Surg. Aug 1990;86(2):287-92; discussion 293-4. [Medline].

7. Barrett WL, Gluckman JL, Aron BS. Safety of radiating jejunal interposition grafts in head and neck cancer. Am J Clin Oncol. Dec 1997;20(6):609-12. [Medline].

8. Beauvillain C, Mahe M, Bourdin S, et al. Final results of a randomized trial comparing chemotherapy plus radiotherapy with chemotherapy plus surgery plus radiotherapy in locally advanced resectable hypopharyngeal carcinomas. Laryngoscope. May 1997;107(5):648-53. [Medline].

9. Blackwell KE, Buchbinder D, Urken ML. Lateral mandibular reconstruction using soft-tissue free flaps and plates. Arch Otolaryngol Head Neck Surg. Jun 1996;122(6):672-8. [Medline].

10. Bova R, Goh R, Poulson M, Coman WB. Total pharyngolaryngectomy for squamous cell carcinoma of the hypopharynx: a review. Laryngoscope. May 2005;115(5):864-9. [Medline].

11. Bowers KW, Edmonds JL, Girod DA, et al. Osteocutaneous radial forearm free flaps. The necessity of internal fixation of the donor-site defect to prevent pathological fracture. J Bone Joint Surg Am. May 2000;82(5):694-704. [Medline].

12. Boyd JB, Mulholland RS, Davidson J, et al. The free flap and plate in oromandibular reconstruction: long-term review and indications. Plast Reconstr Surg. May 1995;95(6):1018-28. [Medline].

13. Brizel DM, Albers ME, Fisher SR, et al. Hyperfractionated irradiation with or without concurrent chemotherapy for locally advanced head and neck cancer. N Engl J Med. Jun 18 1998;338(25):1798-804. [Medline].

14. Byers RM, Clayman GL, McGill D, et al. Selective neck dissections for squamous carcinoma of the upper aerodigestive tract: patterns of regional failure. Head Neck. Sep 1999;21(6):499-505. [Medline].

15. Chisholm M, Ardran GM, Callender ST, Wright R. A follow-up study of patients with post-cricoid webs. Q J Med. Jul 1971;40(159):409-20. [Medline].

16. Chisholm M. The association between webs, iron and post-cricoid carcinoma. Postgrad Med J. Apr 1974;50(582):215-9. [Medline].

17. Choi JO, Choi G, Chae SW, Jung KY. Combined use of pectoralis major myocutaneous and free radial forearm flaps for reconstruction of through-and-through defects from excision of head and neck cancers. J Otolaryngol. Dec 1999;28(6):332-6. [Medline].

18. Chu PY, Chang SY. Reconstruction after resection of hypopharyngeal carcinoma: comparison of the postoperative complications and oncologic results of different methods. Head Neck. Oct 2005;27(10):901-8. [Medline].

19. Clayman GL, Weber RS, Guillamondegui O, et al. Laryngeal preservation for advanced laryngeal and hypopharyngeal cancers. Arch Otolaryngol Head Neck Surg. Feb 1995;121(2):219-23. [Medline].

20. Cole I, Hughes L. The relationship of cervical lymph node metastases to primary sites of carcinoma of the upper aerodigestive tract: a pathological study. Aust N Z J Surg. Dec 1997;67(12):860-5. [Medline].

21. Cordeiro PG, Bacilious N, Schantz S, Spiro R. The radial forearm osteocutaneous "sandwich" free flap for reconstruction of the bilateral subtotal maxillectomy defect. Ann Plast Surg. Apr 1998;40(4):397-402. [Medline].

22. Cordeiro PG, Santamaria E. A classification system and algorithm for reconstruction of maxillectomy and midfacial defects. Plast Reconstr Surg. Jun 2000;105(7):2331-46; discussion 2347-8. [Medline].

23. Czaja JM, Gluckman JL. Surgical management of early-stage hypopharyngeal carcinoma. Ann Otol Rhinol Laryngol. Nov 1997;106(11):909-13. [Medline].

24. Davidson J, Boyd B, Gullane P, et al. A comparison of the results following oromandibular reconstruction using a radial forearm flap with either radial bone or a reconstruction plate. Plast Reconstr Surg. Aug 1991;88(2):201-8. [Medline].

25. Dikshit RP, Boffetta P, Bouchardy C, et al. Risk factors for the development of second primary tumors among men after laryngeal and hypopharyngeal carcinoma. Cancer. Jun 1 2005;103(11):2326-33. [Medline].

26. El-Deiry M, Funk GF, Nalwa S, et al. Long-term quality of life for surgical and nonsurgical treatment of head and neck cancer. Arch Otolaryngol Head Neck Surg. Oct 2005;131(10):879-85.

27. Ethunandan M, McVicar IH. Preformed above elbow cast for composite radial forearm free flap. Br J Oral Maxillofac Surg. Apr 1996;34(2):193-4. [Medline].

28. Farrington WT, Weighill JS, Jones PH. Post-cricoid carcinoma (a ten-year retrospective study). J Laryngol Otol. Jan 1986;100(1):79-84. [Medline].

29. Ferlito A, Rinaldo A. Level I dissection for laryngeal and hypopharyngeal cancer: is it indicated?. J Laryngol Otol. May 1998;112(5):438-40. [Medline].

30. Foster RD, Anthony JP, Sharma A, Pogrel MA. Vascularized bone flaps versus nonvascularized bone grafts for mandibular reconstruction: an outcome analysis of primary bony union and endosseous implant success. Head Neck. Jan 1999;21(1):66-71. [Medline].

31. Foster RD, Anthony JP, Singer MI, et al. Microsurgical reconstruction of the midface. Arch Surg. Sep 1996;131(9):960-5; discussion 965-6. [Medline].

32. Fu KK. Combined-modality therapy for head and neck cancer. Oncology (Huntingt). Dec 1997;11(12):1781-90, 1796; discussion 1796, 179. [Medline].

33. Fu KK, Cooper JS, Marcial VA, et al. Evolution of the Radiation Therapy Oncology Group clinical trials for head and neck cancer. Int J Radiat Oncol Biol Phys. Jun 1 1996;35(3):425-38. [Medline].

34. Garden AS, Morrison WH, Clayman GL, et al. Early squamous cell carcinoma of the hypopharynx: outcomes of treatment with radiation alone to the primary disease. Head Neck. Jul-Aug 1996;18(4):317-22. [Medline].

35. Garrett MJ. Megavoltage technique for treatment of carcinoma of the post cricoid region. Clin Radiol. Jan 1971;22(1):136-8. [Medline].

36. Gavilan J. Controversial issues in the management of the N+ neck. Proceedings from the 5th International Conference on Head and Neck Cancer. San Francisco, Calif; July 29-August 2, 2000:. 443-8.

37. Giovanoli P, Frey M, Schmid S, Flury R. Free jejunum transfers for functional reconstruction after tumour resections in the oral cavity and the pharynx: changes of morphology and function. Microsurgery. 1996;17(10):535-44. [Medline].

38. Goldberg P, Leclerc A, Luce D, et al. Laryngeal and hypopharyngeal cancer and occupation: results of a case control-study. Occup Environ Med. Jul 1997;54(7):477-82. [Medline].

39. Guenel P, Chastang JF, Luce D, et al. A study of the interaction of alcohol drinking and tobacco smoking among French cases of laryngeal cancer. J Epidemiol Community Health. Dec 1988;42(4):350-4. [Medline].

40. Hartley BE, Bottrill ID, Howard DJ. A third decade''s experience with the gastric pull-up operation for hypopharyngeal carcinoma: changing patterns of use. J Laryngol Otol. Mar 1999;113(3):241-3. [Medline].

41. Ho CM, Ng WF, Lam KH, et al. Submucosal tumor extension in hypopharyngeal cancer. Arch Otolaryngol Head Neck Surg. Sep 1997;123(9):959-65. [Medline].

42. Hoffman HT, Karnell LH, Shah JP, et al. Hypopharyngeal cancer patient care evaluation. Laryngoscope. Aug 1997;107(8):1005-17. [Medline].

43. Inglefield CJ, Kolhe PS. Fracture of the radial forearm osteocutaneous donor site. Ann Plast Surg. Dec 1994;33(6):638-42; discussion 643. [Medline].

44. International Agency for Research on Cancer Working Group. Alcohol drinking. 13-20 October 1987. IARC Monogr Eval Carcinog Risks Hum. 1988;44:1-378. [Medline].

45. International Agency for Research on Cancer Working Group. Tobacco smoking. IARC Monogr Eval Carcinog Risk Chem Hum. 1986;38:35-394. [Medline].

46. Jisander S. Lag screw fixation of composite radial forearm grafts in the reconstruction of mandibular discontinuities. J Oral Maxillofac Surg. Jan 1998;56(1):34-7. [Medline].

47. Jones NF, Johnson JT, Shestak KC, et al. Microsurgical reconstruction of the head and neck: interdisciplinary collaboration between head and neck surgeons and plastic surgeons in 305 cases. Ann Plast Surg. Jan 1996;36(1):37-43. [Medline].

48. Julieron M, Germain MA, Schwaab G, et al. Reconstruction with free jejunal autograft after circumferential pharyngolaryngectomy: eighty-three cases. Ann Otol Rhinol Laryngol. Jul 1998;107(7):581-7. [Medline].

49. Kroll SS, Schusterman MA, Reece GP, et al. Timing of pedicle thrombosis and flap loss after free-tissue transfer. Plast Reconstr Surg. Dec 1996;98(7):1230-3. [Medline].

50. Kroll SS, Schusterman MA, Reece GP, et al. Choice of flap and incidence of free flap success. Plast Reconstr Surg. Sep 1996;98(3):459-63. [Medline].

51. Lefebvre JL, Chevalier D, Luboinski B, et al. Larynx preservation in pyriform sinus cancer: preliminary results of a European Organization for Research and Treatment of Cancer phase III trial. EORTC Head and Neck Cancer Cooperative Group. J Natl Cancer Inst. Jul 3 1996;88(13):890-9. [Medline].

52. Marmuse JP, Guedon C, Koka VN. Gastric tube transposition for cancer of the hypopharynx and cervical oesophagus. J Laryngol Otol. Jan 1994;108(1):33-7. [Medline].

53. Mendenhall WM, Amdur RJ, Siemann DW, Parsons JT. Altered fractionation in definitive irradiation of squamous cell carcinoma of the head and neck. Curr Opin Oncol. May 2000;12(3):207-14. [Medline].

54. Mendenhall WM. Altered fractionation for squamous cell carcinoma of the head and neck. Proceedings from the 5th International Conference on Head and Neck Cancer. San Francisco, Calif; July 29-August 2, 2000:. 63-7.

55. Montgomery P, Willson PD, Mochloulis G, et al. Laparoscopically assisted total laryngopharyngoesophagectomy with gastric transposition. J Laryngol Otol. Nov 1996;110(11):1072-4. [Medline].

56. Moore MH, Sinclair SW, Blake GB. The hairless osteotomized radial forearm flap. Plast Reconstr Surg. Aug 1985;76(2):301-6. [Medline].

57. Nakamura K, Shioyama Y, Sasaki T, et al. Chemoradiation therapy with or without salvage surgery for early squamous cell carcinoma of the hypopharynx. Int J Radiat Oncol Biol Phys. Jul 1 2005;62(3):680-3. [Medline].

58. Nakatsuka T, Harii K, Asato H, et al. Comparative evaluation in pharyngo-oesophageal reconstruction: radial forearm flap compared with jejunal flap. A 10-year experience. Scand J Plast Reconstr Surg Hand Surg. Sep 1998;32(3):307-10. [Medline].

59. Nakatsuka T, Harii K, Takushima A, et al. Prefabricated free jejunal transfer: a new reconstructive technique for high pharyngeal defects. Plast Reconstr Surg. Feb 1999;103(2):458-64. [Medline].

60. Nakatsuka T, Harii K, Yamada A, et al. Dual free flap transfer using forearm flap for mandibular reconstruction. Head Neck. Nov-Dec 1992;14(6):452-8. [Medline].

61. Nigam A, Campbell JB, Das Gupta AR. Radiation induced tumours of the pharynx--can they be avoided?. J Laryngol Otol. Feb 1990;104(2):129-30. [Medline].

62. Nunez VA, Pike J, Avery C, et al. Prophylactic plating of the donor site of osteocutaneous radial forearm flaps. Br J Oral Maxillofac Surg. Jun 1999;37(3):210-2. [Medline].

63. Parsons JT, Mendenhall WM, Stringer SP, et al. Twice-a-day radiotherapy for squamous cell carcinoma of the head and neck: the University of Florida experience. Head Neck. Mar-Apr 1993;15(2):87-96. [Medline].

64. Pearson JG. The radiotherapy of carcinoma of the oesophagus and post cricoid region in south east Scotland. Clin Radiol. Jul 1966;17(3):242-57. [Medline].

65. Pickford MA, Soutar DS. Intraoral reconstruction using a second free flap for recurrent or metachronous carcinoma. Br J Plast Surg. Dec 1995;48(8):559-63. [Medline].

66. Pradhan SA. Post-cricoid cancer: an overview. Semin Surg Oncol. 1989;5(5):331-6. [Medline].

67. Richards SH, Kilby D, Shaw JD. Post-cricoid carcinoma and the Paterson-Kelly syndrome. J Laryngol Otol. Feb 1971;85(2):141-52. [Medline].

68. Ridge JA. Gene therapy for head and neck cancer. Proceedings from the 5th International Conference on Head and Neck Cancer. San Francisco, Calif; July 29-August 2, 2000:. 83-9.

69. Rivas B, Carrillo JF, Granados M. Oromandibular reconstruction for oncological purposes. Ann Plast Surg. Jan 2000;44(1):29-35. [Medline].

70. Robbins KT, Kumar P, Regine WF, et al. Efficacy of targeted supradose cisplatin and concomitant radiation therapy for advanced head and neck cancer: the Memphis experience. Int J Radiat Oncol Biol Phys. May 1 1997;38(2):263-71. [Medline].

71. Schusterman MA, Reece GP, Kroll SS, Weldon ME. Use of the AO plate for immediate mandibular reconstruction in cancer patients. Plast Reconstr Surg. Oct 1991;88(4):588-93. [Medline].

72. Sewnaik A, Hoorweg JJ, Knegt PP, et al. Treatment of hypopharyngeal carcinoma: analysis of nationwide study in the Netherlands over a 10-year period. Clin Otolaryngol. Feb 2005;30(1):52-7. [Medline].

73. Sidransky D. Molecular diagnosis and gene therapy of head and neck cancer. Proceedings from the 5th International Conference on Head and Neck Cancer. San Francisco, Calif; July 29-August 2, 2000:. 9-13.

74. Smith AA, Bowen CV, Rabczak T, Boyd JB. Donor site deficit of the osteocutaneous radial forearm flap. Ann Plast Surg. Apr 1994;32(4):372-6. [Medline].

75. Snow DG, Campbell JB, Smallman LA. Fanconi''s anaemia and post-cricoid carcinoma. J Laryngol Otol. Feb 1991;105(2):125-7. [Medline].

76. Soutar DS, Widdowson WP. Immediate reconstruction of the mandible using a vascularized segment of radius. Head Neck Surg. Mar-Apr 1986;8(4):232-46. [Medline].

77. Soutar DS, Scheker LR, Tanner NS, McGregor IA. The radial forearm flap: a versatile method for intra-oral reconstruction. Br J Plast Surg. Jan 1983;36(1):1-8. [Medline].

78. Spector JG, Sessions DG, Emami B, et al. Squamous cell carcinoma of the pyriform sinus: a nonrandomized comparison of therapeutic modalities and long-term results. Laryngoscope. Apr 1995;105(4 Pt 1):397-406. [Medline].

79. Stell PM, Carden EA, Hibbert J, Dalby JE. Post-cricoid carcinoma. Clin Oncol. Sep 1978;4(3):215-26. [Medline].

80. Stell PM. Treatment of post-cricoid carcinoma. J R Soc Med. Oct 1979;72(10):716-7. [Medline].

81. Stell PM, Ramadan MF, George WD. Post-cricoid carcinoma: the place of visceral transposition. Clin Oncol. Mar 1982;8(1):17-20. [Medline].

82. Stell PM, Ramadan MF, Dalby JE, et al. Management of post-cricoid carcinoma. Clin Otolaryngol. Jun 1982;7(3):145-52. [Medline].

83. Swanson E, Boyd JB, Manktelow RT. The radial forearm flap: reconstructive applications and donor-site defects in 35 consecutive patients. Plast Reconstr Surg. Feb 1990;85(2):258-66. [Medline].

84. Swanson E, Boyd JB, Mulholland RS. The radial forearm flap: a biomechanical study of the osteotomized radius. Plast Reconstr Surg. Feb 1990;85(2):267-72. [Medline].

85. The Department of Veterans Affairs Laryngeal Cancer Study Group. Induction chemotherapy plus radiation compared with surgery plus radiation in patients with advanced laryngeal cancer. N Engl J Med. Jun 13 1991;324(24):1685-90. [Medline].

86. Thoma A, Khadaroo R, Grigenas O, et al. Oromandibular reconstruction with the radial-forearm osteocutaneous flap: experience with 60 consecutive cases. Plast Reconstr Surg. Aug 1999;104(2):368-78; discussion 379-80. [Medline].

87. Thoma A, Allen M, Tadeson BH, et al. The fate of the osteotomized free radial forearm osteocutaneous flap in mandible reconstruction. J Reconstr Microsurg. May 1995;11(3):215-9. [Medline].

88. Vohra VG, Mukadum FK. Post cricoid cancer. Indian J Cancer. Mar 1973;10(1):45-54. [Medline].

89. Weinzweig N, Jones NF, Shestak KC, et al. Oromandibular reconstruction using a keel-shaped modification of the radial forearm osteocutaneous flap. Ann Plast Surg. Oct 1994;33(4):359-69; discussion 369-70. [Medline].

90. Weissler MC, Melin S, Sailer SL, et al. Simultaneous chemoradiation in the treatment of advanced head and neck cancer. Arch Otolaryngol Head Neck Surg. Aug 1992;118(8):806-10. [Medline].

91. Wenig BM. Atlas of Head and Neck Pathology. Philadelphia, Pa: WB Saunders; 1993.

92. Wong LY, Wei WI, Lam LK, Yuen AP. Salvage of recurrent head and neck squamous cell carcinoma after primary curative surgery. Head Neck. Nov 2003;25(11):953-9. [Medline].

93. Wookey H. The surgical treatment of cancer of the pharynx and upper esophagus. Surg Gynecol Obst. 1942;75:449-506.

94. Yom SS, Machtay M, Biel MA, et al. Survival impact of planned restaging and early surgical salvage following definitive chemoradiation for locally advanced squamous cell carcinomas of the oropharynx and hypopharynx. Am J Clin Oncol. Aug 2005;28(4):385-92. [Medline].

95. Zenn MR, Hidalgo DA, Cordeiro PG, et al. Current role of the radial forearm free flap in mandibular reconstruction. Plast Reconstr Surg. Apr 1997;99(4):1012-7. [Medline].

Further Reading

Keywords

malignant tumors of the postcricoid area, hypopharyngeal carcinoma, hypopharynx cancer, hypopharyngeal cancer, hypopharynx cancer, head and neck cancer, head and neck carcinoma, postcricoid cancer, post-cricoid cancer, postcricoid carcinoma, post-cricoid carcinoma, hypopharyngeal tumor, hypopharynx tumor, hypopharyngeal malignancy, postcricoid malignancy, Plummer-Vinson syndrome, Paterson-Brown-Kelly syndrome, squamous cell carcinoma, SCC, head and neck squamous cell carcinoma, head and neck SCC

Contributor Information and Disclosures

Author

Douglas B Villaret, MD, Residency Director, Assistant Professor, Department of Otolaryngology, Shands Hospital, University of Florida
Douglas B Villaret, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American Association for Cancer Research, and American College of Surgeons
Disclosure: Nothing to disclose.

Coauthor(s)

Neal D Futran, MD, Director of Head and Neck Surgery, Professor, Department of Otolaryngology-Head and Neck Surgery, University of Washington School of Medicine
Neal D Futran, MD is a member of the following medical societies: American Head and Neck Society
Disclosure: Nothing to disclose.

Scott P Stringer, MD, MS, FACS, Professor and Chairman, Department of Otolaryngology and Communicative Sciences, University of Mississippi Medical Center; Associate Vice Chancellor for Clinical Affairs
Scott P Stringer, MD, MS, FACS is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American College of Surgeons
Disclosure: Nothing to disclose.

Robert J Amdur, MD, Associate Chairman of Clinical Affairs, Associate Professor, Department of Radiation Oncology, Shands Hospital, University of Florida
Robert J Amdur, MD is a member of the following medical societies: American College of Radiology, American Medical Association, American Society for Therapeutic Radiology and Oncology, and Phi Beta Kappa
Disclosure: Nothing to disclose.

William M Mendenhall, MD, Professor, Department of Radiation Oncology, Shands Hospital, University of Florida
William M Mendenhall, MD is a member of the following medical societies: American College of Radiology, American Radium Society, American Society for Head and Neck Surgery, American Society for Therapeutic Radiology and Oncology, and Florida Medical Association
Disclosure: Nothing to disclose.

Medical Editor

M Abraham Kuriakose, MD, DDS, FRCS, Chairman, Head and Neck Institute, Amrita Institute of Medical Sciences
M Abraham Kuriakose, MD, DDS, FRCS is a member of the following medical societies: American Association for Cancer Research, American Head and Neck Society, British Association of Oral and Maxillofacial Surgeons, and Royal College of Surgeons of England
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

Karen Hall Calhoun, MD, Professor, Department of Otolaryngology-Head and Neck Surgery, The Ohio State University
Karen Hall Calhoun, MD is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngic Allergy, American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, American Head and Neck Society, American Medical Association, American Rhinologic Society, Association for Research in Otolaryngology, Society of University Otolaryngologists-Head and Neck Surgeons, Southern Medical Association, Texas Medical Association, and Texas Medical Association
Disclosure: Nothing to disclose.

CME Editor

Christopher L Slack, MD, Otolaryngology-Facial Plastic Surgery, Private Practice, Associated Coastal ENT; Medical Director, Treasure Coast Sleep Disorders
Christopher L Slack, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Medical Association
Disclosure: Nothing to disclose.

Chief Editor

Arlen D Meyers, MD, MBA, Professor, Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine
Arlen D Meyers, MD, MBA is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Head and Neck Society
Disclosure: Covidien Corp Consulting fee Consulting; US Tobacco Corporation unstricted gift unknown; Axis Three Corporation Ownership interest Consulting; Omni Biosciences Ownership interest Consulting; Sentegra Ownership interest Board membership; Syndicom Ownership interest Consulting; Oxlo  Consulting; Medvoy Ownership interest Management position