OBJECTIVES: The management of recurrent or persistent head and neck cancer poses a challenging problem. Salvage surgery for these individuals consists of ablative surgery, interstitial brachytherapy, and microsurgical free flap reconstruction. This study reviews complications after such reconstruction. METHODS: We reviewed 139 consecutive head and neck cancer patients undergoing free flap reconstruction from January 1994 to May 2002. These included 66 patients with recurrent head and neck cancer undergoing intraoperative brachytherapy (IOBT) and free flap reconstruction and 73 undergoing free flap reconstructions only. A total of 142 reconstructions were performed, with three patients in IOBT group receiving two free flap reconstructions per patient, giving us a total of 69 reconstructions in the IOBT group versus 73 in the non-IOBT group. Nine patients were excluded from the IOBT group because of nonsynchronous use of brachytherapy and reconstruction, and 10 patients were excluded from the other group because they had prior radiotherapy or surgical treatment, leaving us with a total of 123 reconstructions, 60 in the IOBT group and 63 in the non-IOBT group. The IOBT group patients received iodine Vicryl seed implants, palladium seed implants, or both, to deliver an average dose of 79.3 +/- 31.8 Gy (mean +/- 1SD) to the surgical bed. RESULTS: All patients were followed for evidence of local wound complications. The IOBT group showed multiple complications in 23 (38.33%) of 60 reconstructions, the most common being wound dehiscence in 11. This, when compared with the non-IOBT group complications (15.87%), was found to be statistically significant (chi test, P <.01). CONCLUSION: IOBT increases the rate of complications in patients undergoing microvascular free tissue transfer. This, however, should not deter or alter the aggressiveness of cancer therapy used for managing recurrent head and neck cancer.
OBJECTIVES: The management of recurrent or persistent head and neck cancer poses a challenging problem. Salvage surgery for these individuals consists of ablative surgery, interstitial brachytherapy, and microsurgical free flap reconstruction. This study reviews complications after such reconstruction. METHODS: We reviewed 139 consecutive head and neck cancerpatients undergoing free flap reconstruction from January 1994 to May 2002. These included 66 patients with recurrent head and neck cancer undergoing intraoperative brachytherapy (IOBT) and free flap reconstruction and 73 undergoing free flap reconstructions only. A total of 142 reconstructions were performed, with three patients in IOBT group receiving two free flap reconstructions per patient, giving us a total of 69 reconstructions in the IOBT group versus 73 in the non-IOBT group. Nine patients were excluded from the IOBT group because of nonsynchronous use of brachytherapy and reconstruction, and 10 patients were excluded from the other group because they had prior radiotherapy or surgical treatment, leaving us with a total of 123 reconstructions, 60 in the IOBT group and 63 in the non-IOBT group. The IOBT group patients received iodine Vicryl seed implants, palladium seed implants, or both, to deliver an average dose of 79.3 +/- 31.8 Gy (mean +/- 1SD) to the surgical bed. RESULTS: All patients were followed for evidence of local wound complications. The IOBT group showed multiple complications in 23 (38.33%) of 60 reconstructions, the most common being wound dehiscence in 11. This, when compared with the non-IOBT group complications (15.87%), was found to be statistically significant (chi test, P <.01). CONCLUSION:IOBT increases the rate of complications in patients undergoing microvascular free tissue transfer. This, however, should not deter or alter the aggressiveness of cancer therapy used for managing recurrent head and neck cancer.
Authors: Alexis Donneys; Noah S Nelson; Joseph E Perosky; Yekaterina Polyatskaya; Jose J Rodriguez; Christian Figueredo; Cheyenne A Vasseli; Hannah C Ratliff; Sagar S Deshpande; Kenneth M Kozloff; Steven R Buchman Journal: Bone Date: 2015-12-23 Impact factor: 4.398
Authors: David Hu; Ontario D Lau; Linda Wang; Guanyu Wang; Dorthe Schaue; Li Zhu; Min Huang; Yuan Lin; Miranda Dennis; Elliot Abemayor; David A Elashoff; Steven M Dubinett; William H McBride; Sherven Sharma; Ben Wu; Maie A St John Journal: Arch Otolaryngol Head Neck Surg Date: 2012-04
Authors: Alexis Donneys; Jordan T Blough; Noah S Nelson; Joseph E Perosky; Sagar S Deshpande; Stephen Y Kang; Peter A Felice; Christian Figueredo; Jonathan R Peterson; Kenneth M Kozloff; Benjamin Levi; Douglas B Chepeha; Steven R Buchman Journal: Head Neck Date: 2015-07-15 Impact factor: 3.147
Authors: Yuan Lin; Jie Luo; Weichao Eric Zhu; Minu Srivastava; Dorthe Schaue; David A Elashoff; Steven M Dubinett; Sherven Sharma; Benjamin Wu; Maie A St John Journal: Otolaryngol Head Neck Surg Date: 2014-05-13 Impact factor: 3.497
Authors: Alexis Donneys; Daniela M Weiss; Sagar S Deshpande; Salman Ahsan; Catherine N Tchanque-Fossuo; Deniz Sarhaddi; Benjamin Levi; Steven A Goldstein; Steven R Buchman Journal: Bone Date: 2012-10-18 Impact factor: 4.398