BACKGROUND: The purpose of this study was to determine the causes of head and neck free flap loss and to evaluate outcomes after subsequent microvascular and non-microvascular reconstruction. METHODS: Patients who experienced free flap loss between 2000 and 2012 were reviewed. RESULTS: There were 40 flap losses out of 3090 free flaps (1.3%). Twenty-eight patients underwent subsequent free flap reconstruction of which 27 free flaps were successful (96.4%), which was not significantly different from our initial flap success rate (p = .81). Of patients who underwent subsequent free flap reconstruction for oral/pharyngeal defects, 100% had >80% speech intelligibility and 87.5% were tube feed independent. By comparison, 42.9% of patients who underwent subsequent pectoralis major flap reconstruction had intelligible speech (p = .01) and 25.0% were independent of tube feeds (p = 0.02). CONCLUSION: Subsequent free flaps after initial free flap losses can be successful in selected patients. Functional outcomes after subsequent free flap reconstruction are favorable compared to pedicled flap reconstruction.
BACKGROUND: The purpose of this study was to determine the causes of head and neck free flap loss and to evaluate outcomes after subsequent microvascular and non-microvascular reconstruction. METHODS:Patients who experienced free flap loss between 2000 and 2012 were reviewed. RESULTS: There were 40 flap losses out of 3090 free flaps (1.3%). Twenty-eight patients underwent subsequent free flap reconstruction of which 27 free flaps were successful (96.4%), which was not significantly different from our initial flap success rate (p = .81). Of patients who underwent subsequent free flap reconstruction for oral/pharyngeal defects, 100% had >80% speech intelligibility and 87.5% were tube feed independent. By comparison, 42.9% of patients who underwent subsequent pectoralis major flap reconstruction had intelligible speech (p = .01) and 25.0% were independent of tube feeds (p = 0.02). CONCLUSION: Subsequent free flaps after initial free flap losses can be successful in selected patients. Functional outcomes after subsequent free flap reconstruction are favorable compared to pedicled flap reconstruction.
Authors: J L McCarty; A S Corey; M W El-Deiry; H M Baddour; B M Cavazuti; P A Hudgins Journal: AJNR Am J Neuroradiol Date: 2018-11-08 Impact factor: 3.825
Authors: Amit Walia; Jake J Lee; Ryan S Jackson; Angela C Hardi; Craig A Bollig; Evan M Graboyes; Joseph Zenga; Sidharth V Puram; Patrik Pipkorn Journal: Otolaryngol Head Neck Surg Date: 2021-09-07 Impact factor: 5.591
Authors: Paolo Iacoviello; Susanna Bacigaluppi; Simone Callegari; Carlo Rossello; Andrea Antonini; Marco Gramegna; Mariano Da Rold; Giuseppe Signorini; Giuseppe Verrina Journal: Front Surg Date: 2022-06-30
Authors: C Copelli; K Tewfik; L Cassano; N Pederneschi; S Catanzaro; A Manfuso; R Cocchi Journal: Acta Otorhinolaryngol Ital Date: 2017-10 Impact factor: 2.124
Authors: William W Thomas; Jason Brant; Jinbo Chen; Orly Coblens; John P Fischer; Jason G Newman; Ara A Chalian; Rabie M Shanti; Steven B Cannady Journal: JAMA Facial Plast Surg Date: 2018-03-01 Impact factor: 4.611