Eli A Gordin1, Yadranko Ducic. 1. Otolaryngology and Facial Plastic Surgery Associates, Fort Worth, Texas, U.S.A.
Abstract
OBJECTIVES/HYPOTHESIS: To assess the feasibility of microvascular free tissue transfer in the multiply irradiated patient. STUDY DESIGN: Retrospective cohort analysis of 48 patients in a tertiary care, private practice setting. METHODS: Inclusion criteria were defined as patients who received multiple courses of radiation and underwent subsequent free tissue reconstruction to manage treatment-related complications (n = 24) or defects following additional oncologic surgery (n = 24). The main outcome measures included total and partial flap necrosis, hardware exposure, and pharyngocutaneous fistula. The minimum follow-up was 6 months. RESULTS: One case of total flap failure, two cases of partial skin paddle necrosis, one case of poor wound healing of the surrounding tissue to the flap, six cases of hardware exposure, 11 cases of fistula with eight requiring operative intervention, three cases requiring and additional free flap to supplement reconstruction, and one stroke. CONCLUSIONS: Microvascular free tissue transfer to the head and neck is expected to provide a successful reconstruction in patients who have received multiple courses of radiation and who develop second primary tumors, recurrence of disease, or who suffer from late complications of their radiation therapy.
OBJECTIVES/HYPOTHESIS: To assess the feasibility of microvascular free tissue transfer in the multiply irradiated patient. STUDY DESIGN: Retrospective cohort analysis of 48 patients in a tertiary care, private practice setting. METHODS: Inclusion criteria were defined as patients who received multiple courses of radiation and underwent subsequent free tissue reconstruction to manage treatment-related complications (n = 24) or defects following additional oncologic surgery (n = 24). The main outcome measures included total and partial flap necrosis, hardware exposure, and pharyngocutaneous fistula. The minimum follow-up was 6 months. RESULTS: One case of total flap failure, two cases of partial skin paddle necrosis, one case of poor wound healing of the surrounding tissue to the flap, six cases of hardware exposure, 11 cases of fistula with eight requiring operative intervention, three cases requiring and additional free flap to supplement reconstruction, and one stroke. CONCLUSIONS: Microvascular free tissue transfer to the head and neck is expected to provide a successful reconstruction in patients who have received multiple courses of radiation and who develop second primary tumors, recurrence of disease, or who suffer from late complications of their radiation therapy.
Authors: Maximilian Gottsauner; Clara Fehrer; Steffen Spoerl; Johannes Schuderer; Florian Zeman; Mathias Fiedler; Michael Maurer; Torsten E Reichert; Tobias Ettl Journal: J Clin Med Date: 2022-08-27 Impact factor: 4.964