Subscribe to RSS
DOI: 10.5999/aps.2014.41.2.148
Free Flap Reconstruction of Head and Neck Defects after Oncologic Ablation: One Surgeon's Outcomes in 42 Cases
Background Free flap surgery for head and neck defects has gained popularity as an advanced microvascular surgical technique. The aims of this study are first, to determine whether the known risk factors such as comorbidity, tobacco use, obesity, and radiation increase the complications of a free flap transfer, and second, to identify the incidence of complications in a radial forearm free flap and an anterolateral thigh perforator flap.
Methods We reviewed the medical records of patients with head and neck cancer who underwent reconstruction with free flap between May 1994 and May 2012 at our department of plastic and reconstructive surgery.
Results The patients included 36 men and 6 women, with a mean age of 59.38 years. The most common primary tumor site was the tongue (38%). The most commonly used free flap was the radial forearm free flap (57%), followed by the anterolateral thigh perforator free flap (22%). There was no occurrence of free flap failure. In this study, risk factors of the patients did not increase the occurrence of complications. In addition, no statistically significant differences in complications were observed between the radial forearm free flap and anterolateral thigh perforator free flap.
Conclusions We could conclude that the risk factors of the patient did not increase the complications of a free flap transfer. Therefore, the risk factors of patients are no longer a negative factor for a free flap transfer.
Publication History
Received: 14 May 2013
Accepted: 20 August 2013
Article published online:
02 May 2022
© 2014. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonCommercial License, permitting unrestricted noncommercial use, distribution, and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes. (https://creativecommons.org/licenses/by-nc/4.0/)
Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA
-
REFERENCES
- 1 Cheng MH, Huang JJ. Oral cavity, tongue, and mandibular reconstructions. In: Neligan PC. Plastic surgery. 3rd ed. London: Elsevier Saunder; 2013: 307-335
- 2 Lenert JJ, Evans GR. Oral cavity reconstruction. In: Mathes SJ, Hentz VR. Plastic surgery: Vol. III head and neck. 2nd ed. Philadelphia, PA: Saunders Elsevier Cop.; 917-956
- 3 Hurvitz KA, Kobayashi M, Evans GR. Current options in head and neck reconstruction. Plast Reconstr Surg 2006; 118: 122e-133e
- 4 Hsing CY, Wong YK, Wang CP. et al. Comparison between free flap and pectoralis major pedicled flap for reconstruction in oral cavity cancer patients: a quality of life analysis. Oral Oncol 2011; 47: 522-527
- 5 Chen CH, Lin GT, Fu YC. et al. Comparison of deltopectoralis flap and free radial forearm flap in reconstruction after oral cancer ablation. Oral Oncol 2005; 41: 602-606
- 6 Foucher G, Schuind F. A new trick for end-to-end anastomosis in microvascular surgery. Modified Harashina procedure. J Reconstr Microsurg 1984; 1: 49-51
- 7 Bozikov K, Arnez ZM. Factors predicting free flap complications in head and neck reconstruction. J Plast Reconstr Aesthet Surg 2006; 59: 737-742
- 8 Bianchi B, Copelli C, Ferrari S. et al. Free flaps: outcomes and complications in head and neck reconstructions. J Craniomaxillofac Surg 2009; 37: 438-442
- 9 Choi JW, Lew DH, Lee WJ. et al. Analysis of 180 head and neck reconstructional cases with free flap transfer. J Korean Soc Plast Reconstr Surg 2003; 30: 573-578
- 10 Bourget A, Chang JT, Wu DB. et al. Free flap reconstruction in the head and neck region following radiotherapy: a cohort study identifying negative outcome predictors. Plast Reconstr Surg 2011; 127: 1901-1908
- 11 Mulholland S, Boyd JB, McCabe S. et al. Recipient vessels in head and neck microsurgery: radiation effect and vessel access. Plast Reconstr Surg 1993; 92: 628-632
- 12 Singh B, Cordeiro PG, Santamaria E. et al. Factors associated with complications in microvascular reconstruction of head and neck defects. Plast Reconstr Surg 1999; 103: 403-411
- 13 Chao AH, Chang DW, Shuaib SW. et al. The effect of neoadjuvant versus adjuvant irradiation on microvascular free flap reconstruction in sarcoma patients. Plast Reconstr Surg 2012; 129: 675-682
- 14 Baek JH, Choi JW, Lee WJ. et al. The versatility of the anterolateral thigh perforator flap in oral cavity reconstruction after cancer ablation surgery. J Korean Soc Plast Reconstr Surg 2004; 31: 643-648
- 15 Smith GI, O'Brien CJ, Choy ET. et al. Clinical outcome and technical aspects of 263 radial forearm free flaps used in reconstruction of the oral cavity. Br J Oral Maxillofac Surg 2005; 43: 199-204
- 16 Bianchi B, Ferri A, Ferrari S. et al. The free anterolateral thigh musculocutaneous flap for head and neck reconstruction: one surgeon's experience in 92 cases. Microsurgery 2012; 32: 87-95
- 17 Kesting MR, Holzle F, Wales C. et al. Microsurgical reconstruction of the oral cavity with free flaps from the anterolateral thigh and the radial forearm: a comparison of perioperative data from 161 cases. Ann Surg Oncol 2011; 18: 1988-1994