title: Head and neck reconstruction using microsurgery: a 9-year retrospective study.
abstract: A total of 137 patients diagnosed with head and neck cancer underwent ablative surgery and primary free flap reconstruction during a period of 9 years, 2001-2009 (men 73.7 %, women 26.3 %). Surgery included a multidisciplinary approach involving plastic, head and neck, and maxillofacial surgeons. Squamous cell carcinoma (SCC) represented the vast majority of the diagnosed tumors (91.2 %); other tumors represented in the study were malignant melanoma, sarcoma, adenocarcinoma and blastoma. The free flaps (n = 143) used for reconstructive surgery included radial forearm flap (n = 128), fibular flap (n = 13) and rectus abdominis muscular flap (n = 2). Twenty patients (15 %) needed reoperation within 48 h due to clinical signs of hematoma (n = 8) and free flap ischemia (n = 12). Furthermore, we report a total of 12 free flap failures, giving an overall free flap success rate of 92 %. Five patients were treated due to infections at donor site (4 %). The overall survival rate (OS) in male patients diagnosed with oral SCC stage II-IV after 2 and 5 years was 82 and 78 %, respectively. Female patients in the same group displayed a 2- and 5-year OS of 78 and 67 %, respectively. Furthermore, analysis of patients treated for recurrence of primary SCC displayed a 2- and 5-year OS of 70 and 55 %, respectively. We conclude that our multidisciplinary approach and treatment algorithm for head and neck cancer including primary free flap reconstruction reconstitutes a safe and reliable tool.
authors: Department of Surgery, Section of Plastic Surgery and Burns, Haukeland University Hospital, University of Bergen, Bergen, Norway.
authors: G H
authors: GH
authors: Holom
authors: H
authors: H
authors: Seland
authors: E
authors: E
authors: Strandenes
authors: P G
authors: PG
authors: Liavaag
authors: S
authors: S
authors: Lybak
authors: S
authors: S
authors: Løes
authors: K
authors: K
authors: Tornes
authors: H N
authors: HN
authors: Vintertun
mesh_terms: D000230:Adenocarcinoma / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D005260:Female; D058752:Free Tissue Flaps; D006085:Graft Survival; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D008297:Male; D008545:Melanoma / Q000601:surgery; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D011183:Postoperative Complications; D019651:Plastic Surgery Procedures / Q000379:methods*; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012509:Sarcoma / Q000601:surgery; D016896:Treatment Outcome