title: Microvascular head and neck reconstruction in the elderly: The University of Brescia experience.
abstract: Microvascular reconstruction in head and neck surgery is increasing in the elderly because of prolonged life expectancy. The purpose of this study was to evaluate the impact of age on outcomes after microvascular reconstruction.
  
  
  
  We retrospectively reviewed 453 microvascular reconstructions and stratified patients according to age (40.8% >65 years old). Medical and surgical complications and flap success rates were evaluated according to the American Society of Anesthesiologists (ASA) score for physical status and age.
  
  
  
  Overall flap success and perioperative mortality were 96.1% and 0.7%, respectively. Minor medical complications were higher in the elderly (28.1% vs 15.3%; p = .001). High ASA scores affected rates of major surgical (20% vs 9.2%; p = .001) and minor medical complications (27.2% vs 13.3%; p < .001).
  
  
  
  Microvascular reconstruction is reliable in the elderly. Age should not be considered a contraindication by itself; comorbidities play a stronger role in predicting adverse events. © 2015 Wiley Periodicals, Inc. Head Neck 38: E1488-E1492, 2016.
authors.affiliation: Department of Otorhinolaryngology - Head and Neck Surgery, University of Brescia, Brescia, Italy.
authors.forename: Cesare
authors.initials: C
authors.lastname: Piazza
authors.affiliation: Department of Otorhinolaryngology - Head and Neck Surgery, University of Brescia, Brescia, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Grammatica
authors.affiliation: Department of Otorhinolaryngology - Head and Neck Surgery, University of Brescia, Brescia, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Paderno
authors.affiliation: Department of Otorhinolaryngology - Head and Neck Surgery, University of Brescia, Brescia, Italy.
authors.forename: Valentina
authors.initials: V
authors.lastname: Taglietti
authors.affiliation: Department of Otorhinolaryngology - Head and Neck Surgery, University of Brescia, Brescia, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Del Bon
authors.affiliation: Department of Geriatrics, Clinical and Experimental Science, University of Brescia, Brescia, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Marengoni
authors.affiliation: Department of Otorhinolaryngology - Head and Neck Surgery, University of Brescia, Brescia, Italy.
authors.forename: Piero
authors.initials: P
authors.lastname: Nicolai
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D019651:Plastic Surgery Procedures; D012189:Retrospective Studies; D013524:Surgical Flaps / Q000637:transplantation*
keywords: advanced age; elderly; free flaps; medical complications; surgical complications