Fistulae After Successful Free Tissue Transfer to Head and Neck: Its Prevention and Treatment.
Fistulas, either between oral cavity and external face or between oral and nasal cavity, are major complications after microsurgical head and neck reconstruction. Any flaw in surgical planning, design, and execution may lead to this untoward outcome. Once fistula develops, it may interface with oncologic treatment, endanger the reconstruction, and increase overall patient suffering. This article analyzes individual factors involved in development of fistulas in spite of successful transfer of a free flap and proposes treatment guideline.
Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chang Gung Medical College, Chang Gung University, 199 Tun-Hwa North Road, Taipei 10591, Taiwan.
Nidal Farhan
NF
Al Deek
Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chang Gung Medical College, Chang Gung University, 199 Tun-Hwa North Road, Taipei 10591, Taiwan. Electronic address: fuchanwei@gmail.com.
Fu-Chan
FC
Wei
Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chang Gung Medical College, Chang Gung University, 199 Tun-Hwa North Road, Taipei 10591, Taiwan.
Chung-Kan
CK
Tsao
D005145:Face / Q000601:surgery; D005402:Fistula / Q000209:etiology / Q000517:prevention & control* / Q000601:surgery*; D058752:Free Tissue Flaps / Q000009:adverse effects* / Q000098:blood supply; D006257:Head / Q000601:surgery; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D008297:Male; D008866:Microsurgery / Q000009:adverse effects* / Q000379:methods; D008875:Middle Aged; D009333:Neck / Q000601:surgery; D019651:Plastic Surgery Procedures / Q000009:adverse effects; D016896:Treatment Outcome; D014947:Wounds and Injuries / Q000209:etiology / Q000601:surgery*
Cancer; Fistulas; Free flap; Microsurgical head and neck reconstruction; Radiotherapy