Free Flaps in Reconstruction of Extensive Defects after Oncological Head and Neck Surgery
Authors:
H. Binková 1; J. Hložek 1
; R. Kostřica 1; Z. Horáková 1
; J. Veselý 2; I. Stupka 2; L. Dražan 2; P. Hýža 2
Authors‘ workplace:
Klinika otorinolaryngologie a chirurgie hlavy a krku FN U svaté Anny, Brno a LF Masarykovy univerzity, Brno
; přednosta prof. MUDr. R. Kostřica, CSc.
Klinika plastické a estetické chirurgie FN U svaté Anny, Brno
1; přednosta prof. MUDr. J. Veselý, CSc.
2
Published in:
Otorinolaryngol Foniatr, 63, 2014, No. 2, pp. 75-81.
Category:
Original Article
Overview
The following study presents a retrospective analysis of microvascular free flap closure of postoperative defects at ENT clinic of St. Anne’s hospital in Brno in years 2002-2011.
87 free flaps were transferred with success rate 97.7%; only one flap underwent a total necrosis. The most frequent were free musculocutaneous flaps from m. latissimus dorsi – 43 and fasciocutaneous forearm Chinese flaps – 34. Postoperative defect closures (after previous maxillectomy -29 and glossectomy -18) for advanced tumors T3+T4 (94%) were predominating. The oncologic success rate can be considered as relatively high (5-year DSS 53%); local recurrence underneath the flap was confirmed in 23(26%) cases.
Keywords:
free flap, head neck cancer, microsurgery, plastics, reconstruction
Sources
1. Ariyan, S.: The pectoralis major myocutaneous flap: a versatile flap for reconstruction in the head and neck. Plast. Reconstr. Surg., 63, 1979, s. 73.
2. Bakamjian, V. Y.: A two-stage method for pharyngoesophageal reconstruction with a primary pectoral skin flap. Plast. Reconstr. Surg., 36, 1965, s. 173-179.
3. Baker, S. R.: Microvascular free flaps in soft-tissue augmentation of the head and neck. Arch. Otolaryngol. Head Neck Surg., 112, 1986, s. 733-737.
4. Bozikov, K., Arnez, Z. M.: Factors predicting free flap complications in head and neck reconstruction. Journal of Plastic, Reconstructive & Aesthetic Surgery, JPRAS, 59, 2006, s. 737-742
5. Brown, J. S., Devine, J. C., Magennis, P., Sillifant, P., Rogers, S. N., Vaughan, E. D: Factors that influence the outcome of salvage in free tissue transfer. British Journal of Oral & Maxillofacial Surgery, 41, 2003, s. 16-20.
6. Gusenoff, J. A., Vega, S. J., Juany, S., Behnam, A. B., Sbitany, H., Herrera, H. R., Smith, A., Serletti, J. M.: Free tissue transfer: comparison of out-comes between university hospitals and community hospitals. Plastic & Reconstructive Surgery, 118, 2006, s. 671-675.
7. Hidalgo, D. A, Disa, J. J., Cordeiro, P. G., Hu, Q. Y.: A review of 716 consecutive free flaps for oncologic surgical defects: refinement in donor-site selection and technique. Plastic & Reconstructive Surgery, 102, 1998, s. 722-732.
8. Hidalgo, D. A., Jones, C. S.: The role of emergent exploration in free-tissue transfer: a review of 150 consecutive cases. Plast. Reconstr. Surg., 86, 1990, s. 492-498.
9. Khouri, R. K., Cooley, B. C., Kunselman, A. R., Landis, J. R., Yeramian, P., Ingram, D., Natarajan, N., Benes, Ch. O.; Wallemark, C., the International Microvascular Research Group: A prospective study of microvascular free-flap surgery and outcome. Plastic & Reconstructive Surgery, 102, 1998, 3, s. 711-721.
10. Kostrzewa, J. P., Lancaster, W. P., Iseli, T. A., Des-mond, R. A., William R., Carroll, W. R., Eben, L. Rosenthal, E. L.:Outcomes of salvage surgery with free flap reconstruction for recurrent oral and oropharyngeal cancer. Laryngoscope, 2009, s. 267-272.
11. Kroll, S. S., Schusterman, M. A., Reece, G. P., Miller, M. J., Evans, G. R., Robb, G. L., Baldwin, B. J.: Timing of pedicle thrombosis and flap loss after free-tissue transfer. Plastic & Reconstructive Surgery, 98, 1996, s. 1230-1233.
12. Kroll, S. S., Robb, G. L., Reece, G. P., Miller, M. J., Evans, G. R.,Baldwin, B. J., Wang, B., Schusterman, M. A.: Does prior irradiation increase the risk of total or partial fdree flap loss? J. Reconstr. Microsurg., 14, 1998, 4, s. 263-268.
13. Kuriloff, D. B., Sullivan, M. J.: Revascularized tissue transfers in head and neck surgery. In Bailey B. J, ed., Head and neck surgery - otolaryngology. Philadelphia, Lippincott-Raven, 1998, s. 2345-2387.
14. Molitor, M.: Radikální operace a rekonstrukce lalokovými přenosy u zhoubných nádorů hlavy a krku a optimalizace vztahu k chemoterapii a radioterapii. Doktorská dizertační práce. https://is.muni.cz/th/47143/lf_d/aaa_DP3.pdf.
15. Nakatsuka, T., Harii. K., Seato, H., Takushima, H., Ebihara, S.,Kimata, Y., Yamada, A., Ueda, K., Ichioka, S.: Analytic review of 2372 free flap transfers for head and neck reconstruction following cancer resection. J. Reconstr. Microsurg., 19, 2003, 6, s. 363-368.
16. Novakovic, D., Patel, R. S., Goldstein, D. P., Gullane, P. J.: Salvage of failed free flaps used in head and neck reconstruction. Head Neck Oncol., 2009, 1, s. 331-335.
17. Seidenberg, B., Rosenak, S. S., Hurwitt, F. S., Som, M. l.: Immediate reconstruction of the cervical esophagus by a revascularized isolated jejunal segment. Ann. Surg., 1959.
18. Sloan, S. H., Blackwell, K. E., Urken, M. L.: Reconstruction of major defects in the head and neck following cancor surgery .In: Myers E. N, Suen J. Y. eds., Cancer of the head and neck, 3rd edn. Philadelphia, PA, Saunders, 1996, s. 712-747.
19. Smilek, P., Kostřica, R., Hložek, J., Veselý, J.: Reconstruction of large postoperative defects after laryngopharyngectomies from an otorhinolaryngologistś point of view. Libri Oncologici, Zagreb, University Hostpital for Tumors, 31, 2003, 1-3, s. 47-51, ISSN 0300-8142.
20. Stupka, I., Veselý, J., Dražan, L., Hýža, P., Justan, I., Dvořák, Z., Novák, P.: 20 let mikrochirurgických rekonstrukcí pro nádorové onemocnění v oblasti hlavy a krku. Sborník abstrakt, Kongres České společnosti plastické chirurgie s mezinárodní účastí, Harrachov 2010, http://www.ruka-kosmetika.cz/sjezd/abstrakta.pdf.
Labels
Audiology Paediatric ENT ENT (Otorhinolaryngology)Article was published in
Otorhinolaryngology and Phoniatrics
2014 Issue 2
Most read in this issue
- Branchiogenic Nasopharyngeal Cyst
- Free Flaps in Reconstruction of Extensive Defects after Oncological Head and Neck Surgery
- Diagnostics of Extraesophageal Reflux in Children with Chronic Otitis Media with Effusion
- Does Antibiotic Therapy Influence Pain after Tonsillectomy?