Preoperative radiation therapy and its effects on outcomes in microsurgical head and neck reconstruction

2005 ◽  
Vol 132 (6) ◽  
pp. 845-848 ◽  
Author(s):  
Samuel Lin ◽  
Jose Dutra ◽  
JAY Keni ◽  
Gregory A. Dumanian ◽  
Neil Fine ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Head And Neck ◽  
Complication Rate ◽  
Head And Neck Reconstruction ◽  
Consecutive Series ◽  
Microvascular Reconstruction ◽  
Preoperative Radiation ◽  
Ischemic Time ◽  
Neck Reconstruction ◽  
Preoperative Radiation Therapy

OBJECTIVE: Preoperative radiation therapy is considered a significant factor in head and neck reconstruction. STUDY AND DESIGN AND SETTING: In our consecutive series of 114 patients, 44 patients had prior head and neck irradiation. The 2 groups were compared on the basis of age, ischemic time, and flap size and were found not to be statistically different. The average ischemic time for the irradiated group was 94.1 minutes, and the average was 102.8 minutes for the nonirradiated group. The average flap size for the irradiated group was 69.5 cm 2 , and was 72.0 cm 2 , for the nonirradiated group. RESULTS: Using a single-factor analysis of variance, the 2 groups did not differ statistically. The overall major flap complication rate for both irradiated and nonirradiated groups was approximately 10%. CONCLUSION: Microvascular reconstruction was accomplished in both irradiated and nonirradiated head and neck patients, with a 99% total flap survival rate and a 10% major flap complication rate.

Mechanical venous Anastomosis in Head and Neck Microvascular Reconstruction as an Equivalent to the Gold Standard

2017 ◽  
Vol 96 (2) ◽  
pp. E32-E36 ◽  
Author(s):  
Eric Thorpe ◽  
Yash Patil
Keyword(s):  
Head And Neck ◽  
Gold Standard ◽  
Case Series ◽  
Head And Neck Reconstruction ◽  
Consecutive Series ◽  
Microvascular Reconstruction ◽  
Venous Outflow ◽  
Venous Anastomosis ◽  
Flap Survival ◽  
Neck Reconstruction

To define the most successful and efficient manner to perform venous microvascular anastomoses, the effectiveness of mechanical venous anastomosis in head and neck microvascular reconstruction is reviewed. Head and neck reconstruction with free flap techniques has become the norm and gold standard for large defects. This retrospective, multicenter case series of a single microvascular surgeon's experience with mechanical venous anastomoses specifically assessed the effectiveness of head and neck reconstruction and the complications associated with it. Data were collected from two separate academic centers and are reported from a consecutive series of patients over the course of 10 years. All patients underwent microvascular reconstruction of the head and neck region using venous couplers and flap survival. Flap survival was greater than 98% using mechanical venous couplers as the primary means for venous outflow in this series of 402 consecutive patients and 431 total microvascular flaps. Venous couplers were performed in every instance. The study shows that mechanical venous anastomosis provides a highly effective and efficient means for venous outflow in head and neck microvascular reconstruction, and should be considered equivalent to the gold standard suture technique, even in the most difficult cases.

Changes in the Ki-67 Labeling Rates of Head and Neck Squamous Cell Carcinomas during Preoperative Radiation Therapy

Oncology ◽  
1992 ◽  
Vol 49 (6) ◽  
pp. 450-453 ◽  
Author(s):  
Yasuhiro Ogawa ◽  
Taisuke Inomata ◽  
Akihito Nishioka ◽  
Tomoho Maeda ◽  
Harumichi Seguchi ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Head And Neck ◽  
Squamous Cell ◽  
Squamous Cell Carcinomas ◽  
Preoperative Radiation ◽  
Ki 67 ◽  
Preoperative Radiation Therapy

Reliability of Temporal Vascular Anastomosis and Techniques for Better Outcomes

2021 ◽  
Author(s):  
Kentaro Tanaka ◽  
Nobuko Suesada ◽  
Tsutomu Homma ◽  
Hiroki Mori ◽  
Mutsumi Okazaki
Keyword(s):  
Venous Thrombosis ◽  
Head And Neck ◽  
Skull Base ◽  
Complication Rate ◽  
Vascular Anastomosis ◽  
Head And Neck Reconstruction ◽  
Temporal Region ◽  
Skull Base Reconstruction ◽  
Anastomotic Complications ◽  
Neck Reconstruction

Abstract Background Although there are several potential recipient vessels in the neck, those in the temporal region are limited. In skull base reconstruction, there are difficulties associated with the anastomosing recipient vessels in the neck region since long nutrient vessels are needed in the flap. We evaluated the reliability of temporal vascular anastomosis by comparing surgical outcomes between reconstructive methods and examined which surgical procedures may achieve better results. Methods We examined the medical records of free tissue transfer cases between April 2007 and March 2018. Seventy-three surgeries were performed in the temporal region, including skull base reconstruction in 48, head and neck reconstruction (without skull base) in 16, and secondary surgery for head deformities in nine cases. In total, 445 neck surgeries were performed. Postoperative complications were retrospectively analyzed. Results The postoperative complication rates were 8.2 and 2.7% for all temporal and neck surgeries, respectively. There were no arterial complications in the temporal region and all of the six postoperative anastomotic complications were due to venous thrombosis. In contrast, there were 12 cases of vascular anastomotic complications, with six cases each of arterial and venous thrombosis in the neck. In the temporal region, the complication rate was 2.1% for skull base reconstruction, 11% for secondary revision, and 25% in head and neck reconstruction. The corresponding values for middle temporal vein (MTV) usage rates were 54, 22, and 25%. In skull base reconstruction, a coronal incision was made in all cases. A more frequent use of the MTV was associated with a reduced complication rate. Conclusion The low complication rate in the temporal region was attributed to the wide surgical field and low tension of anastomotic vessels. Multiple venous anastomoses, including those of the MTV, are recommended to prevent complications.

Anatomy, Exposure, and Preparation of Recipient Vessels in Microsurgical Head and Neck Reconstruction

2020 ◽  
Author(s):  
Hope Xu ◽  
Leila Jazayeri ◽  
Evan Matros ◽  
Peter W. Henderson
Keyword(s):  
Head And Neck ◽  
Clinical Anatomy ◽  
Head And Neck Reconstruction ◽  
Microvascular Reconstruction ◽  
Submandibular Region ◽  
Comprehensive Review ◽  
Neck Reconstruction ◽  
Posterior Triangle

AbstractSuccessful microvascular reconstruction of head and neck defects requires the ability to safely identify, isolate, and utilize recipient vessels. To date, however, a comprehensive review of the anatomy and techniques relevant to the available anatomic regions has not been undertaken. This review covers the relevant clinical anatomy of the anterior triangle, posterior triangle, submandibular region, intraoral region, preauricular region, chest, and arm, taking particular care to highlight the structures that are crucial to identify while performing each dissection. Finally, a step-by-step technique for safely dissecting the recipient vessels at each site is provided.

The effect of preoperative radiotherapy on complication rate after microsurgical head and neck reconstruction

2011 ◽  
Vol 64 (11) ◽  
pp. 1454-1459 ◽  
Author(s):  
Arash Momeni ◽  
Rebecca Y. Kim ◽  
Ahlia Kattan ◽  
Josh Tennefoss ◽  
Tim H.-C. Lee ◽  
...  
Keyword(s):  
Head And Neck ◽  
Complication Rate ◽  
Preoperative Radiotherapy ◽  
Head And Neck Reconstruction ◽  
Neck Reconstruction

scholarly journals Head and neck oncological reconstruction with 114 free flaps in a Portuguese tertiary cancer center

2021 ◽  
Vol 34 (13) ◽  
Author(s):  
Andreia Silva ◽  
Patrícia Caixeirinho ◽  
Miguel Vilares ◽  
Carina Semedo ◽  
Mariluz Martins ◽  
...  
Keyword(s):  
Head And Neck ◽  
Perioperative Complications ◽  
Tumor Resection ◽  
Functional Results ◽  
Cancer Center ◽  
Head And Neck Reconstruction ◽  
Microvascular Reconstruction ◽  
Oncological Surgery ◽  
Microsurgical Reconstruction ◽  
Neck Reconstruction

Introduction: The Portuguese experience in microsurgical reconstruction of the head and neck after oncological surgery is scantly described. The primary aim of this study was to characterize the use of microvascular reconstruction after head and neck tumor resection in a Portuguese tertiary oncological centerMaterial and Methods: The authors retrospectively evaluated 114 microvascular free flap procedures performed for head and neck reconstruction after oncological resection in a department of Head and Neck Surgery of a Portuguese tertiary oncological center. Patients were operated on from January 2012 to May 2018. Data on patient demographic features, tumour characteristics, perioperative complications, postoperative aesthetic and functional results, survival time and time to recurrence were extracted.Results: Most tumours mandating microsurgical reconstruction were mucosal squamous cell carcinomas (85%) and were located in the oral region (95.6%). Around 45% of the patients had a T4a tumour and 30% a T2 tumour. Cervical metastases were present in 45.6% of the cases. The radial forearm flap and the fibular flap were the most commonly used microsurgical reconstructive options (58% and 41%, respectively). More than 80% of patients had no post-operative complications. Partial necrosis of the flap occurred in 6.1% of patients, while total flap necrosis occurred in 3.5% of cases. Aesthetic and functional results were considered at least satisfactory in all patients in which the flaps survived.Discussion: This study is by far the largest series of microsurgical head and neck reconstruction after oncological surgery reported by a single tertiary centre in Portugal. Survival and functional benefits are similar to those reported in other large oncological centres in the world.Conclusion: Microvascular reconstruction seems like a reliable treatment option in head and neck oncological surgery at our institution.

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