Influence of neck dissection and preoperative irradiation on microvascular head and neck reconstruction - Analysis of 853 cases

Ngian Chye Tan, Pao Yuan Lin, Yuan Cheng Chiang, Khong Yik Chew, Chien Chung Chen, Takashi Fujiwara, Yur Ren Kuo*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

32 Scopus citations

Abstract

Background: Previous neck dissection and irradiation is believed to affect the success of free tissue transfers in head and neck reconstruction, but evidence is scarce and conflicting. This study seeks to evaluate flap success rates in the presence of these two factors. Methods: Over a ten-year period, a total of 853 free flap cases were evaluated. Success rates were compared between a control group with no prior intervention (non-irradiation and neck dissection, NRTND) against three other groups: irradiation only (RT), previous neck dissection only (ND), and both (RTND). The choices of recipient vessel used were also compared. Results: The flap failure rate was 6.3% (4/63) in the RTND group; 4.8% (1/21) in the ND group; 5.2% (6/115) in the RT group; and 2.1% (14/654) in the NRTND group. There was no statistical significance among the four groups (P = 0.254). Ipsilateral neck vessels (92.7%) were more frequently used in the NRTND group. In contrast, the superficial temporal vessels, contra-lateral neck vessels were more likely to be selected in the groups with irradiation and/or neck dissection. Conclusions: Free tissue transfer in head and neck patients with previous irradiation and neck dissection is feasible and can be safely done. In addition, superficial temporal vessel could be the first choice in patients with previous radiotherapy and neck dissection.

Original languageEnglish
Pages (from-to)602-607
Number of pages6
JournalMicrosurgery
Volume34
Issue number8
DOIs
StatePublished - 01 11 2014

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© 2014 Wiley Periodicals, Inc.

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