Background Free tissue transfer is a mainstay in reconstruction of complex head and neck defects. The purpose of this study was to determine if perioperative complications were more common in patients with body mass index (BMI) >30 kg/m2 undergoing free flap reconstruction. Methods A multi-institutional retrospective cohort was created. Medical complications, surgical complications, and procedural variables were recorded. Logistic regression was used to investigate univariate and multivariate associations between outcomes and predictors. Results Of 582 cases, 128 patients (22%) had BMI >30. Surgical complications occurred in 153 cases (26.3%), with an adjusted odds ratio (OR) for association of surgical complications with BMI >30 of 0.92 (p 5 .71). Medical complications occurred in 178 cases (30.6%), with an adjusted OR of 0.78 (p 5 .26). Age and advanced comorbidity status (Adult Comorbidity Evaluation-27 [ACE-27] 2 or 3) were associated with medical complications (p < .0001). Conclusion BMI >30 does not predict medical or surgical complications in patients undergoing head and neck free flap surgery.

This abstract was presented at the American Academy of Otolaryngology-Head and Neck Surgery Annual Meeting, Orlando, FL, September 2014 with the abstract published (Neumann C, Thompson D, and Sidman J; Assisted reproduction is not associated with increased risk of head and neck defects; Otolaryngology-Head and Neck Surgery; Vol 151, Issue 1, supplement, 2014). Objectives-Compare the rate of head and neck anomalies between children conceived via artificial reproductive technology (ART) versus those conceived via natural methods.-Determine the risk of congenital head and neck abnormalities associated with ART. Study designA retrospective chart review cross-sectional study from 2004-2014 of all patients admitted to the neonatal intensive care unit (NICU) at a tertiary pediatric hospital. ResultsA total of 14,857 charts were examined; 2,288 patients were conceived via ART, while 12,569 patients were conceived via natural methods. There were 8,022 males and 6,637 females. There were 40 patients born with defects via ART, while there were 681 patients born with defects via natural conception. The total occurrence of congenital malformations was higher for patients conceived naturally versus those conceived with artificial reproduction (5.41% vs. 1.74%). The odds ratio was 0.31 with a 95% CI of 0.23 to 0.43 and a P-value of < 0.0001; the relative risk of having any one of the head and neck defects with ART was 1.04 with a 95% CI of 1.03 to 1.05 and a P-value < 0.0001. ConclusionThere appears to be no increased risk of congenital head and neck defects in children conceived via ART versus those conceived naturally.

Objectives: (1) Compare the rate of head and defects between children conceived via assisted reproductive technology (ART) versus those conceived via natural methods. (2) Determine the risk of congenital head and neck abnormalities associated with ART. Methods: A retrospective chart review was conducted of all patients admitted to the neonatal intensive care unit over 10 years at Children’s Hospital of Minneapolis. The patients were divided into 2 groups: patients who were conceived via ART and patients who were conceived naturally. Each chart was evaluated for 15 different head and neck malformations, 11 of which were included in data analysis due to statistical significance. Results: There were a total of 14,857 charts examined; 2288 patients were conceived via ART, while 12,569 patients were conceived via natural methods. There were 40 patients born with defects via ART, while there were 681 patients born with defects via natural conception. There were a total of 9039 males and 6637 females. The total occurrence of congenital malformations was higher for patients not conceived with artificial reproduction versus those conceived with artificial reproduction (4.58% vs 0.27%). The odds ratio was 0.31 with a 95% confidence interval (CI) of 0.23 to 0.43, P value of <.0001; the relative risk of having any one of the aforementioned defects with ART was 1.04 with a 95% CI of 1.03 to 1.05, P value <.0001. Conclusions: There appears to be no increased risk of congenital head and neck defects in children conceived via ART versus those conceived via natural methods.

No abstract

Objectives: (1) Analyze associated findings in patients with hemifacial microsomia. (2) Determine if a new classification of hemifacial microsomia is possible. Methods: A retrospective chart of all patients diagnosed with hemifacial microsomia treated at Children’s Hospital of Minnesota. Each chart was reviewed for the presence of facial paralysis, microtia/anotia, aural atresia, mandibular hypoplasia, midface hypoplasia, dermoids, vertebral abnormalities, ocular abnormalities, sensorineural hearing loss, laterality, renal abnormalities, developmental delay, and skin tags. Results: A total of 75 patients with hemifacial microsomia were included in this study. There were 43 males and 32 females with an average age of 8.51 ± 5.45 years at the time of chart review. Occurrences for each defect were: facial paresis/paralysis (26.7%), microtia/anotia (73.3%), mandibular hypoplasia (72%), midface hypoplasia (57.3%), vertebral deformities (21.3%), ocular abnormalities (24%), dermoids (21.3%), renal abnormalities (12%), SNHL (17.3%), skin tags (42.7%), bilateral and developmental delay (24%). Regression models were used that showed the odds of having a spinal defect are 3.13 ( P = .001) times higher for each additional craniofacial defect present; furthermore if a patient has 2 or more craniofacial defects, the odds of having spinal defect were 31.6 ( P = .001) times as high as in patients with 1 or fewer. The odds of developing a renal defect were 36.0 ( P = .001) times as high as in patients with 1 or fewer craniofacial defects. Conclusions: The number of craniofacial defects, not just type or severity, increase the risk of having extracranial abnormalities in patients with hemifacial microsomia.