The Effects of Preoperative Radiotherapy on Head and Neck Free Flap Anastomosis Success

Rostetter, Claudio; Kuster, Irina; Schenkel, Jan Samuel; Lanzer, Martin; Gander, Thomas; Kruse, Astrid L

doi:10.1016/j.joms.2016.05.020

Cited by 5 publications

(2 citation statements)

References 21 publications

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“…All of these increase the possibility of wound breakdown and exposure of the mesh. [26][27][28][29] In the present study, although the mesh exposure rate was higher in patients with history of previous surgery, the difference was not statistically significant. Surgery in the maxillary region is much more complicated than in the neck, and resection results in complex defects.…”

Section: Discussioncontrasting

confidence: 72%

“…The scarring and fibrosis that follow wound healing can restrict local blood flow and also increase mechanical tension in the wound. All of these increase the possibility of wound breakdown and exposure of the mesh 26–29 . In the present study, although the mesh exposure rate was higher in patients with history of previous surgery, the difference was not statistically significant.…”

Section: Discussioncontrasting

confidence: 68%

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Long‐term Effect of Individualized Titanium Mesh in Orbital Floor Reconstruction After Maxillectomy

et al. 2021

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The aim of this study was to determine the clinical outcomes and long-term stability of individualized titanium mesh combined with free flap for orbital floor reconstruction after maxillectomy and to identify the risk factors for titanium mesh exposure.Material and Methods: The data of 66 patients who underwent maxillectomy and orbital floor defect reconstruction by individualized titanium mesh in Peking University School and Hospital of Stomatology between 2011 and 2019 were retrospectively reviewed. Postoperative ophthalmic function and success of aesthetic restoration were assessed. Titanium mesh exposure was recorded and the risk factors were identified.Results: Mean follow-up was for 24.8 months (range, 6-92 months). Ophthalmic function was successfully restored in 63/66 patients. Aesthetic restoration was not considered satisfactory by 10 patients. Titanium mesh exposure occurred in six patients (exposure rate, 9.1%). Preoperative radiotherapy was identified as an independent risk factor for mesh exposure (OR = 28.8, P = 0.006). Previous surgery, postoperative radiotherapy, pathological type of the primary lesion, the type of tissue flap applied, and the use of intraoperative navigation were not significant risk factors. Six patients with titanium mesh exposure underwent second surgery, but mesh exposure recurred in two patients due to insufficient soft tissue coverage.Conclusion: Individualized titanium mesh with free flap can effectively restore maxilla-orbital defects. Preoperative radiotherapy is an independent predictor of postoperative titanium mesh exposure. Adequate soft tissue coverage of the mesh may reduce the risk of mesh exposure.

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Section: Discussioncontrasting

confidence: 72%

Section: Discussioncontrasting

confidence: 68%

Long‐term Effect of Individualized Titanium Mesh in Orbital Floor Reconstruction After Maxillectomy

et al. 2021

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Influence of preoperative radiotherapy on head and neck free‐flap reconstruction: Systematic review and meta‐analysis

et al. 2020

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The effect of preoperative external radiotherapy (XRT) on head and neck free‐flap reconstruction is still controversial. In this study, we aimed to determine the impact of preoperative XRT on the outcomes of head and neck microvascular free‐flap reconstruction. A systematic review and meta‐analysis was conducted in concordance with the Systematic reviews and Meta‐Analyses protocol. We searched several databases (PubMed, EMBASE, Web of Science, and Cochrane Library) to find published papers on the topic. The R program was used for data synthesis and statistical heterogeneity evaluation; then, fixed effect or random effect models were used. A total of 37 studies, involving 12 408 patients with 12 668 flaps, were included in this meta‐analysis. The overall flap success rate for all studies was 94.4%. Pooled analysis showed that patients with preoperative XRT were significantly associated with an increased risk of total flap failure (odds ratio [OR] = 1.80, 95% confidence interval [CI] = 1.45‐2.23, P < .001), partial flap failure (OR = 1.90, 95% CI = 1.07‐3.38, P = .029), and postoperative complication rates (OR = 2.22, 95% CI = 1.64‐2.72, P < .001). Our study suggests that preoperative XRT is associated with an increased risk of developing free‐flap failure and an increased postoperative complication rate.

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Immediate Lymphatic Reconstruction for Prevention of Secondary Lymphedema: A Meta-Analysis

Chun

Saeg

Meade

et al. 2022

Journal of Plastic, Reconstructive & Aesthetic Surgery

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The Effects of Preoperative Radiotherapy on Head and Neck Free Flap Anastomosis Success

Cited by 5 publications

References 21 publications

Long‐term Effect of Individualized Titanium Mesh in Orbital Floor Reconstruction After Maxillectomy

Long‐term Effect of Individualized Titanium Mesh in Orbital Floor Reconstruction After Maxillectomy

Influence of preoperative radiotherapy on head and neck free‐flap reconstruction: Systematic review and meta‐analysis

Immediate Lymphatic Reconstruction for Prevention of Secondary Lymphedema: A Meta-Analysis

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