Utilization of Free Tissue Transfer in Head and Neck Surgery

Smith, Russell B.; Sniezek, Joseph C.; Weed, Donald T.; Wax, Mark K.

doi:10.1016/j.otohns.2007.04.011

Cited by 83 publications

(60 citation statements)

References 62 publications

(144 reference statements)

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“…1 On the contrary, 12 out of 93 ICF categories (13%) identiWed a diVerence according to treatment modality. Three categories on anatomical structures were more destructed in the MVFF-group: s420 lymphatic nodes, s7101 bones of the head and neck region, and s810 structure of the skin.…”

Section: Inxuence Of Treatment On Detailed Aspects Of Functioningmentioning

confidence: 98%

“…Major advances in the surgical treatment for HNC during the past have focused on improving function and quality of life without compromising oncologic eVectiveness [1,2]. Besides laser surgery, which signiWcantly fulWlls this aim [3,4], modern free-Xap reconstruction oVered multiple advances for functional outcome in HNC survivors.…”

Section: Introductionmentioning

confidence: 99%

“…These defects often need to be reconstructed. Especially for larger tumors, free tissue transfer is frequently incorporated into a reconstructive algorithm for a multitude of defects and has been shown to improve functional impairment [1,2]. In terms of functional outcome microvascularized free Xaps often show better outcomes than pediculed Xaps [6].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Functional outcome in patients with advanced head and neck cancer: surgery and reconstruction with free flaps versus primary radiochemotherapy

Tschiesner

Schuster

Strieth

et al. 2011

Eur Arch Otorhinolaryngol

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The objective was to compare functional outcome in patients with advanced head and neck cancer (HNC) treated with (a) surgical resection and reconstruction with microvascular free flaps (MVFF) followed by radiochemotherapy versus (b) primary radiochemotherapy (RCT) on the basis of the International Classification of Functioning, Disability and Health (ICF) from WHO. This was a cross-sectional, multi-institutional study. The outcome measures included ICF Core Sets for HNC, the EORTC-QLQ, modules c30 + hn35 and the University of Washington-Quality of life Questionnaire (UW-QOL). Analyses included descriptive statistics, ranking exercises, and regression analyses in a cumulative logit model; 27 patients were treated with MVFF and 22 with RCT. Global Quality of life scores suggested a slightly better functional outcome for the surgical approach. The majority of ICF categories (81/93, 87%) did not show a difference in functional outcome between the two treatment approaches. In the remaining 12 ICF categories, n = 3 body structures were more affected in the MVFF group, while n = 3 body functions, and n = 6 activities/participations were more problematic in the RCT group. This included oral swallowing and weight maintenance functions as well as social relationships, acquiring a job, and economic self-sufficiency. In addition, nine contextual environmental factors were more relevant to the RCT group. Both treatment approaches seemed appropriate to advanced HNC from the perspective of functional outcome. The influence of treatment modalities on the social and economic lives of cancer survivors needs to be explored further. In order to guide rehabilitation according to patients' needs, the ICF offers a multidimensional view comprising body structures, body functions, and activities and participation in life.

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Section: Inxuence Of Treatment On Detailed Aspects Of Functioningmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Functional outcome in patients with advanced head and neck cancer: surgery and reconstruction with free flaps versus primary radiochemotherapy

Tschiesner

Schuster

Strieth

et al. 2011

Eur Arch Otorhinolaryngol

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“…Reconstruction with a regional pedicled flap or microvascular free flap reconstruction is often preferred over healing by secondary intention, skin grafting, or reconstruction with a local flap because of concerns about insufficient tissue to close large defects, poor healing in previously irradiated tissues, and the development of scar contracture that would interfere with speech and swallowing. [3][4][5] Although regional pedicled or microvascular free flaps have become widely adopted for postablative defects of the oropharynx, most patients who undergo surgical resection for SCCOP have advanced or recurrent disease, which is associated with poor postoperative quality of life and limited survival. 6,7 Contemporary oropharyngeal reconstructive techniques must continue to be objectively evaluated to determine whether associated morbidity and functional outcomes justify more complicated reconstructions, with the attendant longer hospital stays and increased costs for surgery and postoperative care, particularly in patients with advanced disease who may have a limited chance for long-term survival.…”

mentioning

confidence: 99%

Complications and functional outcomes following complex oropharyngeal reconstruction

et al. 2009

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“…It is an extensive, mutilating performance to remove the tumor and as the literature attests to, total rehabilitation of lobar structure of the tongue is very difficult, if not impossible 8,9 . The results of reconstruction of the tongue (swallowing, phonation) using free flap depend on the amount of remaining healthy tissue to ensure its mobility 10 . In our department, we encounter tumors in the early stages (T1 favorable sites) requiring mostly extirpation with primary suture and possibly local flap reconstruction.…”

Section: Discussionmentioning

confidence: 99%

Reconstructive procedures in maxillofacial oncosurgery

Pink¹,

Molitor²,

Tvrdý³

et al. 2016

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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Objective. Oropharyngeal cancers are a biologically heterogenous group of tumors with diverse risk factors including tobacco, alcohol, HPV, inherited disorders, the acquired immunodeficiency of Karposi's Sarcoma and non Hodgkin's lymphoma. In the Czech Republic, oropharyngeal cancers represent around 2% of all cancers. The treatment of these tumors is long and complex. Reconstructive procedures in maxillofacial oncosurgery demand good interdisciplinary collaboration and great professional preparedness of the surgical and nursing team. Patient age and stage of disease, including the presence of metastases are of key importance. A prerequisite for the success of surgical treatment is removal of the tumor with a sufficient safety margin. Reconstructive procedures then follow. Aim. To highlight the importance of radical tumor resection and describe reconstruction of the defect in a group of our patients. Methods and Results. From 2008 to 2013, 23 patients with oropharyngeal carcinoma underwent radical surgical removal of tumor, followed by reconstruction of postoperative defects using distant and free flaps. The histopathology showed predominantly squamous cell carcinomas and one of Merkel cell carcinoma. 16 patients had malignant disease detected in III-IV. In only 7 cases was treatment initiated in the first and second stages of the disease. In these patients, the tumors were removed with a safety margin of healthy tissue and in none, did the basic cancer recur . The postoperative course in terms of flap engraftment and overall condition of the patient was uneventful. All of these patients still enjoy a good life quality with a current mean survival in range 5 -76 months. Radical surgical removal of a malignant tumor in the early stages of the disease is associated with fewer postoperative complications and longer survival. Conclusion. To avoid the risk of local and/or systemic postoperative complications, appropriate patient selection is important. Overall, the traditional, classic reconstructive procedures with the use of prostheses, in many cases is still the best option in our experience.

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Utilization of Free Tissue Transfer in Head and Neck Surgery

Abstract: Free tissue transfer continues to be the reconstructive modality of choice for head and neck defects.

Cited by 83 publications

References 62 publications

Functional outcome in patients with advanced head and neck cancer: surgery and reconstruction with free flaps versus primary radiochemotherapy

Functional outcome in patients with advanced head and neck cancer: surgery and reconstruction with free flaps versus primary radiochemotherapy

Complications and functional outcomes following complex oropharyngeal reconstruction

Reconstructive procedures in maxillofacial oncosurgery

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