The use of microvascular free flaps in head and neck reconstruction performed by the otorhinolaryngologists: a series of 65 flaps

Year 2016, Volume: 26 Issue: 6, 317 - 324, 22.12.2016

Bora Başaran Selin Ünsaler İsmet Aslan

Abstract

Objectives: This study aims to assess the success rate of surgery and postoperative morbidity in patients who underwent major head and neck surgery with reconstruction by microvascular free flaps performed by otolaryngologists. Patients and Methods: We retrospectively analyzed the medical records of 63 patients 31 males, 32 females; mean age 47.9±12.5 years; range 20-71 years operated in our clinic between September 2012 - August 2016. The indications of reconstruction by free flap, success rates, need for revision and re-exploration, reasons of flap failure, morbidity and mortality were evaluated. Results: Thirty-seven 56.9% of the 65 microvascular free flaps were radial forearm; 23 flaps 35.4% were fibula and five flaps 7.7% were rectus abdominis. Three of the total 65 flaps ended up in failure; accordingly the success rate was 95.4%. Except for these three failure cases, an urgent re-exploration was performed on 13 patients in the first postoperative 48 hours n=16, %24.6 . No permanent major sequel was observed in any of the patients. Conclusion: From the otolaryngologists’ point of view, we observed that performing microvascular surgery and the successful surgical results not only gives the flexibility in reconstruction but also provides safer resection during ablative surgery.

Keywords

Free flap, head and neck surgery, microvascular, reconstruction

Baş boyun bölgesi rekonstrüksiyonunda kulak burun boğaz uzmanlarınca mikrovasküler serbest doku fleplerinin kullanımı: 65 fleplik seri

Abstract

Amaç: Bu çalışmada majör baş-boyun cerrahisi sonrası, kulak burun boğaz uzmanlarınca mikrovasküler serbest doku flebi ile rekonstrüksiyon yapılan hastalarda flep başarı oranları ve hasta morbiditesi araştırıldı. Hastalar ve Yöntemler: Eylül 2012 - Ağustos 2016 tarihleri arasında kliniğimizde ameliyat edilen toplam 63 hastanın 32 kadın, 31 erkek; ort. yaş 47.9±12.5 yıl; dağılım 20-71 yıl tıbbi kayıtları retrospektif olarak incelendi. Serbest doku flebi seçimindeki endikasyonlar, başarı oranları, revizyon ve reeksplorasyon gereksinimleri; flep kaybı, morbidite ve mortalite nedenleri değerlendirildi. Bulgular: Altmış beş mikrovasküler serbest doku flebinin 37’si %56.9 radyal ön kol, 23’ü %35.4 fibula ve beşi %7.7 rektus abdominis flebi idi. Toplam 65 flebin üçü kaybedildi, buna göre genel flep başarı oranı %95.4 idi. Kaybedilen üç flep dışında, 13 hastada ameliyat sonrası 48 saat içinde ameliyathanede reeksplorasyon yapıldı n=16, %24.6 . Hiçbir hastada donör sahada kalıcı majör sekel gelişmedi. Sonuç: Kulak burun boğaz uzmanı açısından bakıldığında, mikrovasküler tekniğe hakim olunması ve elde edilen başarılı cerrahi sonuçlar, rekonstrüksiyonda esneklik ve dolayısıyla da ablatif cerrahi sırasında da güvenli rezeksiyon rahatlığı sağladığı gözlemlendi.

Keywords

Serbest doku, baş-boyun cerrahisi, mikrovasküler, rekonstrüksiyon

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