Head and neck microvascular reconstruction in the elderly patient: impact of comorbidities

Objectives: Microsurgical free flaps are nowadays considered the gold standard for reconstruction of patients undergoing surgical treatment of advanced head and neck cancer. Our aim is to evaluate the safety and success of the procedure in the elderly population.

Methods: A retrospective review of 70 patients aged 70 years or older who underwent microvascular free tissue transfer for head and neck reconstruction from 1998 to 2012 at our Unit is done. The main location of the defect was the oral cavity. Flap success and surgical and medical perioperative complications were analyzed.

Results: Free flap survival was 94.3%. The overall complication rate was 41.4%. Perioperative medical complications occurred in 25.71% of the cases, mainly cardiovascular and respiratory minor complications. The surgical complication rate was 15.71%. American Society of Anesthesiologists status and significant preoperative comorbidity were associated with an increased risk of development of major complications.

Conclusions: Microsurgical free tissue transfer is a safe and reliable procedure in the elderly population. However, it implies an increased risk of perioperative morbidity and mortality. A better patient selection, a careful preoperative assessment of comorbidities and an exhaustive care and postoperative monitoring of the patient must be performed.

Key words: head and neck; free-flap; elderly; morbidity

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Jan 21, 2018 | Posted by in Oral and Maxillofacial Surgery | Comments Off on Head and neck microvascular reconstruction in the elderly patient: impact of comorbidities
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