Complications of Microvascular Head and Neck Surgery in the Elderly

• Published in: Archives of otolaryngology, head & neck surgery Vol. 124; no. 4; pp. 407 - 411
• Main Authors: Shaari, Christopher M, Buchbinder, Daniel, Costantino, Peter D, Lawson, William, Biller, Hugh F, Urken, Mark L
• Format: Journal Article Conference Proceeding
• Language: English
• Published: Chicago, IL American Medical Association 01-04-1998
• Subjects: Aged; Aged, 80 and over; Biological and medical sciences; Carcinoma, Squamous Cell - pathology; Carcinoma, Squamous Cell - surgery; Female; Follow-Up Studies; Graft Survival - physiology; Head and neck surgery. Maxillofacial surgery. Dental surgery. Orthodontics; Humans; Male; Medical sciences; Microsurgery - methods; Middle Aged; Neoplasm Staging; Otorhinolaryngologic Neoplasms - pathology; Otorhinolaryngologic Neoplasms - surgery; Postoperative Complications - etiology; Postoperative Complications - mortality; Regional Blood Flow - physiology; Retrospective Studies; Risk Factors; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the upper aerodigestive tract; Surgical Flaps - blood supply; Survival Rate; Human; Reconstruction; Mortality; Plastic surgery; Retrospective; Treatment; Surgery; Blood vessel; Microsurgery; Head and neck; Complication; Elderly; Comparative study; Geriatrics
• ISSN: 0886-4470; 2168-6181; 1538-361X; 2168-619X
• DOI: 10.1001/archotol.124.4.407

OBJECTIVES To evaluate the complications of head and neck reconstruction using microvascular free tissue transfers (MFTTs) performed in an elderly population and to determine whether these complications are more common than in a younger population. SETTING Tertiary referral center. PATIENTS AND DESIGN Retrospective, consecutive chart review of patients older than 70 years who underwent MFTT in the past 5 years (group 1). The complications in this population were compared with those in a second group (group 2) of consecutive patients younger than 70 years who were matched according to the site of the primary tumor. MAIN OUTCOME MEASURES Surgical and medical complications. RESULTS The median age for group 1 was 74 years and for group 2, 55 years. The overall complication rate for group 1 was 48%, compared with 57% for group 2. In group 1, surgical morbidity was less common and medical morbidity was more common than in group 2. Mortality rate was 6% for group 1 and 0% for group 2. The types of complications were similar for both groups. There was no difference in complication rates when complications were classified by site of the defect, patient status determined by American Society of Anesthesiologists classification, or use of preoperative radiation. The overall success rate of MFTT was 100% for group 1 and 94% for group 2. CONCLUSIONS Microvascular free tissue transfers for head and neck reconstruction can be safely performed in the elderly. An age older than 70 years does not increase the rate of surgical complications following head and neck reconstruction with MFTT. Medical complications, however, are more common and are equally divided between bronchopulmonary and cardiovascular effects.Arch Otolaryngol Head Neck Surg. 1998;124:407-411-->