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Head and neck free-flap reconstruction in the elderly
E E M Nao1, O Dassonville, E Chamorey
1Département de chirurgie, institut universitaire de la face et du cou, Centre Antoine-Lacassagne, 33, avenue de Valombrose, 06189 Nice, France.
European Annals of Otorhinolaryngology, Head and Neck Diseases
|January 18, 2011
Summary
Free-flap head and neck reconstruction is reliable in elderly patients. While advanced age doesn't increase flap failure, careful patient selection based on comorbidity is crucial for minimizing general complications.
Area of Science:
- Reconstructive Surgery
- Geriatric Medicine
- Head and Neck Oncology
Background:
- Free-flap reconstruction is a cornerstone in head and neck cancer management.
- Assessing its safety and reliability in elderly populations is critical due to potential comorbidities and physiological changes.
Purpose of the Study:
- To evaluate the reliability and outcomes of free-flap head and neck reconstruction specifically in elderly patients (≥70 years).
- To determine the impact of advanced age and comorbidity on free-flap failure and complication rates.
Main Methods:
- Retrospective analysis of 418 patients undergoing free-flap head and neck reconstruction (2000-2010).
- Included 95 patients aged 70 years or older.
- Univariate and multivariate analyses assessed the influence of age, comorbidity, and surgical factors on outcomes.
Main Results:
- Advanced age did not significantly impact free-flap failure or local complication rates.
- Elderly patients had a higher risk of general complications (multivariate analysis: P=0.007).
- High comorbidity levels significantly increased general complication rates (multivariate analysis: P=0.001).
- Circular total pharyngolaryngectomy was associated with increased free-flap failure and local complications.
Conclusions:
- Free-flap reconstruction is a safe and reliable procedure for elderly patients requiring head and neck reconstruction.
- Meticulous patient selection, particularly considering comorbidity levels, is essential for optimizing outcomes and minimizing risks.
