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Impact of radiotherapy on microsurgical reconstruction of the head and neck
Bettina Hohlweg-Majert1, Oliver Ristow, Katharina Gust
1Clinic for Oral, Maxillofacial and Plastical Surgery, Medicine & Aesthetics, Lenbachplatz 2a, 80333 Munich, Germany.
Purpose:
To examine tissue oxygenation and perfusion of free microvascular grafts after primary reconstruction, regarding outcome for patients received adjuvant radiotherapy and different types of grafts.
Patients And Methods:
Free microvascular grafts (n = 48) after primary reconstruction of the head and neck were examined for tissue oxygenation and perfusion over a period of 6 months. 28 patients received adjuvant radiotherapy. Using a laser doppler flowmetry combined with tissue spectroscopy of the Oxygen-to-see(®)--equipment (LEA Medizintechnik, Giessen), we were able to determine oxygen saturation, hemoglobin concentration, blood flow and blood flow velocity in the graft in each of two tissue depths (2, 8 mm). Different types of graft were compared.
Result:
Comparison of irradiated and non-irradiated grafts showed significant differences in tissue perfusion and oxygenation. Results for all radiated radial and fibula flaps showed no significant (p > 0.05) differences for all reviewed parameters. However, it showed no dose-volume effect with impaired functionality was found for irradiated grafts.
Conclusion:
Mircovascular free tissue grafts show an increased perfusion and oxygenation after radiation compared to non-irradiated grafts.