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Cervicofacial Rhytidectomy After Radiotherapy for Head and Neck Tumors.

Justin M Wudel¹, Sarah Novis², Shan R Baker²

¹Renew Facial Plastic Surgery, Edina, Minnesota.

JAMA Facial Plastic Surgery

|October 9, 2015

Summary

This summary is machine-generated.

Cervicofacial rhytidectomy after head and neck radiotherapy increases complication risks, particularly wound dehiscence. Patients need counseling on these elevated risks before cosmetic facial surgery.

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Area of Science:

Plastic Surgery
Oncology
Head and Neck Surgery

Background:

Head and neck cancer treatment often involves radiotherapy.
The safety and complication rates of elective cosmetic facial surgery, specifically cervicofacial rhytidectomy, following radiotherapy are not well-established.
Understanding these risks is crucial for patient selection and informed consent.

Purpose of the Study:

To evaluate complication rates in patients undergoing cervicofacial rhytidectomy after radiotherapy for head and neck tumors.
To compare these complication rates with those of patients who have not undergone radiotherapy.

Main Methods:

Retrospective review of 16 patients who had cervicofacial rhytidectomy post-radiotherapy and 16 age-matched controls.
Analysis of surgical complications, including type, radiation dose, delivery method, and time from radiotherapy to surgery.
Data collected between June and December 2013, analyzed from January 2014 to June 2015.

Main Results:

Two major complications (hematoma, stroke) occurred in the radiotherapy group; controls had transient facial nerve weakness and cellulitis.
Wound dehiscence occurred in two patients in the radiotherapy group.
Subcutaneous face-lift and concurrent chemotherapy were associated with increased complications (P=.02 and P=.04, respectively).

Conclusions:

Cervicofacial rhytidectomy after radiotherapy is associated with a higher risk of complications compared to surgery without prior radiation.
Wound dehiscence is more frequent but generally manageable conservatively.
Patients must be counseled regarding the increased risks before undergoing elective facial cosmetic surgery post-radiotherapy.