Experience with reconstructive surgery in 137 cases of head and neck cancer

A retrospective analysis of 137 patients treated with reconstruction of defects following head and neck cancer surgery is presented. From 1976 through 1984, 151 regional flaps were used: 43 pectoralis myocutaneous, 29 deltopectoral, 19 forehead, 17 nasolabial, 14 combinations of the aforementioned and 15 other types. The minimum follow-up was two years. Of 62 patients (51 stage III and IV) operated as part of the primary treatment, 20 (32%) died due to relapse, of which 14 (23%) occurred within the region reconstructed. The corresponding figures for 64 patients receiving salvage surgery for recurrences were 53% and 39% respectively. Eleven patients had repair of wounds following surgery or irradiation. Major flap necrosis necessitating reoperation occurred in 11%. The average duration of hospitalization was 35 days. We feel that these results justify these resource-demanding operations.