This Article  • References  • Full text PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

Report of 200 Cases and Review of Complications

Mark L. Urken, MD; Hubert Weinberg, MD; Daniel Buchbinder, DMD; Juan F. Moscoso, MD; William Lawson, MD, DDS; Peter J. Catalano, MD; Hugh F. Biller, MD

Arch Otolaryngol Head Neck Surg. 1994;120(6):633-640.

Abstract
Objective
Microvascular free-tissue transfer to the head and neck has become an accepted method of reconstruction owing to increased success rates and superior aesthetic and functional results. Although the large number of arteries and veins in the neck make free-flap revascularization easier than in other recipient sites of the body, there are also unique problems that pose significant risks to the success of the procedure. We report our experience with 200 microvascular free flaps performed between 1987 and 1992.

Setting
This study was conducted at a tertiary referral center.

Patients
The majority of patients in this series underwent surgery for squamous cell cancer. Approximately 75% of the reconstructions were performed for defects of the oral cavity. There were 120 vascularized bone-containing free flaps for mandibular and midface reconstruction. The remaining 80 soft-tissue flaps were used for a variety of defects ranging from the scalp to the pharyngoesophagus.

Results
An overall success rate of 93.5% for free-tissue transfers is reported. Greater experience with this technique has resulted in a reduction and a change in the nature of the complications encountered compared with those seen in the early part of our series. Donor and recipient site complications, including flap failures and anastomotic revisions, are analyzed in detail with respect to age, radiation status, donor site, and whether the ablative procedure was done for a primary or recurrent neoplasm.

(Arch Otolaryngol Head Neck Surg. 1994;120:633-640)

Footnotes
From the Departments of Otolaryngology (Drs Urken, Moscoso, Lawson, Catalano, and Biller), General Surgery/Division of Plastic Surgery (Dr Weinberg), and Oral and Maxillofacial Surgery (Dr Buchbinder), Mount Sinai Medical Center, New York, NY.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Avoiding Secondary Skin Graft Donor Site Morbidity in the Fibula Free Flap Harvest
Kim et al.
Arch Otolaryngol Head Neck Surg 2008;134:1324-1327.
ABSTRACT | FULL TEXT  

The Occipital Flap for Reconstruction After Lateral Temporal Bone Resection
Moore et al.
Arch Otolaryngol Head Neck Surg 2008;134:587-591.
ABSTRACT | FULL TEXT  

Acellular Dermal Matrix Grafts for Prevention of Microarterial Thrombophlebitis
Lee et al.
Arch Otolaryngol Head Neck Surg 2007;133:42-45.
ABSTRACT | FULL TEXT  

Arterial Coupling for Microvascular Free Tissue Transfer in Head and Neck Reconstruction
Ross et al.
Arch Otolaryngol Head Neck Surg 2005;131:891-895.
ABSTRACT | FULL TEXT  

Comparing Microvascular Outcomes at a Large Integrated Health Maintenance Organization With Flagship Centers in the United States
Lueg
Arch Otolaryngol Head Neck Surg 2004;130:779-785.
ABSTRACT | FULL TEXT  

Pectoralis Major Myocutaneous Flap vs Revascularized Free Tissue Transfer: Complications, Gastrostomy Tube Dependence, and Hospitalization
Chepeha et al.
Arch Otolaryngol Head Neck Surg 2004;130:181-186.
ABSTRACT | FULL TEXT  

Reconstruction of Complex Scalp Defects: The "Banana Peel" Revisited
Frodel and Ahlstrom
Arch Facial Plast Surg 2004;6:54-60.
ABSTRACT | FULL TEXT  

Presidential Address: The American Head and Neck Society Legacy: Clinical Care, Teaching, and Research: Staying the Course During Stormy Times
Levine
Arch Otolaryngol Head Neck Surg 2004;130:8-11.
FULL TEXT  

Use of the Operating Microscope and Loupes for Head and Neck Free Microvascular Tissue Transfer: A Retrospective Comparison
Ross et al.
Arch Otolaryngol Head Neck Surg 2003;129:189-193.
ABSTRACT | FULL TEXT  

Inhibitors of Nitric Oxide Promote Microvascular Thrombosis
Azizzadeh et al.
Arch Facial Plast Surg 2003;5:31-35.
ABSTRACT | FULL TEXT  

Leech Therapy for Patients With Surgically Unsalvageable Venous Obstruction After Revascularized Free Tissue Transfer
Chepeha et al.
Arch Otolaryngol Head Neck Surg 2002;128:960-965.
ABSTRACT | FULL TEXT  

Microvascular Reconstruction After Previous Neck Dissection
Head et al.
Arch Otolaryngol Head Neck Surg 2002;128:328-331.
ABSTRACT | FULL TEXT  

The Fibula Osteocutaneous Flap in Head and Neck Reconstruction: A Critical Evaluation of Donor Site Morbidity
Shindo et al.
Arch Otolaryngol Head Neck Surg 2000;126:1467-1472.
ABSTRACT | FULL TEXT  

Reconstruction of Soft Tissue Defects in the Oral Cavity and Oropharynx
Abemayor and Blackwell
Arch Otolaryngol Head Neck Surg 2000;126:909-912.
FULL TEXT  

Ectopic Hair Growth After Flap Reconstruction of the Head and Neck
Toft et al.
Arch Facial Plast Surg 2000;2:148-150.
FULL TEXT  

Radiation and Intra-arterial Cisplatin: Effects on Arteries and Free Tissue Transfer
Valentino et al.
Arch Otolaryngol Head Neck Surg 2000;126:215-219.
ABSTRACT | FULL TEXT  

Assessment of Donor-Site Functional Morbidity From Radial Forearm Fasciocutaneous Free Flap Harvest
Brown et al.
Arch Otolaryngol Head Neck Surg 1999;125:1371-1374.
ABSTRACT | FULL TEXT  

Unsurpassed Reliability of Free Flaps for Head and Neck Reconstruction
Blackwell
Arch Otolaryngol Head Neck Surg 1999;125:295-299.
ABSTRACT | FULL TEXT  

Pharyngoesophageal Reconstruction With the Ulnar Forearm Flap
Li et al.
Arch Otolaryngol Head Neck Surg 1998;124:1146-1151.
ABSTRACT | FULL TEXT  

Complications of Microvascular Head and Neck Surgery in the Elderly
Shaari et al.
Arch Otolaryngol Head Neck Surg 1998;124:407-411.
ABSTRACT | FULL TEXT  

Overcoming the Learning Curve in Microvascular Head and Neck Reconstruction
Blackwell et al.
Arch Otolaryngol Head Neck Surg 1997;123:1332-1335.
ABSTRACT  

Comparison of Cost and Function in Reconstruction of the Posterior Oral Cavity and Oropharynx: Free vs Pedicled Soft Tissue Transfer
Tsue et al.
Arch Otolaryngol Head Neck Surg 1997;123:731-737.
ABSTRACT