Head and Neck Tumor Resection and Free Flap Reconstruction in Low-Volume Center.

OBJECTIVE: To determine the surgical outcomes of free tissue transfer surgery following head and neck tumor extirpation in a low-volume medical center. METHODS: Retrospective chart review of patients who underwent free tissue transfer surgery for head and neck cancer at Moanalua Medical Center from 2015 to 2018. MAIN OUTCOME OF MEASURE: Free flap failure rate and free flap-related complications. RESULTS: From 2015 to 2018, there were 27 free tissue transfer surgery (mean 6.75 flap surgery/year). There were 2 events of partial flap necrosis, and no cases of total flap loss. One patient required leech therapy for venous congestion. One patient required additional free flap surgery. Two patients developed orocutaneous fistula that resolved with local wound care. One patient developed malocclusion following mandible reconstruction using fibular free flap. Overall free flap success rate was 96%. CONCLUSION: This study supports the ability of small-volume centers to produce positive outcomes with few complications in head and neck cancer free flap reconstructive surgery. While the data are limited to a single surgical team in one care center, it provides additional support for the idea that there are factors beyond the surgical volume that determine outcome.

Supraclavicular Artery Island Flap in Head and Neck Reconstruction: A Case Series and Literature Review.

INTRODUCTION: Supraclavicular artery island flap (SCAIF) is emerging as an efficient and reliable flap for various complex head and neck defects after tumor extirpation. OBJECTIVE: To examine a series of cases using a SCAIF for head and reconstruction at our institution. METHODS: We performed a retrospective review of 8 patients who underwent SCAIF reconstruction of various head and neck defects from 2015 to 2018 at our institution. We also reviewed the English-language literature of reports of a SCAIF used for head and neck defects. RESULTS: Eight patients underwent SCAIF reconstruction of head and neck defects. Various anatomic sites were reconstructed including the neck (n = 4), oral cavity (n = 1), and parotid/lateral skull base (n = 3). Two patients had partial flap necrosis, requiring débridement and wound care. There was no total loss of the flap or donor-site complication. CONCLUSION: SCAIF is an excellent choice for reconstructing various head and neck defects, with low complication rates and donor-site morbidity. The outcomes of our SCAIF reconstruction are comparable to previously published outcomes.