Volume 127, Issue 7 pp. 1551-1557

Facial Plastics and Reconstructive Surgery

The price of free tissue transfer after tongue reconstruction: quantifying the risks

Mohemmed N. Khan MD,

Mohemmed N. Khan MD

Department of Otolaryngology–Head and Neck Surgery, Mount Sinai Medical Center, New York, New York, U.S.A

M.N.K. and E.P. are co–first authors.

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Enrique Perez MD, MBA,

Enrique Perez MD, MBA

Department of Otolaryngology–Head and Neck Surgery, Mount Sinai Medical Center, New York, New York, U.S.A

M.N.K. and E.P. are co–first authors.

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Erden Goljo MD,

Erden Goljo MD

Department of Otolaryngology–Head and Neck Surgery, Mount Sinai Medical Center, New York, New York, U.S.A

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Alfred Iloreta MD,

Alfred Iloreta MD

Department of Otolaryngology–Head and Neck Surgery, Mount Sinai Medical Center, New York, New York, U.S.A

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Richard Chan Woo Park MD, FACS,

Richard Chan Woo Park MD, FACS

Department of Otolaryngology–Head and Neck Surgery, Mount Sinai Medical Center, New York, New York, U.S.A

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Eric M. Genden MD, FACS,

Eric M. Genden MD, FACS

Department of Otolaryngology–Head and Neck Surgery, Mount Sinai Medical Center, New York, New York, U.S.A

Department of Otolaryngology–Head and Neck Surgery, Rutgers University, Newark, New Jersey, U.S.A

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Brett A. Miles MD, DDS, FACS,

Corresponding Author

Brett A. Miles MD, DDS, FACS

[email protected]

Department of Otolaryngology–Head and Neck Surgery, Mount Sinai Medical Center, New York, New York, U.S.A

Send correspondence to Brett A. Miles, DDS, MD, FACS, Department of Otolaryngology–Head and Neck Surgery, Mount Sinai Medical Center, Annenberg 10th Floor, One Gustave L. Levy Place, Box 1189, New York, NY 10029-3136. E-mail: [email protected]Search for more papers by this author

Mohemmed N. Khan MD,

Mohemmed N. Khan MD

Department of Otolaryngology–Head and Neck Surgery, Mount Sinai Medical Center, New York, New York, U.S.A

M.N.K. and E.P. are co–first authors.

Search for more papers by this author

Enrique Perez MD, MBA,

Enrique Perez MD, MBA

Department of Otolaryngology–Head and Neck Surgery, Mount Sinai Medical Center, New York, New York, U.S.A

M.N.K. and E.P. are co–first authors.

Search for more papers by this author

Erden Goljo MD,

Erden Goljo MD

Department of Otolaryngology–Head and Neck Surgery, Mount Sinai Medical Center, New York, New York, U.S.A

Search for more papers by this author

Alfred Iloreta MD,

Alfred Iloreta MD

Department of Otolaryngology–Head and Neck Surgery, Mount Sinai Medical Center, New York, New York, U.S.A

Search for more papers by this author

Richard Chan Woo Park MD, FACS,

Richard Chan Woo Park MD, FACS

Department of Otolaryngology–Head and Neck Surgery, Mount Sinai Medical Center, New York, New York, U.S.A

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Eric M. Genden MD, FACS,

Eric M. Genden MD, FACS

Department of Otolaryngology–Head and Neck Surgery, Mount Sinai Medical Center, New York, New York, U.S.A

Department of Otolaryngology–Head and Neck Surgery, Rutgers University, Newark, New Jersey, U.S.A

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Brett A. Miles MD, DDS, FACS,

Corresponding Author

Brett A. Miles MD, DDS, FACS

[email protected]

Department of Otolaryngology–Head and Neck Surgery, Mount Sinai Medical Center, New York, New York, U.S.A

First published: 20 January 2017

https://doi.org/10.1002/lary.26461

Citations: 11

The authors have no funding, financial relationships, or conflicts of interest to disclose.

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Abstract

Objectives/Hypothesis

To evaluate the preoperative variables, mean operative time, morbidity, and mortality associated with reconstruction of partial glossectomy defects.

Study Design

Retrospective data analysis.

Methods

The National Surgical Quality Improvement Program database was queried for patients having undergone glossectomy procedures. The study sample was split into two groups based on the lack or presence of a flap reconstruction. A total of 1,012 glossectomy patients were identified, with 805 undergoing nonflap reconstruction and 207 undergoing free flap reconstruction. Variables evaluated included wound complications, major and minor morbidity, return to the operating room, mortality, and mean operative time.

Results

Patients undergoing free flap reconstruction experienced significantly longer mean operative times (482.1 vs. 183.0 minutes, P < .001), were more likely to return to the operating room (odds ratio [OR] = 2.39, 95% confidence interval [CI] = 1.33-4.29, P = .003), and had higher likelihood of wound complications (OR = 5.78, 95% CI = 2.72-12.26, P < .001), major morbidity (OR = 12.39, 95% CI = 7.02-21.85, P < .001), and minor morbidity (OR = 4.20, 95% CI = 2.12-8.33, P < .001). There was no difference in mortality between groups (OR = 8.62, 95% CI = 0.53-141.7, P = .131).

Conclusions

Free flap reconstruction of glossectomy defects involving up to half of the tongue is associated with increased morbidity and operative time when compared with nonflap reconstruction. Currently available functional outcomes data for tongue reconstruction are poor. Possible functional impairment must be weighed against the associated morbidity when deciding which defects require reconstruction, and the decision to reconstruct should not be taken lightly.

Level of Evidence

4. Laryngoscope, 127:1551–1557, 2017

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Citing Literature

Volume127, Issue7

July 2017

Pages 1551-1557

The price of free tissue transfer after tongue reconstruction: quantifying the risks

Abstract

Objectives/Hypothesis

Study Design

Methods

Results

Conclusions

Level of Evidence

BIBLIOGRAPHY

Citing Literature

References

Information

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The price of free tissue transfer after tongue reconstruction: quantifying the risks

Abstract

Objectives/Hypothesis

Study Design

Methods

Results

Conclusions

Level of Evidence

BIBLIOGRAPHY

Citing Literature

References

Related

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