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Feasibility of flap reconstruction in conjunction with intraoperative radiation therapy for advanced and recurrent head and neck cancer.

Publication ,  Journal Article
Most, MD; Allori, AC; Hu, K; Urken, ML; Persky, MS; Sessions, RB; Nussbaum, M; Harrison, LB; Frank, DK; Smith, ML
Published in: Laryngoscope
January 2008

BACKGROUND: Radiation is a known risk factor for poor wound healing. Patients undergoing intraoperative radiation therapy (IORT) typically receive higher cumulative doses to their wound beds than patients treated with conventional radiation therapy. We review our experience with IORT in patients undergoing resection of head and neck cancer and flap reconstruction. Logistics of delivery and outcomes are discussed. METHODS: A retrospective chart review was performed on all patients at Beth Israel Medical Center who underwent IORT for head and neck cancer between 2000 and 2007. Twenty-one patients receiving 22 treatments involving flap reconstruction were identified. The results of these reconstructions were evaluated for complications and functional outcome. RESULTS: All patients had complex surgical wounds of the face, upper aerodigestive tract, or neck who received IORT in conjunction with pedicled or free flap closure. Twenty-five flaps in 21 patients were performed in the setting of IORT. All patients received between 10 and 15 Gy of IORT administered directly to the wound bed. There were no perioperative mortalities. Wound breakdown occurred in three cases, all of which were treated successfully by operative revision. Functionally, most patients did well and performed similarly to historic controls for their type of reconstruction. CONCLUSIONS: Reconstruction using flaps in the context of IORT can be achieved with expectation of good wound healing in the majority of cases despite heavy cumulative doses of radiation to recipient wound beds.

Duke Scholars

Published In

Laryngoscope

DOI

ISSN

0023-852X

Publication Date

January 2008

Volume

118

Issue

1

Start / End Page

69 / 74

Location

United States

Related Subject Headings

  • Wound Healing
  • Treatment Outcome
  • Surgical Wound Dehiscence
  • Surgical Flaps
  • Retrospective Studies
  • Reoperation
  • Radiotherapy Dosage
  • Radiology, Interventional
  • Postoperative Complications
  • Plastic Surgery Procedures
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Most, M. D., Allori, A. C., Hu, K., Urken, M. L., Persky, M. S., Sessions, R. B., … Smith, M. L. (2008). Feasibility of flap reconstruction in conjunction with intraoperative radiation therapy for advanced and recurrent head and neck cancer. Laryngoscope, 118(1), 69–74. https://doi.org/10.1097/MLG.0b013e3181559ff7
Most, Michael D., Alexander C. Allori, Kenneth Hu, Mark L. Urken, Mark S. Persky, Roy B. Sessions, Moses Nussbaum, Louis B. Harrison, Douglas K. Frank, and Mark L. Smith. “Feasibility of flap reconstruction in conjunction with intraoperative radiation therapy for advanced and recurrent head and neck cancer.Laryngoscope 118, no. 1 (January 2008): 69–74. https://doi.org/10.1097/MLG.0b013e3181559ff7.
Most MD, Allori AC, Hu K, Urken ML, Persky MS, Sessions RB, et al. Feasibility of flap reconstruction in conjunction with intraoperative radiation therapy for advanced and recurrent head and neck cancer. Laryngoscope. 2008 Jan;118(1):69–74.
Most, Michael D., et al. “Feasibility of flap reconstruction in conjunction with intraoperative radiation therapy for advanced and recurrent head and neck cancer.Laryngoscope, vol. 118, no. 1, Jan. 2008, pp. 69–74. Pubmed, doi:10.1097/MLG.0b013e3181559ff7.
Most MD, Allori AC, Hu K, Urken ML, Persky MS, Sessions RB, Nussbaum M, Harrison LB, Frank DK, Smith ML. Feasibility of flap reconstruction in conjunction with intraoperative radiation therapy for advanced and recurrent head and neck cancer. Laryngoscope. 2008 Jan;118(1):69–74.
Journal cover image

Published In

Laryngoscope

DOI

ISSN

0023-852X

Publication Date

January 2008

Volume

118

Issue

1

Start / End Page

69 / 74

Location

United States

Related Subject Headings

  • Wound Healing
  • Treatment Outcome
  • Surgical Wound Dehiscence
  • Surgical Flaps
  • Retrospective Studies
  • Reoperation
  • Radiotherapy Dosage
  • Radiology, Interventional
  • Postoperative Complications
  • Plastic Surgery Procedures