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Risk factors associated with early and late free flap complications in head and neck osseous reconstruction

  • Head and Neck
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purpose

This study was designed to identify risk factors for post-operative complications in micro-anastomosed osteomyocutaneous free flaps (MOFF) and analyzed their consequences in long term.

Methods

A retrospective review of 100 MOFF realized between May 2007 and October 2019 was performed. Demographic data, perioperative management and postoperative complications were enrolled and analyzed in a multivariate model. Patients were followed for ≥ 6 months.

Results

Major surgical complication rate was 20% with 5% of overall free flap failure rate and 6% of anastomosis salvage surgery. Risk identified for major surgical complication was alcohol consumption (p = 0.0054). Minor surgical complications occurred in 26% of patients mostly due to infections (19%). No significant risk factor was associated to minor surgical complications. Major and minor medical complication rates were, respectively, 10% and 10%. Risk identified for major medical complication were age over 70 (p = 0.0253) and history of chemotherapy (p = 0.0277). Risk identified for minor medical complication were alcohol consumption p = 0.0232) and a history of radiotherapy (p = 0.0329).

Conclusions

Alcoholism is an independent risk factor for the surgical complication of MOFF that must be taken into account before surgery. Patients with a history of chemotherapy, radiotherapy or who are over 70 years of age are at greater risk of postoperative medical complications and require special attention.

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Acknowledgements

Estelle Le Pabic [Department Inserm, CIC 1414 (Centre d’Investigation Clinique), Rennes University Hospital, Rennes, France.]

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Authors and Affiliations

  1. Department of Otorhinolaryngology-Head and Neck Surgery, Rennes University Hospital, 2 Rue Henri Le Guilloux, 35000, Rennes, France

    Cassandre Lambert, Gwenaelle Creff, Vincent Mazoue, Paul Coudert, Olivier De Crouy Chanel & Franck Jegoux

  2. COSS (Chemistry Oncogenesis Stress Signaling), UMR 1242, Inserm, Univ Rennes, CLCC Eugène Marquis, Rue Bataille Flandres Dunkerque, 35042, Rennes, France

    Franck Jegoux

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  1. Cassandre Lambert
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  2. Gwenaelle Creff
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  3. Vincent Mazoue
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  4. Paul Coudert
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  5. Olivier De Crouy Chanel
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  6. Franck Jegoux
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Correspondence to Cassandre Lambert.

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Lambert, C., Creff, G., Mazoue, V. et al. Risk factors associated with early and late free flap complications in head and neck osseous reconstruction. Eur Arch Otorhinolaryngol 280, 811–817 (2023). https://doi.org/10.1007/s00405-022-07619-w

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  • DOI: https://doi.org/10.1007/s00405-022-07619-w

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