Microsurgical reconstruction in the setting of complex ablative tumor surgery – an interdisciplinary treatment strategy

Introduction Extensive resections and reconstructions of head and neck tumors require an interdisciplinary interaction between ENT and maxillofacial surgeons for the best possible aesthetic as well as functional rehabilitation. This paper presents the results of patients who underwent interdisciplinary surgery between 2016 and 2021 at the Head and Neck Cancer Center.

Methods A total of 11 head and neck tumor patients who received curative surgical interdisciplinary treatment. Oncologic and functional outcome were evaluated.

Results 8 patients with squamous cell carcinoma (CA) or melanoma of the scalp with infiltration of the external ear received extensive tumor resection, partial petrosectomy, ALT flap reconstruction, and secondary ear canal reconstruction. 2 patients with oral cavity CA with tongue base/epiglottis infiltration received partial pharyngeal/laryngeal resection with radial graft. One patient with laryngeal CA and contralateral mandibular (UK) metastasis received partial laryngeal and UK resection with ALT flap reconstruction. All patients had no flap loss. In 2 cases, patients died postoperatively due to cardiopulmonary complications. 2 patients suffered tumor recurrence 1 and 2 years after first diagnosis, respectively. 7 patients are recurrence-free to date with a mean follow-up of 18 months. Regarding masticatory rehabilitation, 8 patients are able to eat orally.

Conclusion The treatment of head and neck tumor patients with complex tumor surgery and reconstruction requires cooperation between ENT and maxillofacial surgeons. Here, it is essential to discuss each individual case in the interdisciplinary tumor conference to coordinate the surgical approach.

Publication History

Article published online:
24 May 2022