头颈部重建术中上肢皮瓣供体部位的发病率。

IF 1.8 4区医学 Q2 OTORHINOLARYNGOLOGY

American Journal of Otolaryngology Pub Date : 2025-01-01 DOI:10.1016/j.amjoto.2024.104548

Craig Hanna , David Danis III , Rotem Kimia , Heather Merkouris , Peter Steinwald , Miriam O'Leary , Jeremiah Tracy

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引用次数: 0

摘要

目的：本回顾性队列研究旨在比较头颈部重建手术中常用的三种上肢皮瓣：肩胛骨尖游离皮瓣（STFF）、前臂桡骨游离皮瓣（RFFF）和胸大肌蒂皮瓣（PMPF）的供区发病率。方法：查询某城市三级耳鼻喉科诊所的计费数据库，以确定2020年至2023年接受STFF、RFFF和PMPF治疗的患者。主要结果是确定供体部位疼痛和重建后需要进行物理治疗（PT）转诊。结果：73例患者（44M:29F）接受了上肢游离皮瓣或带蒂皮瓣的手术。接受游离组织移植（FTT）的患者需要PT转诊的可能性是接受带蒂组织移植（PTT）的患者的5.455倍。与接受PTT的患者相比，接受FTT的患者报告供体部位疼痛的可能性高出3.417倍。与STFF组和RFFF组相比，术后PT转诊和术后供体部位疼痛没有差异。重要的是，RFFF主要是筋膜皮瓣（33/35）。结论：这些发现对复杂头颈部手术缺陷患者的重建选择具有重要意义。

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Donor site morbidity of upper extremity flaps in head and neck reconstruction

Objective

This retrospective cohort study aims to compare donor site morbidity of three commonly used upper extremity flaps used in head and neck reconstructive surgery: scapular tip free flap (STFF), radial forearm free flap (RFFF), and pectoralis major pedicled flap (PMPF).

Methods

The billing database of an urban, academic, tertiary otolaryngology practice was queried to identify patients who underwent STFF, RFFF, and PMPF from 2020 to 2023. The primary outcome was identification of donor site pain and need for physical therapy (PT) referral after undergoing reconstruction.

Results

Seventy-three patients (44M:29F) underwent surgery that utilized upper extremity free or pedicled flaps. Patients undergoing free tissue transfer (FTT) were 5.455 times more likely to require PT referral compared to patients undergoing pedicled tissue transfer (PTT). Patients undergoing FTT were 3.417 times more likely to report donor site pain compared to patients undergoing PTT. There were no differences in post-operative PT referrals or post-operative donor site pain when comparing STFF or RFFF groups. Importantly, RFFF were primarily all fasciocutaneous flaps (33/35).

Conclusions

These findings have important implications when counselling patients regarding reconstructive options for complex head and neck surgery defects.

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来源期刊

American Journal of Otolaryngology 医学-耳鼻喉科学

CiteScore

4.40

自引率

4.00%

发文量

378

审稿时长

41 days

期刊介绍： Be fully informed about developments in otology, neurotology, audiology, rhinology, allergy, laryngology, speech science, bronchoesophagology, facial plastic surgery, and head and neck surgery. Featured sections include original contributions, grand rounds, current reviews, case reports and socioeconomics.