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Christopher M. Shaari, MD; Daniel Buchbinder, DDS; Peter D. Costantino, MD; William Lawson, MD, DDS; Hugh F. Biller, MD; Mark L. Urken, MD

Arch Otolaryngol Head Neck Surg. 1998;124:407-411.

Objectives  To evaluate the complications of head and neck reconstruction using microvascular free tissue transfers (MFTTs) performed in an elderly population and to determine whether these complications are more common than in a younger population.

Setting  Tertiary referral center.

Patients and Design  Retrospective, consecutive chart review of patients older than 70 years who underwent MFTT in the past 5 years (group 1). The complications in this population were compared with those in a second group (group 2) of consecutive patients younger than 70 years who were matched according to the site of the primary tumor.

Main Outcome Measures  Surgical and medical complications.

Results  The median age for group 1 was 74 years and for group 2, 55 years. The overall complication rate for group 1 was 48%, compared with 57% for group 2. In group 1, surgical morbidity was less common and medical morbidity was more common than in group 2. Mortality rate was 6% for group 1 and 0% for group 2. The types of complications were similar for both groups. There was no difference in complication rates when complications were classified by site of the defect, patient status determined by American Society of Anesthesiologists classification, or use of preoperative radiation. The overall success rate of MFTT was 100% for group 1 and 94% for group 2.

Conclusions  Microvascular free tissue transfers for head and neck reconstruction can be safely performed in the elderly. An age older than 70 years does not increase the rate of surgical complications following head and neck reconstruction with MFTT. Medical complications, however, are more common and are equally divided between bronchopulmonary and cardiovascular effects.

From the Department of Otolaryngology–Head and Neck Surgery (Drs Shaari, Buchbinder, Costantino, Lawson, Biller, and Urken) and the Division of Oral and Maxillofacial Surgery (Dr Buchbinder), Mount Sinai Medical Center, New York, NY.

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