Postoperative morbidity of free flaps in head and neck cancer reconstruction: a report regarding 215 cases.

OBJECTIVES: The aim of this study was to identify the factors responsible for free flap failure, the surgical complications, and the non-oral feeding period in patients treated for an oral squamous cell carcinoma. MATERIALS AND METHODS: This multicentric study included 215 patients treated by tumour resection with immediate free flap reconstruction for an OSCC between 2010 and 2016. All of the patient medical files were reviewed and the data regarding the patient medical history, the tumour-related features, the surgical procedure, and the postoperative recovery were compiled. A statistical analysis with univariate and multivariate logistic regression was carried out. RESULTS: The free flap success rate was 94.4% in our series. A postoperative complication occurred in 101 patients (41%). Minor surgical complications were shown to increase the free flap failure rate (OR 3.32; p = 0.04). A major surgical complication was encountered in 48 patients (22.3%), and these were linked to minor surgical complications (OR 2.89; p = 0.004) and the use of a tracheostomy (OR 5.76, p = 0.002). Conversely, a medical history of high blood pressure had a protective effect (p = 0.04). The non-oral feeding rate at the end of the hospital stay was 28.4%, and it correlated with the tracheostomy (p = 0.002), as well as the major and the minor surgical complications (p = 0.04). CONCLUSION-CLINICAL RELEVANCE: Free flap reconstruction is a safe and reliable technique with head and neck cancer reconstruction. Postoperative care favouring early and safe oral-feeding, and avoiding a tracheostomy can reduce the incidence of surgical complications after OSCC reconstruction.

PNIF measurement in a healthy French population. A prospective study about 234 patients.

OBJECTIVE: A prospective study in a healthy French population to evaluate the normal range of PNIF. MATERIAL AND METHODS: In total, 234 subjects separated into 2 groups (group 1: patients with VAS >or= 8, n = 151 and group 2: patients with VAS < 8, n = 83) have been prospectively enrolled in this study from September 2003 to April 2004. For all participants, nasal obstruction was evaluated through a VAS and two PNIF measurements. RESULTS: The mean PNIF measurements in group 1 and group 2 were 87.5 L/min and 84.7 L/min, respectively with a significant difference between male and female in both groups (p < 0.0001). The reproducibility in group 1 and group 2 was 5.1 L/min and 4.4 L/min respectively. A slight tendency to a reduction due to the age was observed except for patients over 60. CONCLUSION: This study confirms that the technique of PNIF measurement is reliable and simple. The normal range of PNIF in a healthy French population has been determined although our results show lower values than previous published reports from other countries. However, it remains an attractive method for the follow-up and survey of patients complaining of nasal obstruction.